Teeth grinding and other biting habits are more than a nuisance — they can generate twenty to thirty times the forces of normal biting. Over the long term, this can cause significant damage to teeth and supporting gums and bone.
This particular kind of damage is known as occlusal trauma (meaning injury from the bite). In its primary form, the habit itself over time can injure and inflame the jaw joints leading to soreness, swelling and dysfunction. The teeth themselves can wear down at a much faster rate than what normally occurs with aging. And although less common but even more serious, the periodontal ligaments holding teeth in place to the bone can stretch and weaken, causing the teeth to become loose and increasing the potential for tooth loss.
There are a number of techniques and approaches for treating excessive biting habits, but they all have a common aim — to reduce the amount of force generated by the habit and the associated problems that result. A custom occlusal guard, often worn while sleeping, helps lessen the force by keeping the teeth from making solid contact with each other. Tissue soreness and swelling can be relieved with anti-inflammatory drugs like aspirin or ibuprofen, muscle relaxants or physical therapy. In cases where stress is a main driver, behavioral therapy and counseling may also be helpful.
Biting forces are also an issue for patients with periodontal (gum) disease. In this case even biting forces within normal ranges can cause damage because the diseased gums and bone have already been weakened. If gum disease is a factor, the first priority is to treat the disease by removing built up plaque. Plaque is the thin film of bacteria and food remnant that’s both the cause and continuing growth of the infection, as well as tartar (calculus) from all tooth and gum surfaces.
A thorough dental exam will reveal whether a tooth grinding habit is playing a role in your teeth and gum problems or if it’s magnifying the damage of gum disease. In either case, there are appropriate steps to stop the damage before it leads to tooth loss.
If you would like more information on teeth grinding or other biting habits, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Loose Teeth.”
Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.
But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.
To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.
Â If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day.Â Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.
During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.
After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.
As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.
If you would like more information on taking the anxiety out of children’s dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”
If you’re one of the millions of people all over the world tuning in to the Olympics, you know that just watching the competition in your living room can be a real nail-biter. So imagine what it’s like for Tara Lipinski—the former gold medalist in figure skating who’s currently a primetime commentator for the 2018 Winter Olympics in Korea. In a recent interview with Dear Doctor magazine, the skating superstar revealed that she wears a custom-made nightguard to protect her smile.
“I grind my teeth pretty badly,” she said, noting that some days are worse than others. “When I can tell the grinding is bad, or my jaw starts to hurt, [then] at night I wear a mouthguard.”
Tara’s hardly alone: It’s estimated that around one in ten adults suffers from bruxism—the dental term for the habitual clenching or grinding of teeth. This condition, which is linked to stress (and several other risk factors), can occur during the daytime or at night—when it may go unnoticed as you sleep. If left untreated, bruxism can lead to headaches and jaw pain, temporomandibular joint disorder (TMJD), and damage to natural teeth or restorations such as crowns, veneers or fillings.
Fortunately, as Tara as found out, there’s a simple and effective way to help people struggling with the problem of teeth clenching and grinding: We can provide you with a custom-fabricated nightguard to stop bruxism from affecting your health. This device, usually made of high-impact plastic, is created from a model of your actual bite. It fits comfortably over your teeth, and can tooth prevent damage before it occurs.
A nightguard is a very conservative form of treatment, meaning that it involves no invasive or irreversible procedures. While other types of treatment are sometimes recommended for bruxism, it’s generally best to try the most conservative first. But how does it feel to wear it?
“I think it’s comfortable to wear,” Tara told Dear Doctor magazine. “You don’t even think about it.”
So whether you’re a type-A competitor or a dedicated fan watching the games unfold on TV, don’t let bruxism get the better of your smile. If you think you may be clenching or grinding your teeth, ask us about a custom-made nightguard.
For more information about teeth grinding, contact our office or schedule a consultation to find out more about teeth whitening. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”
Since their introduction over thirty years ago, dental implants have become the most popular choice for dental restoration. Their large variety of shapes and sizes — a far cry from the limited choices of the 1980s — has only served to increase their popularity.
In recent years there's also been an expansion in their applicability. Most people recognize them as replacements for individual teeth — but they can do much more. They're now playing a pivotal role in other dental restorations or situations.
Here are 3 of those “cutting edge” ways implants could change your dental health and smile for the better.
Fixed bridgework. In a traditional bridge, prosthetic (false) teeth use the natural teeth on either side of the empty space for support. In this updated version, implants become the support base for the bridge. For example, a bridge as small as three crowns can be supported by two implants attached to the outside crowns of the bridge. Four to eight implants can support a bridge as large as an entire arch of teeth.
Over-dentures. In cases of significant bone loss, a full or partial denture may be a better option than a fixed bridge. Traditional dentures, though, can contribute to even more bone loss, which can cause the dentures to eventually lose their fit. Implants not only can help stop further bone loss but can also stimulate increased bone density. Two or more standard or mini-sized-sized implants can support a full or partial denture.
Orthodontics anchorage. People with missing teeth aren't the only ones who can benefit from implants. While most bite repairs only require the back teeth to provide anchorage for braces, certain complex bites may need a different point of anchorage. Orthodontists can create a more feasible anchorage point with an implant or a temporary anchorage device (TAD) imbedded in the jaw. This can help isolate teeth that need to be moved from those on the arch that don't.
If you would like more information about how dental implants could improve your dental health and appearance, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants: Your Best Option for Replacing Teeth.”
When he isn’t among the ten players vying for position on the basketball court, Cole Aldrich of the New York Knicks sometimes lets his dangle behind one ear. Mason Plumlee, who plays for the Brooklyn Nets, slips his snugly inside one of his socks during off times. Other players can be seen at timeouts gnawing on them nervously, or tucking them into spandex waistbands. But when the whistle blows, they go into the mouth before the players get on the court.
We’re talking about protective mouthguards, of course. According to a recent story in the New York Times, only a handful of basketball players wore them regularly a few years ago. Today, more and more are wearing them, both in practice and during games. What’s the reason for the change?
Partly, it’s the result of better design and improved construction; today’s mouthguards are more comfortable and better-fitting than ever. Part of it comes from mounting evidence that they work: Research studies have consistently demonstrated the benefits of wearing a mouthguard — not only to protect the teeth, but also to reduce the risk of concussion. And partly, it stems from the growing acceptance that safety is an important aspect of all athletic activity.
If the pros are doing it — shouldn’t you be too? While you may think that only contact sports (such as football) are risky, the fact is that “non-contact” sports like baseball and basketball account for the majority of dental injuries. In fact, the American Dental Association recommends you wear a mouthguard when you participate in activities like handball, soccer, surfing and weight lifting — as well as boxing, skydiving, martial arts and “extreme sports” — whatever that may mean to you.
What’s the best kind of mouthguard? It’s the one that you actually wear, of course! And the most comfortable and best-fitting mouthguard is the one that’s custom-made for you by your dentist. Sure, you can pick up an off-the-shelf mouthguard at a big box store; but it can’t offer you the same level of protection and comfort you’ll get from a mouthguard that is made from a model of your own teeth. Custom-made mouthguards from your dentist are reasonably priced — and by preventing dental trauma, they can save an untold amount of hurt… both to your body and to your pocketbook.
So take a tip from the pros: Get a custom-made mouthguard, and wear it every time you play. But when you’re done playing… how about putting it away in a case?
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”
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