Ignoring occlusal trauma signs (fremitus, mobility pattern)
What it is
Failing to recognize (or document) clinical indicators that a tooth/teeth may be experiencing traumatic occlusal forces / occlusal trauma, such as: • fremitus (palpable/visible functional mobility/vibration during occlusal contact) • progressive tooth mobility (worsening over time, not just "stable looseness") • pain/discomfort on chewing or percussion • tooth migration • radiographic clues like widened periodontal ligament (PDL) space AAP "Parameter on Occlusal Traumatism" lists these as clinical features to evaluate (not pathognomonic individually, but important to assess).
Why it happens
• Occlusion gets skipped in urgent visits (pain-driven appointments → focus only on pulp tests/radiograph) • Mobility is noted but not patterned: clinicians record "mobile" without asking stable vs progressive (AAP notes increasing displacement is more concerning; stable mobility may indicate adaptation) • Fremitus isn't routinely checked, even though it's a recognized sign associated with occlusal trauma • Assuming mobility = periodontitis only, without separating: inflammation-related mobility vs trauma-related functional mobility
The full clinical mistake entry includes
- How to avoid it — the prevention protocol
- The clinical tip experienced clinicians use
- The documented reference behind the mistake
More clinical mistakes
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