Posts for: September, 2014

By Randall J. Bartoe, DDS, PLC
September 24, 2014
Category: Oral Health
Tags: tooth wear  
DealingWithTeethGrindingHabitsBothShort-TermandLong-Term

You may not realize it, but the simple act of eating can generate a tremendous amount of force on teeth and jaws. Fortunately, your teeth can absorb much of this biting force — but within limits. If the force exceeds normal limits on a continual basis, you may begin to notice aching teeth or sore jaws, and we may begin to notice unusual tooth wear during your dental checkups.

The most common cause for this is a chronic habit of grinding or clenching the teeth, also known as bruxism. It can manifest itself by teeth grinding against each other, teeth pressing against soft tissue (as with thumb-sucking) or biting or chewing on hard objects such as pencils or nails. We commonly see bruxism with patients who are experiencing excessive stress, sleep-related problems or as a result of lifestyle habits such as smoking or excessive alcohol consumption. You may not even be consciously aware of it as in the case of bruxism that occurs while you sleep, but your sore jaws in the morning (as well as your sleeping partner’s complaints of noise) may be evidence of it.

Treatment involves a two-part approach. First, we want to relieve the pain symptoms and stop the damage. To relieve pain we’ll often prescribe mild, anti-inflammatory or muscle-relaxant drugs, or perhaps medication to help you sleep better. We may also design a bite guard for wear on your upper teeth at night: the lower teeth will tend to glide or skate on the wear-resistant plastic and prevents them from placing excessive forces on your teeth.

The other part is to address the underlying cause for long-term results. If the habit arises from severe stress or other lifestyle issues, we may recommend biofeedback therapy or psychotherapy to improve your coping mechanisms. If an abnormality like a bad bite (malocclusion) is an underlying factor, we may recommend a minor bite adjustment by reshaping the teeth to lessen the bite impact.

The right course of action depends on a thorough dental examination to determine the exact nature of your clenching or grinding habit. From there we can discuss your options on how to relieve the soreness and pain, as well as prevent problems in the future.

If you would like more information on bruxism and its effects, 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 “Stress & Tooth Habits.”


By Randall J. Bartoe, DDS, PLC
September 09, 2014
Category: Dental Procedures
ActorEdHelmsTooth-YankingTrickItWasaDentalImplant

The lengths that some comedians will go to for a laugh! Actor Ed Helms, as dentist Stu Price, pulled out his own tooth in the movie The Hangover. Or did he? Turns out Helms really is missing a tooth, which never grew in. When he was in his late teens, he received a dental implant to make his smile look completely natural.

Helms told People magazine he wasn't exactly eager to remove the implant crown that had served him so well for almost 20 years, but there was no better way to do the famous tooth-pulling scene.

“We started to do different tests with prosthetics and blacking it out and nothing worked,” Helms told the magazine. Helms' dentist said it would be okay to take the implant crown out. “My dentist was really into it,” Helms said. The rest is movie history!

Congenitally missing (“con” – together with; “genital” – relating to birth) teeth are inherited and actually quite common. More than 20% of people lack one or more wisdom teeth, for example. These would not usually be replaced if missing (in fact, wisdom teeth are often removed) but it's a more serious issue when the missing tooth is in the front of the mouth — and not just for aesthetic reasons.

When a particular type of tooth is missing, it disrupts the pattern and function of the teeth. If left alone, sometimes the existing teeth will shift to close the gap. It's like removing a brick from an arch — the rest of the bricks would fall together in a different formation (or collapse entirely). And when upper and lower teeth don't come together properly, they can't function well.

The best treatment for this type of situation is the one Ed Helms had: a dental implant. They look and function like real teeth and do not attach to or damage adjacent teeth as other tooth-replacement options might.

It is important that a child with a congenitally missing tooth wait until jaw growth is complete — different for every person but usually in the late teens — before getting an implant. Otherwise, the artificial tooth might eventually appear too short when the person has stopped growing. In the meantime, there are temporary tooth replacements that can be made.

If you would like more information about options for congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.” Dear Doctor also has more on “Teenagers & Dental Implants.”