Articulating Paper Guide: Thickness, Paper vs Film, Colors and Holders

Articulating paper is the standard chairside indicator of occlusal contacts: a strip coated with colored ink or wax that leaves a mark wherever upper and lower teeth meet as the patient closes. Papers of 100 to 200 microns find contacts quickly and leave large marks, while thin papers, films and foils down to 8 microns leave smaller, more precise marks for the final adjustments.

An occlusal check follows every restoration that changes a biting surface, from a posterior restoration in dental composite to a crown or an onlay. Articulating paper and marking products range from papers of 40 to 200 microns and films and foils of 8 to 21 microns to horseshoe sheets, forceps, indicator sprays and shimstock.

What to Compare Between Articulating Papers

Six characteristics separate the products in the category.

• Thickness. Products run from about 200 microns down to 8; thicker papers mark readily and leave larger marks, while thinner papers and films leave marks closer to the size of the contact.
• Material. Paper, often reinforced with fibers or fleece, is the thickest and softest option; plastic films and metallic foils are thinner and resist tearing when pulled from between closed teeth.
• Color. Blue and red are the usual colors, with black and green also listed, and red/blue products supply both colors for the two-color technique.
• Format. Strips come pre-cut or bound in books, rolls are cut to length, horseshoe sheets cover both sides of the arch, and some foils are pre-mounted on a rigid frame.
• Marking on difficult surfaces. Glazed ceramic, gold, polished metal and moist surfaces take color less readily, and listings name the feature each product relies on, such as bonding agents, hydrophilic waxes or color-filled microcapsules.
• Holder. Strips are held in reusable Miller-type forceps, self-closing clamps or disposable paperboard forceps, while horseshoe sheets and pre-mounted foils need no holder.

Articulating Paper Thickness and Materials at a Glance

Marking materials fall into four groups by thickness, with shimstock as a fifth, non-marking option. The table summarizes the material, formats, marks and typical use of each group.

Thick Articulating Paper: 100 to 200 Microns

Thick articulating paper is the usual first step on a new restoration, crown or denture, when the aim is to find every point that touches. At 200 microns a strip is about a fifth of a millimeter thick, and its mark is larger than the contact itself: it shows where to look, while the amount to remove is judged with a thinner material.

In the category, 200-micron paper comes mostly from Bausch, in blue or red, as dispenser strips, refill boxes, booklets and horseshoe sheets.

For the first check on a new restoration, a 200-micron strip from a chairside dispenser shows the high spots at a glance.

Thin Articulating Paper: 40 to 90 Microns

Once the gross high spots are reduced, a thinner articulating paper narrows the marks to the contacts that remain. The category lists thin papers at 40, 63, 71, 80 and 89 microns, among others, as pre-cut strips and as books of 12 sheets. Double-sided papers carry color on both faces, so a single closure marks the upper and lower teeth together.

For refining contacts after a first pass with thicker paper, a 40-micron strip coated on both sides marks moist and polished surfaces.

Articulating Film and Foil: 8 to 21 Microns

Articulating films replace the paper base with a thin plastic sheet. At 19 to 21 microns, films such as AccuFilm and Exacta-Film leave small, sharp marks and do not tear when pulled from between closed teeth, which suits the final check on crowns and onlays and occlusal equilibration. Ultra-thin and metallic films of 8 to 12 microns, such as Arti-Fol and TrollFoil, are listed for marking small contacts on highly polished metal and ceramic, on rolls cut to length or pre-mounted on a frame.

Thick articulating paper shows the area around a contact and film shows something close to the contact itself, so the two work in sequence: paper to find the high spots, film to confirm the final contacts.

For final checks on crowns, onlays and equilibration, a 21-micron double-sided film keeps marks sharp without tearing.

In limited openings and tight vestibular spaces, a pre-mounted foil on a rigid frame removes the need for forceps.

Strips, Books, Rolls and Horseshoe Sheets

Straight strips, pre-cut in a dispenser or bound in books, cover a single tooth or a quadrant and are held in forceps. Rolls in a dispenser, 16 or 22 mm wide, are cut to the length each check needs. Horseshoe sheets cover both sides of the arch in one closure and are used one-handed without forceps.

Listings recommend the horseshoe shape for patients who tend to bite on one side, since both sides close on marking material at the same time; with straight strips, the same check takes two strips held at once or two separate closures.

For full-arch checks, an extra-thin red/blue horseshoe articulating paper marks both sides of the mouth in a single closure.

Articulating Paper Forceps and Holders

Miller-type forceps are the most widely listed holder in the category: stainless steel instruments about 6 inches long, straight or curved, with serrated or grooved jaws that hold a strip flat across a quadrant and go through the sterilizer with the other restorative instruments. Self-closing designs such as the Miltex PosiGrip clamp the strip without hand pressure, disposable paperboard forceps with rounded edges remove reprocessing from the routine, and Bausch lists curved half-arch forceps and Y-shaped holders for its Arti-Fol films.

For practices that keep a holder in every restorative cassette, a straight serrated Miller forceps is a durable, autoclavable choice.

Reading the Marks: Drying, Closing and the Two-Color Technique

Marks are clearest on dry teeth, so the occlusal surfaces are dried with air before each check. The patient closes or taps lightly on the strip, the marks are read, the high spots are reduced, and the check is repeated, usually moving from thicker to thinner material as the adjustment nears its end.

The two-color technique separates centric stops from excursive contacts. In one common sequence, the patient first slides through lateral and protrusive movements on a strip of one color, for example red, and then closes in maximum intercuspation on a strip of the second color. Marks in the second color are the centric stops, while marks found only in the first color are contacts made during excursions, which the clinician then judges as guidance or interference.

On a composite restoration, the high spots found with articulating paper are reduced with a fine finishing bur, and composite finishing and polishing ends with another occlusal check to confirm that polishing has not changed the contacts.

How Well Articulating Paper Locates Contacts

Rovira-Lastra et al. (2026) tested articulating paper against silicone bite registrations in 32 adults with natural dentitions, using 100- and 200-micron paper and two techniques: holding the paper in place, or pulling it with forceps while the patient kept the teeth together in the intercuspal position. On the right posterior teeth, the paper produced 81% true-positive contacts and 15% false-positive contacts, whichever technique was used.

The 100-micron paper produced more false-positive contacts than the 200-micron paper (20.6% against 9.4%), the lower arch gave a higher true-positive rate than the upper, and pulling the paper made no significant difference. Counting a contact only where the marks matched on both arches brought false positives down to 2.0%.

The study was done on natural teeth, on the right posterior segment only and with two thick papers, without thin papers or films, and a silicone record is itself an approximation of the true contacts. Its practical message fits everyday technique: a double-sided strip and a look at both arches before adjusting reduce the marks that do not correspond to a real contact.

Does a Larger Mark Mean a Heavier Contact?

Not reliably. Qadeer et al. (2012) had 30 dentate women close on articulating paper strips to mark their upper posterior teeth, then recorded the share of bite force on each tooth with computerized occlusal analysis. Across 240 marks in 60 quadrants, the largest and darkest mark in a quadrant fell on the most forceful tooth only 38.3% of the time, and applied force explained only about 6.7% of mark area (r2 = 0.067).

The sample was small and limited to women and to the upper posterior teeth, force was measured with a single computerized system, and the abstract does not name the paper used. Several listings in the category describe darker marks under heavier bites, yet the result suggests that a larger or darker mark is a weak basis for ranking contacts by force. Marks therefore show where teeth touch rather than how hard they press, and where force distribution itself needs measuring, computerized occlusal analysis records it directly.

When Is Shimstock Used Instead of Articulating Paper?

Shimstock is used to check whether two teeth touch at all. It is a metal foil 8 to 12 microns thick, usually uncoated, that leaves no mark: a strip is placed between two teeth, the patient closes, and the clinician pulls it. If the foil holds, the teeth are in contact; if it slides out, they are not.

A typical use comes after a crown is seated, when shimstock that still holds on the neighboring teeth confirms that the crown is not keeping them apart. Coated metallic films sold as shimstock film, such as Arti-Fol Metallic, add a colored side and mark contacts as well.

Articulating Paper and Alara: Get the Best Deals from Trusted Suppliers

A box of articulating paper costs little, yet it is reordered for every operatory, and the same box is sold by many vendors at different prices. Alara compares real-time offers on articulating paper, films, foils and forceps, from Bausch and AccuFilm to Ardent, TrollFoil and Hu-Friedy, across 15+ verified vendors.

References

1. Rovira-Lastra B, ElOtmani-Sabiri S, Ustrell-Barral M, Khoury-Ribas L, Martinez-Gomis J. Clinical Strategies to Improve the Accuracy of Articulating Paper for Detecting Occlusal Contact Points in Adults with Natural Dentitions. Diagnostics (Basel). 2026;16(10):1450. PMID: 42196816. DOI: 10.3390/diagnostics16101450
2. Qadeer S, Kerstein R, Kim RJ, Huh JB, Shin SW. Relationship between articulation paper mark size and percentage of force measured with computerized occlusal analysis. J Adv Prosthodont. 2012;4(1):7-12. PMID: 22439094. DOI: 10.4047/jap.2012.4.1.7