Jared W. Hemmert, D.D.S., P.C.
312 North Main Street
Spanish Fork, UT 84660
801-794-9684
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Teeth grinding during sleep is usually involuntary, and often times an individual suffering from the condition will not know until the symptoms are present or until a dental checkup. Also known medically as bruxism, this condition involves the constant grinding, gnashing or clenching of the teeth. While mild cases may not require treatment, more serious cases can lead to future dental complications if left untreated. Be sure to have regular dental checkups to catch and treat teeth grinding symptoms.
Causes
There are many different reasons why bruxism occurs, and it may be different for everyone. Even doctors today cannot determine the exact cause of teeth grinding. Some of the more universal causes for bruxism include:
- Unresolved anxiety, stress, tension or fear
- Suppressed anger or frustration
- An aggressive, competitive, hyperactive personality
- Abnormal sleep problems or habits
- Misalignment of upper and lower teeth
- Crooked or missing teeth
- In children, response to pain from teething or an earache
- Complications or side effect of other medical diseases, such as Huntington’s disease or Parkinson’s disease
- Side effects of other medication, such as antidepressants
Symptoms
Since teeth grinding often happens during sleep, it is common that a person will not know if he or she is suffering from bruxism until a dentist is consulted. Below are some signs and symptoms that may indicate teeth grinding while sleeping
- Continuous dull headaches
- Sore or painful jaw
- Heightened teeth sensitivity to cold, hot, sweet, or sour foods
- Loose and/or fractured teeth with unknown reasons
- Stress or insomnia
- Earaches (as the jaw bone is close to the ear canal)
- Chronic facial pain
- Damage on the inside of the cheeks or tongue from chewing
- Worn tooth enamel
One guaranteed way is to ask your sleep partner or family members to observe your sleep habits. If they can detect a crunching, grinding or clicking sound during your sleep, you are most likely grinding your teeth. If bruxism is left untreated, your jaw joint and bones may become damaged in the long run due to constant wear and tear. It is also unhealthy for your teeth, as they can fracture or wear down. Untreated teeth grinding can feel extremely uncomfortable and annoying.
YEARS OF UNTREATED BRUXISM
RECONSTRUCTIVE DENTISTRY (CROWNS)
Prevention
There are several steps that can be taken to maximize prevention of teeth grinding during sleep:
- Reduce stress: since stress, fear, and anxiety is a common culprit in teeth grinding, stress reduction may help prevent future episodes of bruxism. Try yoga, meditation or talking to a family member for stress management.
- Avoid stimulants at night: stimulants, such as caffeine, alcohol and smoking, may impede the body from properly relaxing. For sensitive individuals, bright lights, television, and computer screens can also be stimulants. Be sure to properly “cool down” an hour before bed by dimming the lights and relaxing to help avoid teeth grinding.
- Visit your dentist regularly: your dentist will be the most effective person to determine whether or not you suffer from bruxism, as he or she can see the wear and tear effects.
Treatment
While most children outgrow bruxism, it can be a nuisance for adult sufferers. There are several ways to relieve teeth grinding:
- Mouth guards: the most common way to relieve teeth grinding is to wear a mouth guard during sleep. Mouth guards can be easily obtained at the local drug store, or your dentist can also fit you with a customized mouth guard for a more comfortable fit.
- Stress relief: if your bruxism is caused by stress, fear or anxiety, you may find relief through stress management therapy. Exercise, meditation, physical therapy, relaxation techniques or professional counseling can be effective methods to help against teeth grinding due to stress.
- Dental work: if the teeth grinding is associated with dental problems, such as crooked or missing teeth, bruxism may be lessened by fixing such problems. Sometimes, tooth crowns, braces or splints may be used to aid reconstructive dental work.
- Biofeedback therapy: if teeth grinding is of a behavioral nature or is habit-based, biofeedback therapy can be helpful. Biofeedback is characterized by a combination of alternative medicine and monitoring procedures that teaches and regulates involuntary responses. Sometimes, machines and equipment can also be used.
- Medication: although not commonly used, sometimes doctors may choose to prescribe muscle relaxants for the patient to take before sleeping. If teeth grinding is a side effect of a prior medication, the doctor may also change the drug therapy to alleviate bruxism.
Sources:
New "massage method" quadruples protection against tooth decay
25 March 2012 University of Gothenburg
Do you really want to avoid cavities in your teeth? Try massaging them with a high-fluoride toothpaste after lunch. “Rubbing toothpaste onto your teeth increases the fluoride protection by 400%,” says Anna Nordström, dentist, PhD and researcher at the Sahlgrenska Academy at the University of Gothenburg, Sweden.
Eight years ago a new brand of toothpaste was launched in Sweden with more than three times as much fluoride as standard toothpaste. Available without prescription, it is aimed primarily at those with high caries risk.
First scientific evaluation
Researchers at the University of Gothenburg’s Sahlgrenska Academy have now performed the first scientific evaluation of the effect of this so called “high-fluoride toothpaste”. The study has resulted in a new method that quadruples the level of protection from fluoride.
Four times better protection
In the study, 16 volunteers tested a variety of brushing techniques, using either high-fluoride or standard toothpaste, and brushing either two or three times a day.
“The study revealed that those who used a high-fluoride toothpaste three times a day had four times better fluoride protection in the mouth than those who used standard toothpaste twice a day,” says researcher Anna Nordström from the Institute of Odontology at the Sahlgrenska Academy.
Rub your teeth after lunch
Also tested was a new method developed in collaboration with professor Dowen Birkhed, which involves rubbing toothpaste onto your teeth with a finger.
“This ‘massage’ method proved to be at least as effective as a third brushing in increasing the amount of fluoride in the mouth,” Anna Nordström explains. “Rubbing the front of your teeth with toothpaste can be an easy way of giving your teeth a third “shot” of fluoride during the day, after lunch for example. But this should not replace brushing with a fluoride toothpaste morning and evening – it’s an extra.”
Daily use is essential
Brushing with fluoride toothpaste has played – and continues to play – a major role in combating tooth decay, and there is strong scientific evidence that daily use of fluoride toothpaste has a pronounced preventive effect.
The study Effect of a third application of toothpaste (1450 and 5000 ppm F), including a “massage” method, on fluoride retention and pH drop in plaque was published in Acta Odontologica Scandinavia.
Link to article: http://www.ncbi.nlm.nih.gov/pubmed/22320714
THE RESEARCHER´S TOP TIPS
• Use toothpaste at least twice a day, after breakfast and before going to bed.
• If necessary, brush a third time or rub on some toothpaste instead.
• If you have problems with cavities, choose a toothpaste with a higher fluoride content.
• Avoid rinsing out the toothpaste with water.
http://www.ncbi.nlm.nih.gov/pubmed/22320714
Full bibliographic information
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Journal: Acta Odontol Scand. 2012 Feb 9. [Epub ahead of print] Title: Effect of a third application of toothpastes (1450 and 5000 ppm F), including a 'massage' method on fluoride retention and pH drop in plaque.
Authors:Nordström A, Birkhed D.
Canker Sores - What Are Canker Sores?
Definition:
Many people often wonder exactly what are canker sores?
Canker sores, also known as Aphthous Ulcers, are small lesions that occur inside the mouth, and are not contagious.
Symptoms
One to two days before appearing, a burning or tingling sensation may be present in the area of the mouth where the lesion is developing. Rarely, a fever might present itself when developing a canker sore.Canker sores appear inside the mouth as round or oval sores typically with a red border and yellow or white center. Canker sores typically develop:
- On the top surface of the tongue and the tip of the tongue
- Underneath the tongue, on the floor of the mouth
- The inside of the cheek and lip
- On the gum tissue
Canker sores do not develop on the external surfaces of the lips and are not to be confused with coldsores.
Types of Canker Sores
Canker sores may be classified as:
- Minor - Although painful, minor canker sores are often fully healed within two weeks after onset. The size of a minor canker sore varies, but typically stays under 1/3 inch to 1/2 inch.
- Major - Canker sores that appear larger that 1/3 inch to 1/2 inch, last longer than two weeks, and appear to have irregular margins -- oddly shaped -- may be classified as major. Rarely, this type of canker sore may leave behind a scar. Common in immuno-suppressed patients.
- Herpetiform Canker Sores - A cluster of several tiny lesions that appear to form one larger sore. This type of canker sore may last from one week to one month.
Canker sores may become painful, especially when eating, drinking, and talking.
Causes
We know what canker sores are, but the exact cause is still unknown. Women statistically suffer from canker sores more often than men. Canker sores are typically seen in people between the ages of 10 and 40, although they have been known to show up at any age.
There is reason to believe that certain types of bacteria and/or viruses are responsible for the painful mouth sores. Canker sores are not contagious and are not related to the herpes simplex virus, also known as cold sores.
Canker sores are caused by:
- Injuries to the mouth, as seen frequently by contact sports players. Accidentally biting the inside of the cheek or lip may also result in a canker sore
- Temperature hot food or drink may cause a canker sore in the area of the mouth that was essentially burnt by the offending substance
- Spicy and/or acidic foods often produce a canker sore as a response to the irritation these spices and acids create in the mouth
- The use of chewing (smokeless) tobacco will often cause a canker sore to develop in the area of the mouth where the tobacco is held, due to the irritating chemicals found in the addictive product
- Poor-fitting, complete or partial dentures may cause canker sores in the area of the mouth where the denture may rubbing on the tissue. The development of a canker sore is often one of the first signs that indicate the need for a denture reline or adjustment by your dentist
- Orthodontic brackets, bands, and various other orthodontic attachments will often cause canker sores to develop in area of the mouth where there is constant friction on the oral tissues. This is common when orthodontic treatment first begins and may occur after each subsequent adjustments, throughout each stage of treatment
- Allergies to metals such as nickel may become evident in the mouth of a person wearing orthodontic devices necessary to move the teeth. Canker sores may begin to appear adjacent to the metal attachments. This is often referred to as contact dermatitis.
- Broken teeth are often sharp and may rub on the oral tissues to produce painful canker sores. Broken restorations may also cause a similar effect on the oral tissues
- Emotional stress has been identified as a possible trigger that may cause the development of canker sores
- Bacteria responsible for peptic ulcers known as Helicobacter pylori, has been linked to canker sore occurrence
- Vitamin deficiencies, specifically vitamin B12, foliate (folic acid), and iron, may trigger canker sore development
- Hormonal changes, notably during menstruation, pregnancy, and menopause, have been linked to canker sores
- Canker sores often run in families. Genetics my be a factor for many canker sore sufferers
- Allergic reactions and sensitivities to certain foods may cause a canker sore to develop. Allergic reaction to certain types of bacteria found in the mouth may also result in this type of mouth ulcer
- Celiac disease sufferers may experience canker sores. Gluten may be associated with the development of canker sores in those with celiac disease
- Information associated with inflammatory bowel disease (IBD) often will list canker sores as a complication associated with Crohn's disease and ulcerative colitis
- Mouth sores are a common occurrence observed in immuno-suppressed patients, such as those with HIV/AIDS
- Behcet's Disease, a rare autoimmune disease that damages the body's blood vessels notes mouth sores, more specifically canker sores, as a one of the four most common symptoms of the disease
- Sodium lauryl sulfate is a common ingredient in toothpaste and had been associated with the development of canker sores
Treatments
There are canker sore treatments and remedies that help ease pain, discomfort and possibly speed the healing process.
At-home treatment for minor canker sores include:
- Saltwater Solution and Sodium Bicarbonate - Mix 1 teaspoon salt with one cup warm water. Swish the solution in your mouth for 30 seconds, then spit the solution out. In addition to salt, 1/2 teaspoon baking soda (sodium bicarbonate) may be added to the saline solution. Create a paste by mixing baking soda with small drops of water until a thick consistency results. Use this paste to cover the canker sores, which will help relieve pain. These methods may be repeated as often as needed. Saline and sodium bicarbonate both help the mouth heal quickly by gently reducing the alkalinity and bacteria in the mouth.
- Hydrogen Peroxide Solution - Mix one part hydrogen peroxide with one part water. Use a cotton swab to dab the solution directly onto the canker sores. Do not swallow the solution. Hydrogen peroxide is an antiseptic that will help reduce the amount of bacteria in the mouth.
- Milk of Magnesia - Used frequently as an aide to relieve constipation and as an antacid, milk of magnesia is a liquid suspension of magnesium hydroxide. Dab milk of magnesia directly onto the canker sores with a cotton swab, three to four times a day. This method is recommended after using the hydrogen peroxide solution. Milk of magnesia will help reduce the pain and help speed the healing process.
- Liquid Antihistamine - Diphenhydramine (Benadryl) may be used as an oral rinse by mixing one part milk of magnesia and one part diphenhydramine together. Rinse with the solution for one minute, then fully spit out the solution. Take care to avoid swallowing this mixture.
- Over-The-Counter Oral Care Products and Mouth Rinse - Available in most dental care sections, antiseptic mouth rinses contain ingredients intended to help heal mouth sores by reducing the amount of bacteria in the mouth. Oral care products that are manufactured to numb painful areas in the mouth are also useful when treating canker sores. Products such as gels, paste, and rinses that are specifically marketed for mouth sores may provide pain relief and help speed the healing process. It is important that you follow the manufacturers' instructions closely when using over-the-counter products.
Canker sores that are classified as major, or are considered herpetiform canker sores, may require treatment from your dentist. Common methods used to treat more serious canker sores include:
- Oral Medications - Prescription medication may be necessary for treating serious canker sores that have developed into secondary infections. Tetracycline suspension (liquid) may be prescribed with instruction to hold the medicine in the mouth for two to five minutes before swallowing. Tetracycline is typically not prescribed for children as it has been shown to cause permanent discoloration in developing teeth. Zovirax (Acyclovir) is an antiviral drug that may be prescribed for cases where there are multiple, very painful canker sores.
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Corticoid Steroids - Although rare, corticoid steroids such as prednisone and dexamethasone may be prescribed as a treatment for canker sores.
Dexamethasone suspension (liquid) may be prescribed for use as an oral rinse with instruction to fully spit out after a determined time.
Keep in mind that even though they are painful, canker sores tend to heal well on their own. Consult your dentist when canker sores do not heal after 14 days, are accompanied by a fever, or appear to be infected.
Sources:
A.D.A.M. "Canker Sores"
A.D.A.M. "Canker Sore Treatment"
American Dental Association. Oral Health Topics - "Mouth Sores"
Colgate World Care. Oral & Dental Health Basics - "What are Canker and Mouth Sores?"
WordNet - Princeton University Cognitive Science Laboratory - "Milk of Magnesia"
Beyond Allergy. "Allergies to Metal in the Mouth" May 8, 2007.
Herlofson BB. Barkvoll P. "Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study." Acta Odontol Scand 1994: 52: 257-259. Oslo. ISSN 0001-6357.
NYU Langone Medical Center. "Aphthous Ulcers"
Root Canal Myths
The Top Root Canal Myths -- Busted
The inaccurate information about root canal therapy prevents patients from making an informed decision regarding their teeth. There are many patients that go as far as requesting that a tooth is extracted, rather than save it with a root canal.
Before you believe the hype, take a look at the top root canal myths, and learn the truth for yourself.
Myth #1: Root Canal Therapy Is Painful
Root canal therapy is almost always preformed because a tooth is causing pain from an irreversible condition. Pulpitis, an infected pulp, broken teeth, or a slowly dying nerve are all common reasons for root canal therapy.
Root canal therapy is used to alleviate pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better afterward.
According to the American Association of Endodontists, the perception that root canal therapy is painful stems from early treatment methods used to preform the procedure. In addition, if you are suffering from pain on the day of your appointment, your apprehension and fear may heighten the sensations you feel during the procedure.
Myth #2: Completing a Root Canal Requires Several Appointments
Root canal therapy may be completed in one to two appointments. Factors that determine the number of appointments necessary to complete a root canal include:
- The extent of the infection
- The difficulty of the root canal
- Whether a referral to a root canal specialist, known as an endodontist, becomes necessary
Restoring the tooth after root canal therapy is necessary in order to ensure the tooth functions properly. A crown is required after a root canal on a posterior tooth. Sometimes crowns are not required after a root canal on an anterior tooth. The appointments necessary to completely restore the tooth, in essence, should not be considered part of the root canal process.
Myth #3: Root Canal Therapy Causes Illness
The idea that bacteria trapped inside an endodontically-treated tooth will cause illness, such as heart disease, kidney disease, or arthritis, stems from research conducted by Dr. Weston Price from 1910 to 1930 -- almost 100 years ago. Recent attempts to confirm Dr. Price's research has been unsuccessful in proving that root canal treatment causes illness.
Bacteria can be found in the mouth at anytime. Even teeth free from decay and gum disease will test positive for bacteria.
Myth #4: Teeth Need to Hurt Before Root Canal Therapy Becomes Necessary
Teeth that require root canal therapy are not always painful. In fact, teeth that are already dead may require root canal therapy to prevent the tooth from becoming infected.
Your dentist will examine your teeth thoroughly during your regular check-up. It is usually during this routine appointment where your dentist will discover a tooth that has died or is on its way. Tests used to confirm a dead tooth include:
- Temperature testing
- Percussion testing
- Using a pulp vitality machine
Myth #5: The Benefits of Root Canal Therapy Don't Last Very Long
A common misconception is that the benefits of root canal therapy don't last very long after the procedure has been completed. This myth originated after patients experienced their tooth breaking months after a root canal was performed on their tooth.
When the nerve is removed from the inside of the tooth, the blood supply is eliminated from inside the tooth. The tooth eventually becomes brittle, and depending on the size of the filling used to close the tooth after the root canal, the forces from grinding, eating, and even talking may cause the tooth to break. Failing to have a crown placed on the tooth may cause this to happen.
Technically, it is not the root canal that has failed; it is the restoration on the tooth that has failed.
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Sources:
From Shawn Watson, former About.com Guide
American Association of Orthodontists. Myths About Root Canals. Accessed November 30, 2009.
American Dental Association. Root Canal (Endodontic) Treatment. Accessed November 30, 2009.
See a Baby Tooth? See a Dentist
Baby teeth are worth more than just a dollar under the pillow. Providing proper care and oral hygiene during a child's first year of life can mean a lifetime of good oral health.
Traditionally, parents have waited to bring their children to the dentist until primary teeth begin to appear. A 2002 consumer poll by the American Academy of Pediatric Dentistry shows that nearly 70 percent of parents wait until their children are 3 years old before taking them to the dentist. But a dental visit by age 1 – or within six months of the eruption of the first baby tooth – is crucial, says Academy of General Dentistry (AGD) spokesperson Cynthia E. Sherwood, DDS.
Dr. Sherwood says this early visit gives a dentist the opportunity to see potential problems such as early-childhood caries (also known as baby bottle tooth decay); educate the parent on proper oral hygiene for the child; and give the toddler a positive experience in a dental setting. This can do wonders in allaying fears and boosting the child's future attitude toward visiting the dentist, Dr. Sherwood says.
Education is the heart of the age-1 exam. "When we see a toddler, we primarily talk to the parents about growth, development, thumb sucking, bottle and breast feeding, oral hygiene and nutritional issues, use of fluoride and why baby teeth are important," Dr. Sherwood said.
During this first visit, the dentist usually will sit knee-to-knee with the parent, with the child nestled in the parent's lap, and the dentist will ask the parent to demonstrate how she or he brushes the child's teeth. Then, if parent and tot are comfortable, the dentist will turn the child around onto his or her lap, so the dentist can get a good look at the child's teeth and gums. This "pleasant, painless visit" should take no more than 15 minutes, Dr. Sherwood said.
"Sitting knee-to-knee with the parent, playing with the baby and talking with the parent, I can get a very good sense of the child's oral health care, and this position gives us a good opportunity to get a good look at the child's teeth," says Dr. Sherwood. "It's a great experience for everyone involved."
Toddler dos and don'ts:
DO:
- Take your child to the dentist within six months of the eruption of the first baby tooth, definitely by age 1.
- Follow your dentist's advice regarding nutrition, hygiene routine, fluoride and dental-visit schedule.
- Teach your child how to brush around age 3, and brush your teeth with your children to model good technique and spot problems.
DON'T:
- Think baby teeth don't matter "because they'll just fall out anyway."
- Allow children to have continual access to a bottle or "sippy cup" filled with anything other than water.
- Give your children the impression that visiting the dentist is unpleasant.
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