Occlusion and postural control: current evidence and critical perspectives

This narrative review examines the neurophysiological, biomechanical, and clinical relationships between dental occlusion and postural control, integrating more than six decades of indexed scientific literature (1960–2025). Drawing from studies published in PubMed, Scopus, and Web of Science, the review evaluates both historical and contemporary evidence regarding how mandibular position, occlusal contact, and temporomandibular function interact with the multisensory mechanisms governing human posture. The analysis encompasses neurophysiological models of trigemino-cervical integration, biomechanical concepts of myofascial continuity, and instrumental studies employing stabilometry, electromyography, and motion analysis. Clinical research on temporomandibular disorders, orthodontic treatments, and occlusal splint therapy is critically appraised to determine the strength and reproducibility of reported effects. A structured synthesis (Table 1) ranks the scientific validation of major assumptions in postural dentistry, revealing that while trigeminal and cranio-cervical interactions have moderate to strong neurophysiological support, claims of systemic postural correction via occlusal interventions lack empirical foundation. An interdisciplinary decision algorithm (Table 2) is also proposed to guide collaboration among dentists, physiatrists, and physiotherapists, promoting evidence-based practice grounded in the ethical principle of primum non nocere. By excluding non-indexed, anecdotal, and pseudoscientific sources, this review delineates the boundary between verified physiological mechanisms and unsupported clinical speculation. The work advocates for standardized methodologies, multidisciplinary cooperation, and a transition from reductionist models toward a systems-oriented understanding of postural regulation, in which dental occlusion functions as a modulatory—not determinant—component of human equilibrium.