Anterior guidance for protrusive movements. In a perfected stable occlusion, protrusive movements will be guided evenly on the central and lateral incisors. Most importantly, the cusps of the posterior teeth will never contact during this movement. There is immediate disocclusion of posterior teeth with any anterior movement, resulting in no wear on posterior teeth.

Canine guidance for lateral movements. Lateral excursive movements will be guided on the upper and lower canine teeth. Posterior cusps should never contact during this jaw movement. Wear facets on posterior teeth are evidence that anterior guidance or canine guidance is not appropriate along with interferences involving nonworking cups. In a perfected occlusion, the posterior interferences will need to be removed.

No CR-MIC shift (stable occlusal centric contacts. A shift indicates interferences of the posterior dentition). There should be no shift from initial centric relation contact to maximum intercuspation. For example, when watching a mandible close, if the mandible moves to either the right or left side to obtain MIC, then a shift has occurred.

The initial exam. This is the best time to gain a thorough understanding of the stability of the patient’s TMJ. Here are some ideas of how to incorporate this evaluation into a clinical practice.

Ask the patient if they currently have headaches or have ever suffered with headaches in the past. Are there any specific muscles that “feel tired” or sore i.e., temporalis, masseter, pterygoids, or neck muscles? Does the patient report any discomfort of their temporomandibular joint? Ask the patient to point to the sources of the pain.