During my professional career as a clinician, author, international dental educator, and clinical consultant I found there is a great deal of confusion about the term, occlusion amongst the dentists & dental laboratory technicians I met. Occlusion and dentition design concepts have varied from their earliest conception in the mid-1800’s through today giving rise to numerous theories and clinical practices regarding them. These concepts of occlusion are associated with a great deal of dogma and division that has resulted in various occlusion camps promoting several different occlusion philosophies. I found some of the traditional concepts are evidence-based and true and need to be kept. However, I also found that some of the concepts are not founded on evidence and simply don’t work in clinical practice and should be discarded.

I began writing in the early 1990’s to share with dentists and others what I had discovered about occlusion – which by the way means simply the way the maxillary and mandibular teeth statically come together. My first book was titled Orthocranial Occlusion & The AccuLiner System in which one of the discoveries I shared was that occluding oral-craniofacial-cervical muscle contraction forces affected the function of a great deal more of the structural components of the human body than the teeth. So, I coined the term orthocranial to express a concept of one of the ways in which this bodily part (the dentition) functions normally, thus physiologically. The term ortho means simply: straight or upright, perpendicular to or at right angles, (90°), orthogonal. The term cranial means simply: of or pertaining to the cranium or skull. Eventually, the book became two books – Physiologic Occlusion and The AccuLiner System.

All during the past 25 years I have continued adding new knowledge and information to the contents of the book that I was taught concerning the structure and function of the stomatognathic system. With all the additions, I recently changed the title once again to, Orthocranial Dentition Design to describe the arrangement, alignment, and position of all the teeth as a complete functional unit. The term dentition design refers to the way all the teeth, as a structural functional unit, are arranged, aligned, positioned, and functionally occlude and articulate. I define orthocranial dentition design as: a physical state of the human body that occurs when the maxillary plane of occlusion created by the intercuspation of the maxillary and mandibular teeth is orthogonally aligned at right-angles 90° to the internal muscle contraction forces created by the oral-craniofacial-cervical muscles of the head and neck during functional movements of the mandible, such as chewing, biting, clenching, and swallowing.

The structure and function of the human body is extremely complex, composed of many organized systems and bodily parts that interact to perform vital functions. From my studies and clinical experiences during that time I realized the stomatognathic system is one of those bodily parts and segments that should be considered as an integral part of the neuromusculoskeletal system of the rest of the human body. I found it has also been referred to as the chewing mechanism, or the masticatory system, or the cranio-maxillomandibular-cervical-dental system and that the dentition is only one component of this complex structural functional body segment.

From my studies I found out the body’s neuromusculoskeletal system is comprised of a series of structural platforms which, in a healthy body, are aligned level, parallel to the surface of the ground, parallel with one another, and are orthogonally aligned 90° (perpendicular) to the body’s vertical axis of force. Under normal conditions, this structural arrangement results in bilateral body symmetry and balance. When the structural platforms are aligned in this manner, body weight and the internal muscle contraction forces created by the skeletal muscles are evenly dissipated within the body from head-to-toe. I reasoned that the cranial-maxillomandibular-cervical-dental system was one of those structural body platforms. Thus, forces within the craniofacial neuromusculoskeletal system can only occur physiologically when its structural component is orthogonally aligned as well. I thought it reasonable that if other healthcare practitioners who dealt with structural disorders below the head and cervical spine were concerned about the effects of physical internal forces and body structures being aligned level, dentists should too.

During that time, I learned that oral-craniofacial-cervical muscle contraction forces and their alignment, magnitude, and direction not only affected their function, but the dentition (all the teeth as a complete unit), and temporomandibular joints, and a great deal more. They affect cranial bone mobility, the function of the mechanoreceptors and proprioceptors within the cranial sutures, the brain, brain stem, cranial nerves, cranial and spinal dura mater, cerebral spinal fluid and cranial blood flow, cranial respiratory motion, the sacral occipital/cranial system, and the rest of the central and peripheral nervous system. I also found their function was normal and physiologic only when the dental plane of occlusion was aligned level and orthogonal (90°) to those muscle contraction forces. So, it became apparent to me that the condition of the structure and function of the cranio-maxillomandibular-cervical-dental system plays a major role in the health and well-being of human beings. Being the structure and function of the dentition is integrated and interrelated with the other components, its condition also plays a similar role.

In 1896 Louis Sullivan, an American architect, in an article he wrote, coined the adage – form follows function. Even though this principle is primarily associated with architectural structures and industrial design, it can be applied to the structure of the human body as well, meaning the form of its parts is related to their purposes. Since the human body of everyone on earth has already been designed and built, how well its various bodily parts function depends largely on how well they are formed. Consequently, when analyzing the condition of the structure and function of various bodily parts, the converse of this principle is also true function follows form.

These adages not only apply to the structure and function of the components of the stomatognathic system but to the dentition as well. Realize, the term occlusion means simply the way the maxillary and mandibular teeth come together. Functional dentition on the other hand refers to: the arrangement and alignment of all the teeth functioning together in harmony with the functions of the masticatory system, which then requires a physiologically formed and harmoniously functioning stomatognathic system. So, what does a physiologically formed structure and functioning cranio-maxillomandibular-cervical-dental system look like? I don’t have all the answers to the question, but you might find some in the pages of the book.

The knowledge and information contained in this book is for dentists, dental lab technicians, and other healthcare practitioners who may want to go beyond considering the teeth, craniofacial-cervical bones, temporomandibular joints, and the motor and sensory nerves and skeletal muscles of the head, neck as separate unconnected bodily parts of the neuromusculoskeletal system of the human body. Instead, regarding them as components of an integrated, interconnected, inter-related neuromusculoskeletal system. Especially, as clinical dentists, considering the effects that oral-craniofacial-cervical muscle contraction forces created during chewing, clenching, biting, and swallowing have on the structure, arrangement, alignment, and function of the components of the cranio-maxillomandibular-cervical-dental system realizing, force affects structure & function. Therefore, this adage certainly applies to the effects that the muscle contraction forces have on the structure and function of the stomatognathic system, contents of the neurocranium, and on structural components and functions of other parts of the human body. Thus, physiological forces facilitate physiological function.

The book is 242 pages long, contains well-over a hundred illustrations, and is divided into five sections with a bibliography of 136 references.

• Physiologic Functional Dentition & Why Normal Alignment of Dental Occluding Forces is Important
• Structure & Alignment of the Cranio-Maxillomandibular Complex & Why it’s Important
• Structure & Alignment of the Maxillary Complex & Cranial Neurophysiological Function
• Orthocranial Dentition its Structure, Alignment, & Position
• Normal & Abnormal Mandibular Positions & Movements

My purpose in writing the book is to share what I have learned to benefit clinical dentists, other healthcare practitioners, and the patients they care for. – Dr. Carlson