Sierra Studio - Grinding

An estimated one in 20 adults and three in 20 children unconsciously grind their teeth at night. It is the sound of bruxism. While the noise may disturb spouses or children, it has a far more distressing effect on the sleeper.

Nightime grinding can exert thousands of pounds of pressure per square inch on the surfaces of teeth. It can be rough not only on teeth but on the supporting bone, the gums and jaw joint.

For many years, bruxism was attributed to the release of tension from emotional stress. However, many dental authorities today believe that the causes exist in the patient's mouth. Night grinding may be an unconscious effort to correct irregularities of the chewing surfaces of the teeth. Dentists term this a malocclusion. They grind away to eliminate a spot that is too high or to find a comfortable place to fit the upper and lower teeth together.

What Can I Do About Grinding?

One of the most common types of dental mouth guards being used today is the full upper mouth guard/splint. This therapeutic device is constructed of a specialty material and can be constructed to your mouth's exact specifications by your Sierra dentist. Most commonly, the mouth guard fits over all of the upper teeth, but can also be fashioned for the lower set of teeth, should that be necessary, while providing the same results. The full upper mouth guard, sometimes called a bite plate, holds the jaw in a more comfortable position during sleep, reducing jaw clenching and teeth grinding.

The NTI is another type of mouth splint that may be used to treat jaw clenching, teeth grinding, and other TMJ disorders. Unlike the full upper mouth guard, which covers all of the upper teeth, the NTI is worn only around the top front teeth. These devices are also custom fit to your mouth's specifications, and can reduce clenching up to 66%.

If you have this nightly grinding problem, your first stop should be to contact a Sierra Orthodontist before you do any serious damage to your teeth.

Sierra Studio - Clenching

Teeth clenching, otherwise known as bruxism, is a common phenomenon amongst people.  For all intensive purposes, almost everybody clenches his or her teeth.  The problem lies in whole intense the scale of teeth clenching is. A person with severe bruxism will often clench their teeth with much force, usually, while they sleep. The pressure that can be generated across the teeth can range from 100 to 600psi (pounds per square inch), and this is an incredible amount of force.

Here is a summary of signs/symptoms you may be experiencing by teeth clenching:

1. Wearing of teeth – When the teeth grinds harshly against one another with sufficient force on a daily basis, the teeth understandable will become worn down. It is especially noticeable when a person has front teeth that appear having the same length - as if they were filed down.
2. Breaking of teeth – The chances of breaking or chipping your teeth increases with the constant wearing down of your teeth.  The edges of front teeth and the cusps or corners of back teeth will begin to show micro-fractures or cracks. These cracks are minute and cannot be detected by x-rays.  Teeth with these types of fractures will eventually chip, break a corner, or require root canal therapy. The reason for root canal therapy is that the fracture begins on the surface of the tooth and eventually deepens until the crack enters the area of the nerve.
3. Sensitive teeth - Usually a generalized soreness and/or a cold sensitivity.
4. Receding gums - When teeth grind hard against each other over time, they flex at the gum line and the enamel (which ends thinly at the gum line) microfractures away. This results in an exposed area (abrasion area) at the gum line that is extremely sensitive.
5. Loose teeth – Grinding may cause teeth to loosen due to the ”rocking” back and forth motions that they undergo. When the tooth gets loose, there may be a general horizontal loss of supporting bone around the teeth – periodontal pockets.
6. Bony ridges - Instead of losing bone support - some people actually develop "extra" bone to support the teeth. These appear as bony ridges that can be seen and felt on the jawbones as a smooth raised area about at the level of the roots.
7. Cheek irritation – The formation of a ridge or line of toughened tissue on the inside of the cheek where the teeth come together will often cause cheek irritation. It is normal for people to actually bite themselves along this line – which is most common in the most posterior molar area.
8. Sore jaw muscles – Occur especially in the cheek and temple area when these two muscles are overused, as with teeth grinding throughout the night.
9. TMJ problems - Is related to jaw joint pain and sore jaw muscles. In severe cases, the jaw joint may become overloaded and the resulting problem may lead to the need for surgical intervention.

If you suspect that you have bruxism – i.e. you feel that you have some of the above signs/symptoms of the disorder, or you have been told that you grind your teeth while sleeping – you can have a test performed that looks for evidence of jaw muscle activity during the sleep period and the absence of abnormal movement during sleep.  Whatever the case, earlier diagnosis of the problem will minimize long-term damage to the teeth and jaws.

What treament options do I have for clenching?

Currently, the most common treatment against bruxism is a custom-made mouth-guard that is worn during your sleep to prevent unconscious teeth grinding. Your dentist can make you this mouth-guard that fits over your lower set of teeth and prevents the two sets of teeth from grinding against each other.

Sierra Studio - Sensitive Teeth

Many of us say we have "sensitive teeth." We usually mean that we feel twinges of pain or discomfort in our teeth in certain situations, including:

• Drinking or eating cold things
• Drinking or eating hot things
• Eating sweets
• Touching the teeth with other teeth or the tongue

There are two types of tooth sensitivity:

Dentinal sensitivity occurs when the dentin (middle layer) of a tooth is exposed. Normally, the dentin is covered by enamel above the gumline and by cementum below the gumline. Dentin is made up of tiny openings called tubules. Inside each tubule lies a nerve branch that comes from the tooth's pulp (the center of the tooth). When the dentin is exposed, cold or hot temperature or pressure can affect these nerve branches. This causes sensitivity.

Dentinal sensitivity can affect one or more teeth. Dentinal sensitivity occurs when the outer protective layers of enamel or cementum are removed, exposing the dentin. Some causes of dentin exposure include:

• Brushing your teeth too hard. This wears away the enamel layer.
• Poor oral hygiene. This may allow tartar to build up at the gum line, leaching minerals from the tooth.
• Long-term tooth wear
• Untreated cavities
• An old filling with a crack or leak
• Receding gums that expose the tooth's roots. Receding gums often are caused by periodontal diseases or by brushing too hard.
• Gum surgery that exposes a tooth's roots
• Excessive tooth whitening in people who have tooth roots that already are exposed
• Frequently eating acidic foods or drinking acidic beverages

Pulpal sensitivity is a reaction of the tooth's pulp. The pulp is a mass of blood vessels and nerves in the center of each tooth. Pulpal sensitivity tends to affect only a single tooth. Causes include:

• Decay or infection
• A recent filling
• Excessive pressure from clenching or grinding
• A cracked or broken tooth

If you experience a sharp pain upon biting, you may have a cracked tooth or a broken or cracked filling.

Both dentinal and pulpal sensitivity usually involve reactions to temperature or pressure. Sensitivity to cold drinks or foods is the most common symptom. Less often, the teeth are sensitive to hot temperatures. If a single tooth changes from cold sensitivity to hot sensitivity, the tooth's nerve may be dying. In this case, root canal treatment is necessary.

A Sierra dentist will look at your dental history and will examine your mouth. He or she will ask about your oral habits. Grinding or clenching your teeth can contribute to sensitivity. They will also will look for decay, deep metal fillings and exposed root surfaces.

A tooth may be sensitive to cold for several weeks after a filling is placed. The metals in amalgam (silver) conduct the cold very well, transmitting it to the pulp. Bonded (tooth-colored) fillings require etching the tooth with acid before the filling is placed. In some cases, this etching removes enough enamel to make the tooth sensitive. However, advances in bonding now make it less likely to cause tooth sensitivity.

Reducing Dentinal sensitivity — You might be able to reduce your chances of dentinal sensitivity by:

• Brushing twice a day and flossing daily
• Using a soft or ultrasoft toothbrush and brushing gently up and down, rather than side to side
• Using a fluoride toothpaste and mouth rinse
• Using a toothpaste that has the American Dental Association (ADA) Seal of Approval and provides protection against sensitivity
• Getting treatment for grinding or clenching your teeth (bruxism

Reducing Pulpal sensitivity — If a tooth needs root canal treatment, there is no good way to prevent pulpal sensitivity other than to get the needed treatment. Delaying root canal treatment may result in further problems and is not recommended.