Thank you for sending the critique of my editorial on occlusion from Drs. Greene, Klasser and Epstein. I appreciated hearing their views on the topic. I have followed the work of these individuals and would expect them to have the opinions expressed in their letter. I respect their views and research. I only wish all of us were as confident of our positions on any topic as these individuals. In my opinion, seldom is there a "black and white" answer on any subject, especially occlusion.
After several decades of teaching occlusion to all levels of students, from predoctoral to graduate school, and having treated virtually thousands of occlusal problems as a practicing prosthodontist, I will share some thoughts that I am confident represent the views of the majority of practicing dentists, prosthodontists and some periodontists.
Patients with the occlusal challenges I [described] in the editorial have teeth that do not occlude harmoniously. Slight to major occlusal equilibration allows the teeth to occlude more adequately, reduces tooth and restoration fracture and encourages periodontal and orthodontic stability.
Whether or not occlusal equilibration cures TMD or bruxism has been debated for many years by brilliant clinicians and researchers on both sides of the argument, and I am still awaiting a definitive answer to the question.
Pathologic occlusal conditions have been around since the beginning of mankind, with references to gnashing of teeth written in the Bible many times. Most clinicians have been in "scientific" meetings where views such as those expressed by Drs. Greene, Klasser and Epstein have been vigorously attacked by similarly intelligent professionals with completely opposite views.
Which "camp" is right? I don’t think I will live long enough to know the answer. The research on occlusion from the University of Illinois, with which I am very familiar, has been excellent over the years, and I congratulate those involved. However, it has not reduced my activity providing occlusal equilibration and alleviating pain and other problems for the clinical situations noted in my editorial.
