Primary occlusal trauma occurs when greater than normal occlusal forces are placed on teeth, as in the case of parafunctional habits, such as bruxism or various chewing or biting habits, including but not limited to those involving fingernails and pencils or pens.An example of secondary occlusal trauma. This X-ray film displays two lone-standing mandibular teeth, #21 and #22, or the lower left first premolar and canine. As the remnants of a once full complement of 16 lower teeth, these two teeth have been alone in opposing the forces associated with mastication for some time, as can be evidenced by the widened pdl surrounding the premolar Because this trauma is occurring on teeth that have 30-50% bone loss, this would be classified as secondary oclcusal trauma.Secondary occlusal trauma occurs when normal occlusal forces are placed on teeth with compromised periodontal attachment.

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