Are you still using long-term provisionals just to test OVD?

Is an occlusal splint really the best way to assess vertical dimension?

Could raising the OVD actually harm your patient?

Dr. Lukasz Lassmann joins Jaz and Mahmoud Ibrahim  this AES special episode to challenge conventional thinking around occlusion, vertical dimension, and full mouth rehab. Lukasz shares his unique perspective as a clinician, educator, and researcher, bringing clarity to a topic that often feels murky and divided.

They explore real-world questions like managing asymptomatic clicks before ortho, why occlusion alone won’t “cure” bruxism, and the number one reason not to raise the vertical without proper understanding.

Plus, Lukasz drops an incredible airway assessment tip at the end of the episode!

Protrusive Dental Pearl: Use a comprehensive TMD history-taking form to effectively triage patients into urgent (red), moderate (amber), or low-risk (green) categories—this allows you to prioritize care appropriately and build rapport by focusing on examination rather than data collection during the appointment.

Download the form: protrusive.co.uk/tmdhistory

Download the Patient History Evaluation Form

Takeaways

• Understanding red flags in TMD patients is essential.
• Patient history is vital for effective treatment.
• Phonetics can be unpredictable in dental rehabilitation.
• Diet and sleep significantly affect TMD management.
• Gut health is linked to chronic pain conditions.
• Communication with patients is key to successful outcomes. Bruxism may not be solely caused by occlusion issues.
• Palpating the lateral pterygoid is often ineffective and painful.
• Equilibration and centric relation are controversial topics in dentistry.
• Increasing vertical dimension can exacerbate sleep apnea.
• Holistic approaches are essential in diagnosing and treating TMD.
• Not all patients with TMD have malocclusion or attrition.
• Sleep apnea is increasingly common in younger, slimmer patients.
• Polygraphy is a useful diagnostic tool for sleep apnea.
• DISE (drug-induced sleep endoscopy) is a valuable diagnostic procedure.

Highlights of this episode:

• 02:48  Protrusive Dental Pearl
• 04:37 Lukasz Lassman’s Journey and Philosophy
• 08:11 Debunking Myths About Vertical Dimension
• 12:10 Patients in the Red Zone
• 23:15 The Role of Diet and Lifestyle in Facial Pain
• 31:38 Adapting to New Restorative Methods
• 34:41 Phonetic Challenges in Dentistry
• 39:02 The Role of Occlusion in Bruxism
• 41:18 Palpating Lateral Pterygoid Muscle
• 43:27 Centric Relation vs. Equilibration Debate
• 50:07 OVD Red Flag: Airway
• 01:03:27 Conclusion and Future Events

Studies Mentioned:
Gut Bless Your Pain—Roles of the Gut Microbiota, Sleep, and Melatonin in Chronic Orofacial Pain and Depression

Randomised controlled trial on testing an increased vertical dimension of occlusion prior to restorative treatment of tooth wear