Dr. John Kois Reframes Occlusion

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Episode Description

Occlusion is one of the most talked-about—and most misunderstood—topics in restorative dentistry. In this first installment of a two-part conversation, Dr. John Kois challenges many of the static, mechanical definitions of occlusion that most dentists were taught in dental school and offers a fundamentally different way of thinking about how the masticatory system actually works in real patients.

Drawing from decades of clinical practice, specialty training in both periodontics and prosthodontics, and his experience educating restorative dentists around the world, Dr. Kois reframes occlusion as a dynamic, adaptive system rather than a fixed set of contacts to be checked off with articulating paper. He explains why relying solely on traditional concepts like MIP, right and left working movements, and morphological classifications often fails to predict long-term outcomes—and why this gap is at the root of many restorative failures, postoperative sensitivity, mobility, muscle pain, and patient dissatisfaction.

This episode lays the foundation for understanding occlusion through the lens of function, adaptation, and risk, rather than dogma. Dr. Kois introduces key concepts such as pathway wear, jaw position relative to the head, and the body's adaptive responses to occlusal disharmony—highlighting why so many problems are misattributed to bruxism, airway issues, or "parafunction," when the true etiology lies elsewhere.

You'll hear why:

• MIP should be viewed as a terminal position, not the starting point of occlusal analysis

• Static bite relationships often tell us very little about whether an occlusion is actually working

• Pathway wear is one of the most critical—and commonly missed—risk factors in restorative cases

• Many restorative "failures" are actually adaptive responses by the body trying to protect itself

• Dentists often succeed not because occlusion is ideal, but because patients adapt—sometimes at a long-term biological cost

This conversation is especially relevant for dentists who want to move beyond single-tooth dentistry and into more comprehensive care—full-mouth cases, complex restorative planning, implant rehabilitation, and interdisciplinary treatment. If you've ever had a case that looked perfect on the articulator but unraveled clinically, this episode will help you understand why.

Part one sets the conceptual framework. In part two, the discussion continues into how these principles influence diagnosis, restorative decision-making, and long-term predictability.

If occlusion has ever felt confusing, frustrating, or inconsistent in your hands, this episode will help you start seeing the system differently—and more clearly.