Tooth Wear & Fracture
Do you have a history of fillings and teeth wearing or breaking? Or is your smile being affected by ragged incisal edges and shortening of your teeth?
If so, the answer is likely to be that you are unconsciously grinding or clenching your teeth.
Often people are not aware that this is occurring as it can happen while a person is asleep. People also often grind when awake but have been doing it for so long that they are not even aware of it. It is not uncommon for us to identify that parafunctional stresses have been placed on teeth for quite some time. After their attention has been drawn to the clinical evidence through the use of clinical photography of the teeth, these patients often report back being more aware of this habit and often find their jaws clenched.
Why am I doing it?
It is thought to be a sleep disorder and certainly we see it across generations in families. But also it can occur more severely in times of stress, both physical and psychological. It can be exacerbated by an abnormal bite.
Signs to look out for include:
- Tooth wear
- Tooth breakage
- Sensitive teeth
- Loose teeth
- Jaw pain or jaw clicking.
We often recommend wearing a night guard that is very effective at reducing the above symptoms. We provide out patients with a full hard acrylic mouthguard generally to the top teeth. We generally use the Mini Fm fabricated at Sleepwise Dental Laboratory, Melbourne.
We also commonly refer our patients to our local physiotherapist who can give symptomatic relief and help with strategies to improve symptoms.
Without prevention, the habitual grinding or clenching of teeth can lead to increase failure of teeth and restorations as well as wear of the front teeth with an unaesthetic smile.
Case Study - Full mouth rehabilitation
Full mouth rehabilitation with Implant supported crown and bridges and ceramic veneers to restore aesthetics. This patient presented quite distressed, unhappy with her smile and had also lost the ability to chew food…
Case Study - Resin Veneers
When this patient initially visited our practice, she was diagnosed with Bruxism, which is a condition where the patient grinds their teeth at night and during the day. This patient only had her front teeth remaining as she lost her back teeth for various reasons over the years.
A common problem that we have to deal with here at Contemporary Smiles is the fracture of restorations and of teeth and with cracked tooth syndrome.
With the general improvement in the oral health of our patients with lower levels of decay and periodontal disease compared to previous generations, teeth are lasting longer in the mouth. This is presenting a different set of challenges.
When a restoration is placed in a tooth, the integrity of that tooth has been fundamentally compromised. With repeated use over years and much more so in people who grind or clench their teeth, this can lead to fracture of teeth and restorations. We also can find cracks radiating from teeth. This tends to happen more frequently in teeth with old amalgam fillings.
In cracked tooth syndrome, patients can attend with discomfort to chewing especially hard foods or when the dentist does a bite test there is discomfort to biting and release of pressure.
If left untreated these cracks can migrate towards the root and pulp of the tooth that cause the loss of this tooth.
We strongly recommend that a full occlusal coverage, indirect ceramic restoration in these situations is necessary in order to prevent this eventuality. Thankfully here at Contemporary Smiles with the use of our CEREC Ceramic machine, we can fabricate durable, aesthetic and conservative restorations in one visit. The introduction of this has revolutionized the way we do dentistry resulting in superior outcomes for our patients.
Case Study - Cracked Teeth
A lady presented with pain to chewing in 2012 on her lower left second molar. This tooth had been restored when she was a teenager with amalgam…
Erosion is the wear of teeth by acid. This acid comes from either dietary habits or from the gut and has different wear patterns.
If you suffer from heartburn or regurgitate a lot of acid, which is common during pregnancy, this wears the inner surface of the tooth. The tooth progressively thins out. Sometimes people notice that their teeth feel thinner and are more translucent.
Often the incisal edge of front teeth can fracture off due to years of gradual weakening. Left unchecked this condition can also have long-term detrimental impacts on the lining of your throat and can lead to more serious conditions, such as cancer.
We strongly recommend our patients who show this type of wear to see their GP or a specialist Gastroenterologist for diagnosis and treatment.
Some simple tips to reduce tooth erosion are:
Avoid foods and drinks that cause reflux, such as alcohol
Use high Fluoride toothpaste or the use of whitening trays at night with Fluoride gel inside the tray.
In more severe cases we place resin or ceramic veneers to protect the teeth from further wear and to reinforce the tooth to prevent fracture.
Wear from dietary acids present differently and generally affect the outer surface of the teeth.
Citrus fruit, sugary drinks even carbonated water all are culprits in causing this type of damage. As previously mentioned, if habits aren’t changed, further deterioration may occur.