Issue 12.14
Most people are unaware if they grind their teeth until the teeth are quite worn down. The outer enamel coating of teeth is the hardest substance in the body—so hard that a dentist must use a diamond bur just to cut it. Unfortunately, there is only so much of it and once it is worn away it is gone forever. Think of a tooth as an m&m with a hard outer shell and a soft center. When the protective enamel is gone the soft yellow dentin inside begins to show through and cavities can develop more easily. Also, an unbalanced bite can develop leading to accelerated wear and breakdown in the supporting structures of the teeth or jaw joints or TMJ.
Most people that have bruxism (technical term for tooth grinding) do so at night. This is difficult to stop and the usual management is to wear a plastic protective guard that can be remade inexpensively when it wears out. The guard doesn’t cure the grinding, but it can reduce the destructive effects. Daytime clenching, on the other hand, is treatable if the person is made aware of their habit. Even nail biting or playing certain musical instruments can cause abnormal posturing and result in tooth wear.
There a growing body of evidence that bruxism can be related to sleep apnea and the release of cortisol in the central nervous system with a similar subconscious addictive effect as endorphin release. Tooth wear can become extreme when harsh conditions exist such as stomach acid reflux or bulimia, over vigorous tooth brushing, smokeless tobacco use, or breathing in dust or other gritty particles. This is especially true for teeth that are “genetically soft.”
If you are unsure if you grind your teeth at night an electrode patch can be placed on your cheeks at night which counts the number muscle activities. If the damage is already done, teeth can be restored back to their original beauty and health using bonding, veneers, or crowns.
Dr Andrus is a member of the American College of Prosthodontists—the specialty recognized by the ADA for the restoration and replacement of teeth.