Occlusion Myths and Red Flags with Lukasz Lassmann – PDP225

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. https://youtu.be/ZhIoUxdMMsg Watch PDP225 on Youtube Download the form: protrusive.co.uk/tmdhistory Download the Patient History Evaluation Form Need to Read it? Check out the Full Episode Transcript below! 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 📅 Upcoming Talks & Courses AES Annual Meeting 2026: The Evolution of Oral Physician – February 18-19, 2026 Lassmann Education: SummerCamp 2025 If you loved this episode, be sure to watch Myth Busting Occlusion and TMJ – PDP022 #PDPMainEpisodes #OcclusionTMDandSplints This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance.  This episode meets GDC Outcomes B and C. AGD Subject Code: 180 OCCLUSION (Occlusal therapy) Aim: To enhance clinical understanding of occlusal principles, vertical dimension management, and red flag indicators that impact prosthodontic and TMD treatment, based on current best evidence and insights from Dr. Lukasz Lassmann.  Dentists will be able to – 1. Identify common myths and misconceptions about vertical dimension increase and temporization. 2. Recognize red flag patient presentations that are not suitable for prosthodontic treatment. 3. Understand the airway implications of increasing vertical dimension and how mandibular rotation impacts it.