Episode Details

Why does occlusion feel so confusing at dental school?

What if the problem is not that occlusion is too complex, but that it was taught in the wrong order?

How do you make sense of worn teeth, bite scans, shimstock, leaf gauges, provisionals and T-Scan without getting overwhelmed?

And which small ideas can genuinely change the way you diagnose, plan and restore?

In this episode, Jaz is joined by Dr. Mahmoud Ibrahim for a brilliant occlusion-focused conversation. They each bring five clinical “pearls” that helped occlusion finally click for them — from facially generated treatment planning to checking the contralateral side, muscle palpation, provisionals and digital occlusal data.

Protrusive Dental Pearl

Create a PowerPoint or Keynote library of your clinical photos so you can quickly show patients relevant examples during consultations.

⚠️ Avoid hunting through random folders chairside — it feels clunky and breaks the flow of the conversation.

✅ Build a scrollable visual library of cracks, before-and-afters, complications, direct restorations, overlays, crowns and consent examples to support clearer patient communication.

Key Takeaways

• Occlusion becomes easier when it is placed inside the treatment planning sequence, not treated as a separate subject.
• Facially generated treatment planning starts with where the upper teeth need to be for aesthetics.
• Once the central incisors are planned, the rest of the occlusion becomes easier to organise.
• Worn teeth that are still in occlusion are often in the wrong position.
• Anterior wear may be caused by tooth position, contact time, contact force, or a combination of all three.
• Gingival levels can reveal whether worn lower incisors have over-erupted.
• Digital bite scans are useful, but they are not always a perfect representation of the patient’s bite.
• Shimstock remains one of the most valuable and inexpensive tools for checking true occlusal contacts.
• After fitting a restoration, checking the contralateral side first can reveal whether the new restoration is high.
• Anterior guidance should be steep enough to separate the back teeth, but shallow enough to allow the lower incisors room to move.
• Muscle palpation should assess the quality and symmetry of contraction, not just whether the muscles exist.
• Always assess the opposing tooth before placing composite, ceramic or an indirect restoration.
• A leaf gauge can help create a more repeatable jaw position when planning more complex occlusal cases.
• Provisionals are essential for testing aesthetics, function, vertical dimension and occlusion before committing to final restorations.

Highlights of the Episode:

• 00:00 Teaser
• 00:56 Introduction
• 03:36 Pearl: Build a Clinical Photo PowerPoint
• 12:48 Pearl 1: Facially Generated Treatment Planning
• 15:56 Pearl 2: Worn Teeth in Occlusion Are in the Wrong Position
• 18:05 Why Tooth Position Matters
• 18:22 Three Causes of Wear to Consider
• 19:34 Pearl 3: Digital Bite Scans Are Not Always Accurate
• 20:24 Why Shimstock Still Matters in Digital Dentistry
• 24:18 Pearl 4: Check the Contralateral Side After a Restoration
• 26:27 Pearl 5: The First Movement of Opening Is Not Pure Rotation
• 28:27 Midroll
• 33:10 Pearl 6: Healthy Occlu