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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)!
We are saving more teeth these days through gum treatments, root canals, and better patient awareness. As such, with more teeth in patient’s mouths than we saw 20 years ago, we are finding more wear on the teeth. The wear is not simply a sign of age, it is an indication of other conditions.
Wear has three causes, and it is important for the dental team to identify which of the three causes has affected your teeth, because the treatments will differ. (See my website for more dental information)
The three causes are:
1. Attrition – which is true tooth-to-tooth grinding.
2. Erosion – which causes tooth wear by demineralizing the tooth structure with acid and demineralized tooth areas getting rubbed away.
3. Abrasion – which is when a person aggressively brushes his or her teeth over a period of time and that abrades portions of the teeth. Another abrasion cause is when older over-contoured porcelain crowns abrade the opposing teeth, wearing them away.
Prevention should serve as a lifestyle pattern for total health, not the least of which is dental health. Prevention in dentistry leads to improved long-term oral health and reduced dental costs. It encourages a bright smile, fresh breath, and an overall good feeling of personal security. Prevention is your insurance policy toward a healthier, pain-free, debt free lifestyle.
Our dental hygienists can provide an excellent service to assist you in the maintenance of your overall dental health. Your cooperation with her can serve to increase your knowledge of your present oral condition. When you keep your appointment with your hygienist, the following benefits will result:
* Your hygienist will customize a personal home care and preventive maintenance program for you and inform you of those dental products that are appropriate for your particular needs. You will be instructed in the proper methods of tooth brushing, flossing and adjunctive dental health devices.
* Your entire mouth will be thoroughly and carefully examined for gum disease, growths, lesions, and any abnormalities that would affect your general health.
* Your teeth will be cleaned and polished to remove plaque and tartar both above and below the gum line, eliminating bacteria that lead to cavities, bad breath, and gum disease.
* Fluoride will be applied to teeth to prevent decay (for children), and root sensitivity / root cavities for adults.
* Sealants can be easily applied to the chewing surfaces of children’s teeth as a protection against future decay.
For our periodontal maintenance patients, your hygienist will use her specialized cleaning instrument, the Cavitron, to not only remove tartar, but also flush bacteria and debris from the periodontal pockets. She will also irrigate and medicate those same pockets with Chlorohexidine Gluconate.
Dental disease is a silent invader, presenting itself in various forms (puffy, bleeding gums, cavities, oral cancer, and abscesses). Although your mouth may appear to be in good health at this time, stresses, body changes, life changes, medications, illness, and age can tax your immune system. Maintaining regular re-care appointments with your hygienist and follow-ups with Dr. Briscoe offer you the assurance that any problems in regard to your oral care will be addressed immediately.
Taking care of tomorrow’s problems today will give you tremendous peace of mind. If you have postponed or missed your last hygiene maintenance appointment, remember: it’s not just a cleaning, it’s an INVESTMENT in your overall health.
Home Care Instructions:
1. Floss twice a day (morning and night). Wrap the dental floss around your middle finger and guide the floss with your index fingers and/or your thumbs as instructed in a “C” shape and scrap up and down.
2. Brush three times a day (morning, lunch, and bedtime). Hold the toothbrush at a 45 degree angle toward the gum line and direct the toothbrush under the gums using a small circular stroke. DO NOT RUSH! Spend 3 to 5 minutes brushing. Dry brushing is fine if it is more convenient. Rinse with water and expectorate.
3. Rubber tip one or two times a day. Using the tip of the stimulator, trace around the gum line of the teeth. Place the rubber tip between the teeth from the inside and outside surfaces and use gentle pressure to massage the gum tissue.
4. Proxabrush one or two times a day if recommended by your dental hygienist. Work the brush between open spaces and around bridgework.
5. If using a water pik, fill the tank with warm water and use medium speed directing the water at the right angle to the long axis of the tooth (never angle the waterjet down into the gum tissue). If you have a heart murmur, heart disease, or an artificial joint, check with your physician before using a water jet device.
6. Use fluoride rinses or desensitizing toothpastes daily if recommended.
For more information visit my website at www.lajolladental.com
Gingivitis is inflammation of the gums caused by the prolonged presence of plaque and tartar on the teeth. The gums become red, puffy and swollen. Gingivitis is a mild form of gum disease that can be reversed with professional dental cleanings by our hygienist and daily brushing and flossing. The gums may bleed during the cleaning and initially when flossing. Gingivitis can be reversed (the inflammation eliminated) because it does not involve bone loss or gum recession.
When the gums are not treated (the person may be brushing but not flossing) the inflammation increases to a point in becomes periodontitis. Here, the plaque builds up below the gums forming pockets. The body’s natural immune system creates enzymes that fight the bacterial toxins within the pockets, but mechanical removal of the plaque and tartar are essential. Left untreated, with time the pockets become deeper, bone loss around the teeth occurs, and the gums recede. Sooner or later the teeth become loose.
