by Dr Mark Spencer, Coffs Coast Dental, NSW
I use a Huffman Leaf Gauge to gain centric relation position of my patients’ jaws in the adjustment of occlusions and mounting of study casts for diagnosis and treatment planning.
What’s good about it
The Leaf Gauge has a large number of leaves on one hinge pin. By placing a couple of leaves between the front teeth, the back teeth become separated. The muscles will eventually bring the condyle back to the least strained position and the patient will start to feel teeth contacting again. By adding leaves until there’s no more contact, you can find the centric relation position. You can then adjust the bite to coincide the best fit of the teeth with the centric relation position of the condyle.
A lot of our patients present with cold sensitive teeth or a feeling of bruised uncomfortable teeth. Sometimes they also complain about open contacts that allow food to get caught.
In most cases there is an occlusal or bite trauma element and—in addition to looking at side-to-side excursive movements—I’m looking at possible retruded movements as well. This is where the leaf gauge makes the job easier.
What’s not so good
I’m always concerned that dentists play around with bite adjustments without knowing the bigger picture. If they are dealing with a precarious situation in the jaw joint, it’s important to tread gently and not exacerbate the patient’s joint problems. Bite adjustments should not be feared but it’s imperative the dentist has a full understanding of the situation in relation to the jaw joints.