To kick off 2018, we’re catching up with T-Scan user and digital occlusal analysis expert, Dr. Robert Kerstein, DMD, to see how his year went and also chat about the current state of occlusal analysis in dentistry. Read our conversation with Dr. Kerstein, a leading author in researcher in the field.

Describe your role in the dental industry.

At this point in my career I am mostly an educator, author, and researcher, as I have lessened my clinical hours since selling my Prosthodontic practice in 2014. I still treat patients, but fairly often these days I am mentoring chairside T-Scan clinical use skills to doctors, as they work with their own patient’s occlusal problems. I am also very fortunate to be a speaker who travels the globe lecturing about Digital Occlusion from podiums in Asia, Australia, Europe, Scandinavia, South America, Canada, India, and the USA.

You lecture and train dentists all over the world—where did your work take you in 2017?

This past year I was in Korea 3 separate times teaching Disclusion Time Reduction (DTR). I lectured in Finland twice, and in the Netherlands, I was a speaker at the 1st international T-Scan User meeting, which was very well attended by dentists from many countries. This year I also traveled all over the United States training many dentists on DTR, the T-Scan-guided occlusal therapy for muscular TMD symptoms. Colorado and Tennessee had the most doctors trained in 1 state with 5 each. Next was both California, and Georgia where I trained 3 each.  I visited practices in Kansas, Nebraska, North Carolina, Virginia, Texas, Oregon, Connecticut, Maine, Florida, and New York. Because of the exposure on the internet that DTR has gotten in the past few years, doctors from all over the US are wanting to learn how to properly perform the ICAGD coronoplasty, which is very different procedure than traditional Occlusal Equilibration. The best way for doctors to gain competency in performing ICAGD is chairside, 1-on-1 in their own office with their staff participating.

What was the most interesting question you were asked on the road (about T-Scan) and how did you answer it?

Doctors frequently wonder how I am able to use the T-Scan to practice without splints, and still successfully treat TMD problems.  They are amazed that I practiced splint-free for almost 30 years now, because for those same years most docs had been using splints as the primary TMD treatment, especially where the clenching and bruxing of teeth is a component of the patient’s condition. What’s interesting is they often inquire out of frustration, because splints have not predictably resolved many of their TMD patients’ problems, despite the doctor’s best effort to adjust the occlusion with articulating paper, and the patient complying by nightly wearing their splint.

I explain that I can effectively treat TMD without these plastic tooth barriers, because the T-Scan allows me to obtain a level of occlusal adjustment accuracy that is so much higher than what can be obtained with “by eye, paper-only adjustments”, and the adjustments actually control the tooth’s pulp and PDL neurologic function. These T-Scan occlusal adjustment tolerances are so precise that the TMD symptoms quickly turn way down without the patient wearing a splint. These T-Scan guided corrections make the teeth function without needing a barrier between them, and without creating the TMD symptoms that hurt the patient.

What dilemmas do you think the dental industry faces today around digital occlusion?

The most significant dilemma for Dental Medicine to truly face: is the need to replace subjectively assessed occlusion with measured and objective occlusion by making the use of digital occlusal/muscle/TM Joint diagnostic technologies the modern occlusion Standard of Care. The dental profession has been unwilling to accept the scientific fact that non-digital occlusal indicators (articulating paper, wax, silicone imprints, stone casts and articulators) offer dentists no true occlusal force descriptive capabilities, while still using them with patients as if they did. The dental industry coming to the reality that articulating paper does not show dentists occlusal force or time, would be in the best interest of dental patients.  The available alternative (Digital Occlusion), allows doctors to provide much higher quality occlusal care, because the T-Scan accurately reports occlusal contact force levels and occlusal contact timing. The dental industry owes its patients the highest quality care available, and Digital Occlusion is a vast improvement in that care over all of the subjectively interpreted, unmeasured, traditional, non-digital occlusal indicators dentists routinely employ. The dental industry’s long-standing belief that articulating paper shows force by how it looks on teeth, must be changed for the greater good of all dental patients worldwide. 

What was your favorite trip and why?

This year my favorite trip was to Ermelo in the Netherlands to be part of the International T-Scan User meeting. To be with so many interested T-Scan users in one place, all expanding their understanding of its amazing capabilities to better employ it with their own patients was, for me, very gratifying. The positivity around the importance of occlusal measurement combined with each attendee’s strong desire to learn how to use the T-Scan more effectively with Implants, TMD, Posture, Prosthodontics and in general occlusal diagnosis, was a noteworthy moment for me, in my 30 years of traveling around the world educating dentists about the T-Scan.

If you could deliver one key message about the power of digital occlusion, what would it be?

That Digital Occlusion has known and effective diagnostic and treatment uses in every discipline of Dental Medicine, which makes the daily dental practice of occlusion simpler and more predictable for the dentist. Whether one is a Prosthodontist installing an implant prosthesis, or a Periodontist adjusting someone’s occlusion as part of tissue preservation, or an Endodontist trying to figure out if that painful tooth was a pulpitis or from occlusal overload, or a General Dentist dealing with these and other common occlusal maladies daily, the T-Scan technology helps the dentist make accurate decisions occlusally, that are absent of subjectivity, regardless of what type of dentistry one practices. Using the T-Scan allows any dentist to effectively target truly problematic occlusal contacts, which ramps up their practice occlusal adjustment predictability, leading to improved case outcomes.

We want to thank Dr. Kerstein for taking the time to chat with us, and hope you enjoyed reading.

Happy New Year!