Subtract 3 millimeters from your rest vertical and consider this the occlusal vertical dimension. The occlusal vertical is always smaller than the rest vertical. The difference is the free way space. (In the natural dentition the free way space can vary from 1-10mm.)

Now insert your mandibular occlusion rim and adjust the wax to make it equal your calculated occlusal vertical dimension. More often than not the vertical is open and the waxes are hitting in the posterior. Start removing some mandibular wax. (You will need to remove some wax distal to the canines when you do the centric record.) You can also remove some of the maxillary wax if necessary.

Make sure the acrylic bases are not hitting in the back. If the acrylic touches just cut it off liberally. You can always add back the base when doing the waxup.

Have the patient speak, watching to see if there is a "speaking space" between the wax rims. (If there is premature contact in the posterior then the wax rims will stay apart anteriorly and you will think there is a speaking space.)

The closest speaking space occurs during the "S" sound. That is the reason you ask the patient to count from 60 to 70, or say "Mississippi." Make sure the rims do not touch during the "S" sound.

When the patient deliberately closes on the wax rims the face should look normal.

©1999 by Julius Rosen, D.D.S.