Dental Education: Responses from Dr. Peter Dawson

With the release of Dr. Dawson’s latest whitepaper, “Why Front Teeth Don’t Hit First in Centric Relation,” we have received quite a few responses and questions. The following are the questions/comments and Dr. Dawson’s responses. If you have a question or comment about this whitepaper, we encourage you to comment on this blog post.Question: I agree with the statement that if front teeth hit first there is no functional movement that can get the posterior teeth to contact. So why is it that Dr. Dawson would say that biting into a leaf gauge can cause distalization of the condyle? It’s the same thing as an anterior tooth hitting first. There is still NO movement possible that can make the posterior teeth come closer together while at the same time the condyle is moving downward and backward into CR. The closing muscles can only seat the condyles regardless of what you are biting into with your front teeth. I believe it might be more correct to say that a leaf gauge can cause muscle incoordination that may cause the disc to slip off the condyle. Please comment. – Dr. Bruce Wilderman

Answer: Your thinking is good. It shows that you understand the centric relation concept as an apex of force. It overlooks one factor that can force the condyle back and down. The leaf gauge will do this ONLY if the vector of the lingual slope of the anterior teeth is much steeper than the posterior slope of the fossae. I too was surprised when we saw this happen in our centri-chek studies. Not common… but it does happen with very steep overbites. Otherwise the leaf gauge works well but you should still load the joints when you use it.

Question: Thank you. Dr Dawson it is my pleasure to read your thoughts on the matter. How much has changed in the last 20 to 30 years, since your last book ? – Dr. Robert Moses

Answer: Thanks for your comment. Dentistry has seen amazing changes in materials, instrumentation, implantology, imagery, cementation and digitized everything. What has not changed are the principles that must be understood to use all the new options. That is why we have brought in fresh minds to our faculty, and why we still operate as a multidisciplinary think tank. We try to sort out all our options in order to pick the best ones.

Question: Could you be any more wrong or full of mis-information? – Dr. Francis Stapleton

Answer: I’m sure our faculty and seminar alumni would be interested in why you feel my comments are “wrong” and “misinformation.” Please help me understand what your objections are so I can respond intelligently. If our records are correct, you have never attended a Dawson Academy Seminar. You might consider that if you have interest in really understanding functional occlusion as it relates to the anatomy, physiology, and biomechanics of the masticatory system. You might be surprised at how nicely you will be treated. Incidentally, thank you for signing your name. I try to respond to all signed comments.
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