Secondary Occlusal Trauma
What is Secondary Occlusal Trauma?
When a patient exerts abnormally heavy biting forces on the teeth, stress cracks, chips and wear may result. This is known as primary occlusal trauma. Primary occlusal trauma implies there has been no loss of the periodontal attachment (gingival attachment fibers, periodontal ligament, or bone), and the teeth themselves are damaged by the excessive forces on them.
Secondary occlusal trauma occurs when there has been some degree of periodontal attachment loss, and normal biting forces which were once tolerated by the gums, periodontal ligaments and bone are now too excessive for those structures to withstand. The result is loosening, tipping and movement of the teeth. Frequently primary and secondary occlusal trauma are both present in the same patient, who may have areas that are periodontally healthy and others that are not.
How does the dentist diagnose Secondary Occlusal Trauma?
Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.
The dentist will also evaluate the condition of the periodontal structures (gums and bone) around your teeth. A periodontal measuring probe is used to measure the depth of gum pockets around the teeth. Measurements of 4 millimeters or more support indicate attachment loss, which support a diagnosis of periodontitis (periodontal disease). If there is inflammation (red, puffy gums that bleed easily when gently stimulated) and attachment loss, active periodontal disease is diagnosed. If the teeth are also loose, abnormally tipped, and/or have moved, the secondary occlusal trauma diagnosis will also be established. It is possible to have both primary and secondary occlusal trauma diagnoses simultaneously.
How is Secondary Occlusal Trauma treated?
Secondary occlusal trauma can be treated on multiple levels. First, the periodontal disease should be controlled. This may involve scaling and root planing, localized antibiotic administration, and regular periodontal maintenance procedures to keep the disease under control. Patients with moderate to advanced periodontal disease may require surgical periodontal treatment to control progression of the illness.
Once the periodontal disease is under active management (it is not curable), stabilization of the teeth may be achieved through periodontal splinting and/or use of an occlusal guard. If the periodontal disease is controlled, and adequate supporting bone is present, orthodontic treatment may be possible to achieve correct alignment of the teeth, and more ideal distribution of chewing forces. Orthodontic tooth movement should not be done if a patient has active periodontal disease.
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