Grinding and Clenching

Unexplained soreness of the jaw or neck muscles and persistent headaches could be an indication that you are suffering from bruxism, or grinding and clenching of the teeth.  The problem is treatable and more common that you may realize, even though most people are completely unaware that they do it.

Frequently, people who clench and grind their teeth do so during sleep, and learn about it from their sleep partner.    Sometimes bruxism is discovered when clients ask their dentist about pain or an odd sensation that their teeth are loose. However, the habit can create a long list of symptoms from mild to significant and can be quite destructive to the teeth themselves as well as to supporting structures, causing the gum recession and bone loss which can eventually cause teeth to be lost. Among people who chronically grind, fractured teeth and damage to the nerves which can require root canal therapy are common.  Unfortunately, this treatable behavior can exist for a long time before it is diagnosed, because many of the symptoms can be easily overlooked or ignored, and may be thought to have another cause.  Consider bringing to your dentist’s attention any of the following symptoms:

• Earache
• Headaches or Migraines
• Loose teeth
• Changes in the way your teeth fit together
• Sensitive teeth
• Tinnitus
• Gum recession
• Neck pain
• Insomnia
• Soreness of the jaw or neck

Bruxism is thought to run in families but it is also be a common response to stress, anxiety and depression. Other causes of the habit include bite problems, eating disorders, excessive alcohol use, and medical conditions such as Parkinson’s disease and obsessive compulsive disorder.  Ideally, treating bruxism involves managing or eliminating the cause but obviously, this is not always possible andtreatment for the behavior and its symptoms often focuses on interruption of the grinding, relieving stress on the jaw joint and and preventing damage to the teeth .

Careful examination of the teeth may reveal fine cracks, wear facets in the tooth anatomy, and otherwise unexplained changes in the bone around the teeth. These findings, along with a thorough medical history will help your dentist diagnose bruxism and suggest a treatment plan.  Most frequently, a hard plastic occlusal splint is custom made to fit the teeth. Worn while sleeping, this “nightguard ”  protects the teeth by covering their surface and enabling them to  glide easily.  The night guard is form-fitting, covers all of the upper teeth and  prevents them from shifting over time which ultimately prevents gradual changes in how teeth  fit together.  A different type of  FDA approved appliance called an NTI(Nociceptive Trigeminal Inhibition system)  fits only over the upper front teeth and prevents the back teeth from touching at all.  Other treatment options including biofeedback, hypnosis, dietary supplements and (rarely) Botox injections are less well known and have had mixed or questionableresults.

People who have been grinding their teeth for a long time may have significantly damaged their teeth;  in severe cases they can even be worn down to the gum line. The damage may have left teeth  sensitive and susceptible to cavities, and may have even caused changes in the shape of your face or the way you feel about your smile. The first step in addressing these issues is always to treat the  bruxism  so that no further damage occurs; and the good news is that there are several cosmetic options that can improve the function of your teeth as well as their appearance.      Your cosmetic dentist may suggest crowns, veneers or bonding as part of your complete treatment  plan.

Unexplained symptoms may not be as mysterious as you think… why not talk to your dentist about bruxism and what treatment options may be right for you?  You deserve a beautiful, pain-free smile!

Oral Piercing: The Price of Beauty

Body piercing is a popular form of self-expression these days, but it isn’t as safe as you may have been told. The American Dental Association opposes the practice of piercing the tissues in and around the mouth and you may want to research and think about some of the consequences that the local piercer may not know about…

Even if the piercing salon is reputable and the equipment is sterile, the human mouth is a warm, moist environment with a rich blood supply and home to literally millions of bacteria. A piercing site is an open wound, and the perfect place for bacteria to enter the blood stream and cause serious or life threatening infections such as septicemia. When these bacteria multiply in the blood stream and colonize in distant parts of the body such as the heart, they can cause endocarditis, a serious (and sometimes fatal) inflammation of the heart valves and tissues.

Common problems following piercing in and around the mouth include scar tissue, excessive drooling and speech problems. Oral jewelry may interfere with chewing or swallowing, and excessive sensitivity to metals such as eating utensils – and even your own fillings- is not uncommon. Jewelry that is accidentally bitten will likely fracture or chip tooth enamel or fillings, damage which is not just cosmetic- it can necessitate a root canal and crown or even an extraction. When jewelry consistently rubs against gum tissue, recession that exposes the roots and sometimes the bone can occur. Unfortunately, these effects are often permanent and require surgery to correct. In practical terms, some other undesirable effects of an oral piercing include

Complications of tongue piercing are very possible: Damage to the blood vessels in the tongue can cause serious blood loss; and the nerve can be easily punctured causing numbness, loss of taste or movement – damage that is sometimes temporary, but can also be permanent. After a piercing the tongue will swell, as you might expect- but occasionally the swelling is serious enough to block the airway.
If your mind is made up, and you are still sure that you want an oral piercing, there are some precautions that can make your choice safer:
• Plan ahead: Speak to your dentist (the expert in oral anatomy) for advice about the location you have chosen.
• Be sure your piercer has good references and is professional and competent. Sterile equipment and a clean environment are essential.
• Get instructions for aftercare, and follow them. Kissing, alcohol, or touching the site with unwashed hands are out of the question until it has healed, and good oral hygiene is imperative to minimize the risk of infection. There are several good over the counter, alcohol free mouth rinses that are effective at reducing bacteria. If it becomes necessary, the dentist can prescribe an effective antiseptic rinse.
• The piercing procedure and your oral jewelry should use surgical grade stainless steel, which is hypoallergenic. However, watch for inflammation (redness, swelling and pain) that doesn’t go away- this could be an indication that you are allergic to the metal in your jewelry, and you will need to remove it.
• When the tongue has been pierced, a short length of barbell is best, because it moves less and is less tempting to play with. Even tapping of jewelry against your tooth enamel can create tiny fractures

• Plastic jewelry is always preferable to metal because it is gentler and kinder to the enamel.

• As with anything else in the mouth, oral jewelry collects plaque and food particles. Remove and clean it regularly, and replace it if it becomes damaged.

• Don’t wear oral jewelry during a dental visit because it can interfere with x-rays, but do be sure to tell the dentist or hygienist about your piercing so that they can examine the site and look for possible problems.

• Most importantly, if your piercing causes any sensitivity or discomfort don`t hesitate to remove it.
• See your dentist or doctor right away if you experience symptoms of illness!

Fashion trends come and go and although most are harmless and fun, the price of being trendy may be higher than you expected. The potential cost of an oral piercing can be anything from minor cosmetic issues and sensitivity to thousands of dollars worth of repairs to the teeth, or permanent damage to the nerves and skin in the mouth. Ask yourself if the fashion statement is worth the potential long term cost. Have you experienced any negative effects as a result of oral (lip, tongue, cheek, etc.) piercings?