An Occlusion-Focused Hygiene Exam

By: Bill Gregg DDS
Topic Originally Appeared on

During an occlusion-focused hygiene exam, there are certain things the hygienist should pinpoint. This will help them develop a deeper relationship with the patient as well.

A Hygiene + Occlusion Exam

What the hygienist should look for:

  • “Can you eat/drink cold things comfortably?”
  • Subtle wear facets – those shiny spots on the edges of teeth.
  • Chipping of the edges of teeth. Can you get the patient to line up an incisal “chip” with a sharp edge of a lower front tooth?
  • Fremitis – that subtle shimmying of an upper front tooth when you gently place your fingernail on the facial of a maxillary incisor and ask the patient to grind side-to-side and front-to-back.
  • NCCL – could that be from clenching or orthodontic expansion? Both/and?
  • Persistent marginal inflammation that could be a sign of clenching (or an imbalanced bite).
An Occlusion-Focused Hygiene Exam

The Hygienist Role in a Hygiene + Occlusion Exam

1. Raise Awareness

The hygienist’s role is to raise patient awareness –  to “discover” changes that can be brought to the doctor’s attention for long-term protection of the patient’s teeth.

2. Inform the Doctor of the Discovery

The doctor’s arrival for an exam is the time that real skill and teamwork begin. The hygienist takes the lead and informs the doctor what they (hygienist and patient together) have been discovering/discussing.

Many times, the most significant questions come when I am behind and feeling rushed. Our goal, practiced for years, is for me to get in and out of the hygiene room in under 5 minutes.

Therefore, our total goal together is to encourage the patient to schedule another appointment for a more thorough evaluation of any changes/discoveries.

3. Support & Reassure the Patient

The hygienist then supports and reassures the patient about the need for a more thorough understanding to protect their teeth and eating for a lifetime.

They confirm the uniqueness of a full understanding of teeth, harmonizing bite forces, and oral-systemic health and well-being.

“This is what sets our office apart. Together we strive for the best in your total oral health prevention.”

Learn More: Why Study Occlusion

Set Your Dental Practice Apart from the Rest

A well-thought-out and choreographed hygiene appointment can truly establish you in the relationship-based sector of dental care.

Learn More: Valuable Skills Every Hygienist Needs

Sable Muntean

Sable Muntean

Doctor of Dental Medicine with Masters in Health Services Administration currently in an Advanced Education in General Dentistry residency. Experienced Marketing Director with a demonstrated history of working in the dental practice industry. Skilled in Nonprofit Organizations, Marketing Management, Business Planning, Coaching, and Sales. Co-Founder of ignitePreDent-- helping predental students with resources and mentorship to be admitted to dental school.