Friday, December 2, 2016

Signs of a Tooth Clencher

Bruxism or clenching effects 80-90% of patients in my practice. Whether stress or pharmaceutic induced, clenching is a difficult habit to control. Nightguards are recommended for most patients and required for those who have dental implants.

Common signs of bruxism or clenching are the usual wear and wear faucets on teeth including pits and abfraction lesions.

Another less conspicuous sign is buccal extosis or overgrowth of bone.

The body will compensate for the additional biting force and help protect the dentition (teeth) by applying more bone as a protective mechanism.

Those patients who have wide ridges with extosis should receive nightguards.

Teeth in a Day

Teeth in one day. Final prothesis pictured. 

All-on-7. Full cemented PFM implant bridge with 7 custom abutments. #titanium #implants #conebeam#allon7 #teeth #newteeth #teethinaday #dental #dentist #os #nobelbiocare #nodentures #youwouldneverknow

Bruxing, Grinding and Soft Nightguards

Soft nightguards are highly recommended for all implant patients. Implant teeth function differently than natural teeth in many ways. The most important reason is that implant teeth are fixed, rigid anchors that have no mobility. Natural teeth are slightly mobile and move all the time when in use. The reasoning behind this is that natural teeth have something call the periodontal ligament or PDL. This stucture allows for mild movement which can actually serve as a buffer for compression. This is another reason why the occlusion or bite must be checked every 6 months during the recall appt. 

What is Bruxism?

Bruxism is the grinding of teeth during the day or night. Forces in bruxism tend to be stronger than regular chewing forces. These biting forces can wear down, fracture and devitalize teeth as well as induce jaw muscle soreness. Bruxism is also very harmful to dental implants. Grinding of teeth on implants can result in fracture of implant failure. 

What is Clenching?

Clenching is the constant squeezing or applied force of keeping the teeth together. Clenching has similar signs also found in bruxism.

What is a Nightguard?

A nightguard is a dental appliance made from soft acrylic that is typically worn at night while sleeping and sometimes during the day if grinding is present. Soft nightguards make a large of difference for bruxers and clenchers by reducing force on teeth, and help prevent the fracture and failure of crowns, fillings and dental implants. As a dental implant patient, soft nightguard is highly recommended for future care of your implants. 

The Dental Implant vs. Bridge Conundrum

Patients will always ask me if I recommend a bridge or dental implant.  First an understanding of both procedures is required. A bridge will require the patient to reduce the adjacent teeth on both sides of the missing tooth. This, sadly, is very difficult for me to justify, given both adjacent teeth are healthy and do not require full coverage crowns. This  will be restored with a one piece restorative unit encompassing three teeth, which is then cemented in permanently. Daily maintainence is also an ordeal.  Since the restoration is connected as one piece, bridges cannot be flossed similar to regular teeth.  

Dental implants serve as root replacements. After healing, a tooth is attached to this implant, mimicking the original tooth. Implant teeth are difficult to separate from natural teeth as they are cosmetically similar and they can be flossed normally as well.