Teeth grinding is one childhood habit that sounds worse than it usually is: often the most harm done is to your night’s sleep. That said, though, it’s still a habit to keep your eye on.
Also known as bruxism, teeth grinding is so common among children that it’s considered normal behavior by many healthcare professionals. As for causes, some suggest a child’s immature neuromuscular chewing control may trigger it, while others point to the change from deeper sleep to a lighter stage as a possible cause. Problems like airway obstruction, medications or stress also seem to contribute to the habit.
For most children, teeth grinding usually fades by age 11 with no adverse effect on their teeth. If the habit extends into adolescence, however, there’s an increased risk for damage, mainly tooth wear.
This can happen because grinding often produces chewing forces 20-30 times greater than normal. Over time this can cause the biting surfaces of the teeth to wear and reduces the size of the teeth. While teeth normally wear over a lifetime, accelerated wear can pose a significant health risk to your teeth. Any sign of tooth wear in a child or adolescent is definitely cause for concern.
If your child’s tooth grinding habit appears to be developing into a problem, your dentist may recommend a few treatment options. The most common is a thin, plastic night guard worn in the mouth during sleep that prevents the upper and lower teeth from making contact. If the suspected cause is airway obstruction, they may refer you to an ear, nose and throat (ENT) specialist to seek treatment for that, as well as other professionals to help with managing stress or medications.
Like thumb sucking, the habit of teeth grinding usually ends with no permanent ill effects. But if you notice it continuing late into childhood or your dentist finds tooth wear or other problems, take action to avoid problems long-term.
If you would like more information on childhood bruxism, 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 “When Children Grind their Teeth.”
All treatments for periodontal (gum) disease focus on one goal — to remove any bacterial plaque and calculus (hardened plaque deposits) that are at the heart of the infection. Plaque is a thin surface film of food particles and bacteria that cause gum disease.
Plaque builds up on tooth surfaces due to inadequate oral hygiene. And as the disease progresses brushing and flossing won’t be enough — you’ll need our services and specialized equipment to fully remove the plaque and calculus. The basic technique is called scaling in which we remove plaque and calculus manually from tooth surfaces above and just a few millimeters below the gum line.
As the disease develops, though, the slight natural gap between teeth and gums may begin to increase to form voids known as periodontal pockets. Filled with infection, these pockets can extend below the gum line onto the roots of the tooth. If the pocket extends more than 4 millimeters, basic scaling may not be able to remove all of the plaque and calculus.
Periodontists (dentists who specialize in the treatment and care of gum tissues) can perform a surgical method to access these deeper areas. Known as flap surgery, this procedure aims not only to reach and disinfect periodontal pockets and root surfaces, but also repair damaged gum tissue and create a better environment for future hygiene and treatment.
As the name implies, we create an opening in the gum tissue with one side remaining attached to the gum structure — much like the flap of a paper envelope. Through this opening we’re able to reach areas to remove plaque and calculus, as well as install both bone grafts to regenerate lost bone and growth factors to stimulate tissue growth. Once finished, we stitch the flap back into place with sutures and, in many cases, place a moldable dressing to protect and hold the flap secure while the incision heals.
This relatively minor procedure can be performed with local anesthesia and requires only a few days of recuperation. The results, though, can provide long-term benefits — reduced infection, better bone and gum health, and a more conducive environment for future maintenance of health — that could save your teeth and your smile for many years to come.
If you would like more information on treatments for gum disease, 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 “Periodontal Flap Surgery.”
There are a number of ways to improve unsightly teeth. You can, of course, replace them with dental implants — but not if they're still viable. You can crown them: however, you'll have to significantly reduce their structure for the crowns to fit over them.
There is another less invasive option for teeth with mild to moderate imperfections — you can cover them with porcelain veneers. As the name implies, a veneer is a thin covering of dental porcelain bonded to the outside surface of a tooth. They literally put a “new face” on chipped, stained or slightly gapped teeth.
You'll first need a dental examination to ensure your teeth are reasonably healthy and that you don't have any significant dental problems that could interfere with the veneers. We can then design your veneers' shape and color to achieve the look you desire. We can also create a temporary “trial smile” with acrylic replicas of your proposed veneers to give you a realistic impression of your future smile.
The next step is the possibility the teeth need to be prepared for the veneers. Although quite thin, veneers can still make the teeth look larger or bulky. To compensate, we remove some of the tooth enamel. Although much less than for a crown, this alteration is still permanent: your teeth will need some form of restoration from now on. There are also “no-prep” veneers, which require no tooth surface reduction.Â Ask us if this is an option.
We then make an impression of the teeth, which with other information will guide a technician at a dental laboratory to manually create your new veneers. This can take several weeks and requires a high degree of artistry to produce a custom product that will match your teeth.
Once they've arrived, we'll use a permanent bonding process to precisely attach them to your teeth.Â It will then be up to you to care for your veneers, especially not biting down on anything hard that could chip or crack them. You should also maintain regular dental visits and proper oral hygiene to keep your smile as bright and attractive as possible.
Although small in size, veneers can make a big impression. They can restore the smile you once had — or give you the look you've always wanted.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
Sometimes dental conditions point to health problems beyond the teeth and gums. An astute dentist may even be able to discern that a person’s oral problems actually arise from issues with their emotional well-being.Â In fact, a visit to the dentist could uncover the presence of two of the most prominent eating disorders, bulimia nervosa or anorexia nervosa.
Here are 3 signs dentists look for that may indicate an eating disorder.
Dental Erosion. Ninety percent of patients with bulimia and twenty percent with anorexia have some form of enamel erosion. This occurs because stomach acid — which can soften and erode enamel — enters the mouth during self-induced vomiting (purging), a prominent behavior with bulimics and somewhat with anorexics. This erosion looks different from other causes because the tongue rests against the back of the bottom teeth during vomiting, shielding them from much of the stomach acid. As a result, erosion is usually more severe on the upper front teeth, particularly on the tongue side and biting edges.
Enlarged Salivary Glands. A person induces vomiting during purging by using their fingers or other objects. This irritates soft tissues in the back of the throat like the salivary glands and causes them to swell. A dentist or hygienist may notice redness on the inside of the throat or puffiness on the outside of the face just below the ears.
Over-Aggressive Brushing. Bulimics are acutely aware of their appearance and often practice diligent hygiene habits. This includes brushing the teeth, especially after a purging episode. In doing so they may become too aggressive and, coupled with brushing right after purging when the minerals in enamel are softened, cause even greater erosion.
Uncovering a family member’s eating disorder can be stressful for all involved. In the long run, it’s best to seek out professional help and guidance — a good place to start is the National Eating Disorders Association (www.nationaleatingdisorders.org). While you’re seeking help, you can also minimize dental damage by encouraging the person to rinse with water (or a little baking soda) after purging to neutralize any acid in the mouth, as well as avoid brushing for an hour.
If you would like more information on the effect of eating disorders on oral health, 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 “Bulimia, Anorexia & Oral Health.”
Your teenager is about to take a big step toward better health and a more attractive appearance — orthodontic treatment. You both know the benefits: better chewing function, lower risk of dental disease, and, of course, a straighter and more beautiful smile.
But your teen might also dread the next couple of years of wearing braces. And it's hard to blame them: although they're effective, wearing braces restricts eating certain snacks and foods, they require extra time and effort for brushing and flossing, and they're often uncomfortable to wear. And of high importance to a teenager, they may feel embarrassed to wear them.
But over the last couple of decades a braces alternative has emerged: clear aligners. This form of bite correction requires fewer food restrictions, allows greater ease in hygiene, and is considered more attractive than braces. In fact, most observers won't notice them when a wearer smiles.
Clear aligners are a series of clear plastic trays created by computer that are worn in a certain sequence. During wear each tray exerts pressure on the teeth to gradually move them in the desired direction. The patient wears a single tray for two weeks and then changes to the next tray in the sequence, which will be slightly different than the previous tray. At the end of the process, the teeth will have been moved to their new positions.
Clear aligners aren't appropriate for all bite problems. When they are, though, they offer a couple of advantages over braces. Unlike braces, a wearer can remove the aligner to brush and floss their teeth or for rare, special or important social occasions. And, of course, their appearance makes them less likely to cause embarrassment while wearing them.
In recent years, design improvements have increased the kinds of bites aligners can be used to correct. For example, they now often include “power ridges,” tiny features that precisely control the amount and direction of pressure applied to the teeth. They've also become thinner and more comfortable to wear.
If you're interested in clear aligners as a treatment option, talk with your orthodontist about whether your teen is a good candidate. If so, they could make orthodontic treatment for achieving a more attractive and healthy smile less of an ordeal.
If you would like more information on clear aligners as an orthodontic option, 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 “Clear Aligners for Teens.”
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