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Bruxism is a catch-all term that encompasses both teeth grinding and teeth clenching. Teeth grinding is rubbing your teeth together and is usually something that happens while you are sleeping. Teeth clenching is pushing your teeth together and can happen at any time of day or night.
Your top teeth and bottom teeth should not touch each other when you’re at rest. They should only touch when you are chewing, swallowing and sometimes when you are talking. The force on your teeth when they come together is 300 lbs. (Imagine a football player standing on your tooth!) Over time, that force can cause some big problems to your teeth!
The earliest sign of bruxism are flattened areas on the chewing surfaces of your teeth. (We call these wear facets.) You may also see indentations on your teeth in places where they shouldn’t be; the most common areas are on the tips of the cusps or at the gumline. Sometimes, you might see a scalloped border on your tongue where it has pushed up against your teeth or bite marks on the inside of your cheeks.
Over time, bruxism can cause teeth and fillings to crack or break. But your teeth aren’t the only part of your mouth affected by bruxism. The bone around your teeth can also be affected. You might also get headaches from the muscles tensing while you brux or have pain in your jaw joint. Your jaw might even lock (open or closed) so that you can’t move it.
So, as you can see, bruxism has the potential to cause many problems. What can you do about it? The three main treatment types are: medications, occlusal nightguards, and behavioral interventions.
There is no medication that can prevent or stop bruxism, but some medications such as muscle relaxers or anti-inflammatories are helpful in treating the symptoms and pain that result.
Occlusal nightguards are a removable appliance that creates a barrier between your teeth to protect them and also maintains the space between your teeth to assist the jaw muscles in not closing all the way. Professionally made ones are the best because they are custom made for your teeth and mouth, but they can be pricey. Over-the-Counter ones are cheaper but may feel bulkier or cause more drooling, both of which may make it less likely that you will wear it. Over-the-Counter ones may also be more likely to fall out overnight, negating their protection.
Behavioral interventions can include exercises (especially for those experiencing jaw joint issues), lifestyle changes (stress reduction etc.), meditation or yoga, biofeedback (to help you learn triggers and how to control muscles that you might not usually think about), physical therapy and/or massage of the jaw joint.
The earlier you start wearing an occlusal nightguard and the more faithful you are to wear it each night, the more protection it will give you and your teeth. If you think you are clenching or grinding your teeth, talk to your dentist. If you do not have a dentist, Dr. Robb is taking new patients. You can contact her office by phone at 440-960-1940 or by using the contact form at her website: www.drjrobb.com
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.
You’ve probably felt like your mouth was on fire if you’ve eaten spicy foods. (Just FYI: dairy products seem especially helpful in taking this type of burning feeling away.) Sensations caused by something like this fade, but imagine having to live with a frequent or constant burning sensation and not knowing why! Dentists and physicians call this condition Burning Mouth Syndrome. Let’s explore what it is and what you can do if you have it.
What is burning mouth syndrome?
Burning mouth syndrome is characterized by a painful feeling in your mouth that lasts for months or years. Some people describe it as a burning sensation, others as a scalding feel, and still others say it is more of a prickly feeling. It can occur anywhere in your mouth, but common areas are your tongue, lips, or roof of your mouth.
The sensations can be constant or occasional. A good many people have reported that their symptoms start in the late morning, peak by evening and subside at night.
Other symptoms include tingling or numbness of your mouth, bitter or metallic changes to your sense of taste, and dry or sore mouth. Because this condition is so long lasting and finding its root cause is difficult or frustrating, you may also experience depression or anxiety.
What causes burning mouth syndrome?
No one knows for sure. Several possible causes have been identified, but it is possible your symptoms could be caused by more than one factor or the cause may not become apparent until later in your treatment.
Possible causes of your burning mouth syndrome include:
- Damage to the nerves that control pain or your sense of taste
- Hormonal changes (which explains why this problem is most common in women of middle age or older)
- Dry mouth (often caused by your medications or by a disorder such as diabetes, thyroid problems or Sjogren’s syndrome)
- Nutritional deficiencies
- Oral fungal infections
- Acid reflux
- Poor fitting dentures (or other oral appliances) or an allergy to materials used in these appliances
- Anxiety or depression
What can I do?
First, discuss what you are feeling with your physician or dentist. He or she will ask for a detailed medical history to help identify possible underlying causes. A thorough oral exam is also needed. If your physician is not comfortable with this, he or she may refer you to your dentist. You may also have blood work (to look for infection, nutritional deficiencies or medical diseases), an oral swab (to check for oral fungal infections) and allergy testing (for dental materials, foods or other suspected allergens).
Because causes are so diverse, it may be necessary for you to see several medical or dental professionals before a diagnosis is made and your treatment can begin. Your professionals understand that this is a frustrating time for you. Sometimes treatment of the symptoms can begin even though an underlying cause has not yet been found.
In the meantime, you can try these self-care tips to help relieve your symptoms:
- Sip water frequently (plain water is best)
- Suck on ice chips
- Avoid irritating substances such as hot or spicy foods, mouthwashes that contain alcohol, and products high in acid like citrus fruits or juices
- Chew sugarless gum
- Brush your teeth or dental appliances with baking soda and water
- Avoid alcohol and tobacco products
What treatments are possible?
Treatments are tailored to your individual needs and depend on the cause of your symptoms. If no underlying cause is immediately found, treatment is often aimed at relieving your symptoms.
Treatments can include any of the following:
- Adjusting or replacing your ill-fitting dental appliances
- Prescribing to relieve your dry mouth, to treat an oral fungal infection, to help control pain from a damaged nerve, or to relieve your anxiety or depression
- Switching your medications to ones that don’t contribute to problems in the mouth (if possible)
- Treating existing disorders or diseases (such as diabetes, thyroid problems or Sjogren’s syndrome)
- Taking supplements for nutritional deficiencies
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals
As you can see, finding the cause of your burning mouth syndrome is not an easy path and may take some time, but if you persevere, it should be possible to ease some of your symptoms. If you are suffering from burning mouth syndrome and do not have a dentist, please contact my office at 440-960-1940. You may also contact us through our website at www.drjrobb.com or on facebook at www.facebook.com/drjenniferrobb
If you get a literal kick in the teeth, you’ll figuratively feel like you’ve gotten a kick in the teeth. A kick in the teeth is a saying used to mean an unplanned surprise or setback. Being hit in the mouth or teeth certainly qualifies!
An injury to your tooth is an injury you have for the rest of your life. Yes, we can do repairs to your tooth to make it look more natural, but the repaired area is not quite the same as your natural tooth. Sometimes the break will need a root canal right away; other times the trauma to the tooth will lead to a root canal many years later.
You’d probably suspect that activities like football or martial arts have a high chance of taking a hit to the mouth. Surprisingly though, most of the sports injuries I’ve seen have come from basketball or wrestling matches/horseplay between siblings. I even had one mother tell me she was getting a mouthguard for her daughter who is on a competitive cheerleading squad!
The best way to protect your teeth is to wear a professionally made mouthguard when you are doing any sport or activity that has the potential for contact.
Yes, you can buy one much cheaper at the sporting goods store, but often the less expensive ones do not protect as well. And, if cared for properly, a professionally made mouthguard will last a long time. There is also some evidence that a properly made professional mouthguard might help decrease the chance of having a concussion. Also, the professionally made ones fit much better, so you can breathe and speak better while wearing it.
Professionally made mouthguards have several thicknesses and protective levels to choose from. Which one is best for you depends on how you plan to use it. The middle of the line model is about $150.00 for a solid color one. (More than one color and the lab charges a fee for the additional color.)
Remember, mouthguards aren’t just for football!
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.
Jennifer G. Robb, DMD is a general dentist with an office at 1320 Cooper Foster Park Rd., Lorain, OH
A question that I had come up this week is "what does non-restorable mean in a dental context?".
The basic answer is that non-restorable means that a tooth or appliance cannot be restored to adequate function or usability. The questioner went on to ask for more details about why this would happen. I thought I'd also share my answer with you.
In order to restore a tooth, we need a certain amount of tooth structure available to hold the filling or crown. Generally speaking, the more tooth structure you have, the better. In school, we were taught that a minimum of 2-3mm height above the gumline is needed for a crown. So if a tooth is broken off at or below your gumline it is probably non-restorable. (Note: In some cases heroic measures can be taken to try to restore your tooth, but I always warn that there is no guarantee of how long these heroic measures will hold up.)
What are those "heroic measures"? First, you would need to see if your tooth is a candidate for a crown lengthening procedure. Crown lengthening is a surgery to expose more tooth structure above your gumline to try to get that 2-3mm that we need. This surgery involves both the bone around your tooth and the gums around your tooth. But we also need to be careful to leave enough support for your tooth (more on that later). IF your tooth is a candidate for crown lengthening surgery, then you'd also need to get a root canal done on the tooth. The root canal is needed for two reasons: first, if you've broken your tooth off to this point, then the dental pulp is probably already exposed to the bacteria in your mouth and already infected and second because we need the extra surface area that being able to use the pulp canal provides. After the root canal, you would need a post & core procedure. The post part is what goes down into the pulp canal (it is cemented there) and the core part is what builds up the part of the tooth above the gumline to provide something for the final restoration to grip. Post & cores can be one piece (custom cast for your tooth by a dental laboratory or milled in a CAD/CAM machine) or be separate pieces (a pre-fabricated post cemented in place with a restorative material built up around it). I tend to prefer the one piece ones for severely broken down teeth because it means there is one less junction for the final restoration to fail around. Then, as the final restorative step, you would need a crown.
Now that we have dental implants available, if you are a candidate for those, they are a much more reliable long-term restoration than heroic measures. Yes, dental implants are expensive--but so are heroic measures.
Another reason that a tooth may be non-restorable is if there is not enough bone support for it. Our teeth are held in our jaw by the bone around them. If bone is lost, either due to gum disease or trauma, then the tooth becomes mobile or loose. Right now, we do not have reliable methods to replace bone around a tooth when it has been lost to gum disease. So if a tooth does not have adequate supporting structures, it may not be able to be restored.
Teeth are not the only thing that may not be fixable. Dental appliances (dentures, partials, retainers, splints, etc.) may also break in ways that cannot be repaired. Remember that any time an appliance breaks, even if it is repaired, that area is now a weak point that can break again or cause another spot to break.
If your appliance has broken, generally the bigger the pieces you have, the more likely it can be repaired. I remember once having a patient bring me pieces of an appliance that her pet had chewed up. Most were tiny fragments and none of the pieces were recognizable enough to orient where they would have been on the original appliance. That's an extreme case, but it's one we weren't able to repair--meeting the criteria for non-restorable.
If you haven't worn your appliance for a while, your teeth may have shifted or moved so that the appliance no longer fits. If we're able to get it to fit you again, we've probably removed quite a bit of material from the appliance which could compromise looks or comfort as well as strength of the material.
Remember that each person is unique and the information presented here is general. Your dentist will be able to evaluate your specific situation and provide you with an opinion and the options that you have. If you're unsure, you can also always seek a second opinion for another dentist or dental specialist.
Note: The information in this article is not meant to replace the clinical judgement of your health care professionals.
Jennifer G. Robb, DMD is a general dentist who sees both adults and children at her office located at 1320 Cooper Foster Park Rd. W, Lorain, OH 44053. Call 440-960-1940 for appointments.
Bad breath—everyone has it sometimes, but what causes it? And what do you do when it becomes more than occasional?
Bad breath occurs when your mouth’s bacteria break down proteins in mucous and food resulting in the release of sulfur compounds. Sweets and dairy products are the worst “inside the mouth” offenders. But odors from foods like onions and garlic can make their way to your lungs and cause bad breath as well. You should also be aware that anything that dries out your mouth might make bad breath worse. This can include your medications since many have dry mouth as a side effect. Using tobacco in any form contributes to bad breath, as well as making it more likely you will have dental problems such as gum disease.
First, see your dentist to make sure your mouth is healthy. Persistent bad breath is one sign of gum disease. If you have gum disease, you will have pockets between your teeth and gums that fill up with food, plaque and bacteria. Cavities in teeth can also catch food and plaque. As this “stash” breaks down, it releases sulfur compounds. Treating your gum disease or cavities will often reduce bad breath. If you smoke or chew tobacco, quitting will not only help your breath, it will help reduce your risk of other diseases. Your dentist will also ask for a health history that may highlight medical conditions that contribute to bad breath. If this is the case, you will be referred to a medical doctor for follow up.
Once your mouth is healthy, anything that increases your saliva will help your bad breath. Try to stay hydrated. Plain water (rather than the flavored varieties) is the best for counteracting bad breath. Green tea contains polyphenols that have been shown to reduce sulfur compounds; however, adding milk or sugar to the tea increases bacterial activity in your mouth and decreases its effectiveness. Mint tea has been shown to be quite effective at neutralizing garlic oils.
Fibrous vegetables or fruits are also helpful for increasing your saliva, and their firmness will scrape some plaque off your teeth. Fruits have natural sugars in them so vegetables, such as cucumbers or celery, are slightly better choices. Parsley, which is often used as a garnish, also seems to have some anti-bad-breath properties when it is chewed.
Chewing sugar-free gum or using sugar-free mints are also good ways to increase your saliva. Look for ones that contain xylitol or sorbitol. As a plus, recent studies have indicated that xylitol might also reduce your cavity rate. Be careful not to overuse them, however, since these sugar alcohols can upset some people’s digestive systems.
You may be tempted to turn to mouthwashes to help with your bad breath. Some mouthwashes merely mask the problem and do not do anything to help it. Choose one with antibacterial properties to help temporarily reduce the number of bacteria in your mouth or choose one specially formulated for relief of dry mouth.
You should also make sure you are brushing and flossing correctly. You should brush at least twice a day for about 4 minutes each time. Floss once a day, making sure you are keeping the floss tight against your tooth and taking the floss below the gum. You may also want to clean your tongue with your toothbrush, a tongue brush or tongue scraper. Tea tree oil has antibacterial properties and some experts recommend placing a drop at the back of your tongue. (Tea tree oil is not recommended if you are pregnant or breast-feeding since it has not been tested for safety in these situations.) If you are not sure how to brush or floss, ask your dentist or hygienist.
NOTE: the information in this article is not meant to replace the clinical judgement of your healthcare professionals.
If you do not have a dentist, please contact my office at 440-960-1940 or by using the contact form on my website www.drjrobb.com You can also interact with Dr. Robb on facebook at https://www.facebook.com/drjenniferrobb Dr. Robb is a general dentist who sees both adults and children.