Treatment for Bruxism

To minimize and control attrition (tooth-tooth wear) we need to keep the teeth apart during sleeping hours and create a daytime bite that is comfortable and well balanced.
For nighttime control of attrition a night guard (also called occlusal guard, biteguard, or splint) can be used. They are custom-made hard acrylic mouth pieces fabricated to order by the dental office. They can be made to fit over the upper or lower teeth, can cover two teeth or all the teeth in that arch. In extreme cases, they can also be worn during the day. Without the mouthpiece in place, the teeth worn by attrition will continue their destructive process.
To overcome this, an individualized treatment plan is indicated. The plan must realign the biting position of the upper and lower jaws to be in harmony with each other, with the muscles, and with the jaw joints. To accomplish this, we take impressions for study models as well as wax registrations to determine the best course of treatment. The more common treatments include bite adjustment, restoring the worn teeth, orthodontics to realign the upper and lower teeth, jaw surgery to reposition and realign the two arches, joint surgery, or a combination of several of these. The most common treatment in our office is bite adjustment and restoration of some or all of the teeth. Orthodontics is another common treatment. (For more dental information, see my website at www.lajolladental.com)
It is important to note, many dentists don’t understand attrition and how to realign the upper and lower arches and restore the teeth in harmony with each other, with the muscles, and with the jaw joints. Too many crowns get placed on worn teeth without correcting the cause of the attrition. No surprise, then, the wear continues on the new crown(s)!

Periodontal Disease is a Silent Disease

Knowing all that we know about Periodontal Disease (PD), how is it that 75-80% of us are affected by it?
Periodontal Disease is a silent disease in that it does not hurt (until advanced stages) and can go undetected in its earliest stage. Too often, people don’t go to the dentist regularly and start to build up plaque between their teeth. If the person is not a flosser, the plaque starts to accumulate more and more between their teeth. The once healthy gums, pink and firm around each tooth, now start to become inflamed between the back teeth where the plaque is building up. With gingivitis now established, the bacteria residing in the plaque produce toxins that start to break down the attachment of the gums to the teeth. The body’s inflammatory response is to bring increased amounts of blood to those areas to fight off the toxins. The gums become puffy, tender and swollen, and can bleed easily with brushing and flossing (not likely any flossing is occurring in this person).
A cleaning at the dental office at this point could start to turn things around. Flossing and brushing would go a long way toward health. Of course, this person doesn’t have any pain, and is unaware of this situation.
Periodontitis sets in as the plaque by-products, the toxins, destroy the tissues that hold the teeth in the bone. The attachment of the gum to the root surfaces start to be destroyed and pockets develop between the gum and the teeth. The gums pull away from the teeth and recede. More plaque is now accumulating below the gum line in these pockets. Some of the plaque on the root surfaces is hardening into tartar. Like the barnacles forming on the piers at the ocean, the tartar is rough and more plaque sticks to the rough surfaces and become hardened. As the disease progresses, bone under the gums that anchors the teeth begins to dissolve away. The person may notice an unpleasant odor coming from their mouth – bad breath. The gums may bleed when brushing. At this point, with less bone anchoring the teeth and less gum tissue covering the roots, the teeth appear longer and are sensitive to cold and are more susceptible to decay.
In advanced periodontitis, the toxins deep in the pockets continue to destroy the periodontal ligaments and bone, causing the teeth to lose more support. Unless treated, the affected teeth become more mobile and may fall out.
The key, is to not let this all get started. Should you find yourself progressing down the path described above, work hard on brushing and flossing and get into the dental office for evaluation and necessary treatment. You do not have to lose teeth to periodontal disease!

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Periodontal Disease and Cardiovascular Disease

Cardiovascular disease kills more Americans each year than cancer. Most people are aware that lifestyle choices such as quitting smoking, eating right, and getting enough exercise can lessen one’s risk of cardiovascular disease. But, what most may not know, is that by just brushing and flossing their teeth each day, they can also prevent this potentially lethal condition.
Periodontal patients whose bodies show evidence of a reaction to the bacteria associated with periodontitis (gum disease) may have an increased risk of developing cardiovascular disease, according to the Journal of Periodontology (December 2007). Thus, it is important to understand that simple activities like brushing and flossing your teeth everyday, and periodic professional cleanings at the dental office can help lower your risk to cardiovascular disease and other conditions.

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