Leaf Gauge Refinements

If you like using the leaf gauge as much as I do, you undoubtedly have occasions when you wonder why there is a discrepancy between what you see clinically and what you get when the case is mounted. While there can be many reasons for this, one of the reasons that I can control is how I help the patient show me the reference I’ve chosen for my inter-arch relationship. I’ve discovered over the years that the way I direct the patient to close into the gauge can impact what they actually do.

If you put something between someone’s teeth and tell them to “squeeze,” they will. They squeeze into whatever you’ve placed between their teeth. If that something is a leaf gauge between their front teeth, the squeeze that occurs may be forward of the fully seated condylar position, not the reference we are usually looking for.

I’ve refined my patient interaction when using the leaf gauge to always direct them to their posterior teeth by telling them to bite there (in the back) rather than just asking them to squeeze.

Here is the “script” I use whenever I use the leaf gauge:

Close onto the gauge

Slide all the way out on the gauge

Slide all the way back

Close gently on your back teeth

Anything touching?

If yes, add leaves and start over

If no, squeeze gently (or “half hard”) on your back teeth

Anything touching?

If yes, add leaves and start over

If no, squeeze hard on your back teeth

Anything touching?

If yes, add leaves and start over

If no, hold that squeeze on your back teeth for 20-30 seconds

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Gary DeWood, D.D.S., M.S., Spear Faculty and Contributing Author