Posts for: March, 2017
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
A root canal treatment is a highly effective way to save a deeply decayed tooth. Sometimes, though, complications make it difficult or even impossible to perform the traditional procedure. In those cases, we may need to use a different option.
Tooth decay becomes an imminent threat to a tooth's survival if it works its way into the pulp, the innermost layer of a tooth. It's only a short advancement from there into the roots by way of the root canals.
In a typical root canal treatment, we access the pulp by drilling a small hole in the biting surface of a back tooth or the back side of a front tooth. We remove all the tissue within the pulp and fill it and the root canals with a special filling to prevent re-infection. After sealing the access hole, we cap the tooth with a crown to further protect it.
Although root canal treatments have a high success rate, re-infection can still occur. Often, a second root canal will save the tooth from the new infection.
In some cases, though, using the traditional procedure might do more harm than good. It's possible we may find extra canals previously undetected branching out from the primary canal at the root end. Canals can calcify and narrow, making them extremely difficult to fill. Subsequent dental work may also prove troublesome: we would have to take the restoration apart, which could further weaken the tooth.
The alternative is a procedure known as an apicoectomy. Instead of accessing the pulp through the crown, we access the root end through the gum tissue. We then focus on removing infected tissue at the tooth's root end, along with a tiny amount of the root tip. We then place a small filling at the end of the root canal (essentially plugging it up) to prevent further infection. We may also perform grafting to encourage bone growth in any voids left by the procedure.
Endodontists, specialists in root canals, have the advanced training and specialized equipment to perform an apicoectomy. With their expertise, they may be able to save your tooth with this specialized procedure when a root canal treatment won't work.
If you would like more information on options for treating decayed teeth, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”