Cuspal refers to the chewing or tearing points of certain teeth, such as: Cuspids, Bicuspids and Molars. It is derived from the word cusp, which in dental terminology means “the elevated surface of a tooth.” For example, Canines have one cusp. Maxillary (top) Premolars and the Mandibular (bottom) first Premolars usually have two cusps. Molars usually have four or five cusps.