Do you grind your teeth? If you're not sure, ask your family—sometimes the sound of teeth grinding against teeth might make enough noise to be keeping them up at night. You might also be waking with sore jaw muscles and joints.

If you suspect you have this habit of involuntarily grinding, gnashing or clenching your teeth, it's a good idea to get it checked. Here are 3 things you should know about this odd habit.

Teeth-grinding more prevalent among children. Children are more likely than adults to grind their teeth in their sleep, thought to be a consequence of their developing swallowing mechanism, but usually grow out of it without any long-term effects. Adults with the habit seem to grind their teeth for different reasons, one of the most significant being a response to high stress. Tobacco could be another factor: users are twice as likely as non-users to grind their teeth. Adult teeth-grinding may also be associated with high caffeine consumption, illicit drug use or Parkinson's Disease, which impairs brain nerve function.

Sleep apnea can be an underlying cause. There's one other major underlying cause to add to that list: obstructive sleep apnea. One international study of thousands of patients from different countries found both high anxiety or stress and sleep-related breathing disorders were two of the most significant risk factors for adult teeth-grinding. It's believed the physical stress generated by these temporary episodes of breathing obstruction occurring several times a night could trigger teeth-grinding.

Teeth-grinding can cause dental problems. While having a teeth-grinding habit doesn't automatically mean you'll have dental issues, your risk can increase dramatically. Due to its chronic nature, teeth-grinding can lead to excessive tooth wear, dental work damage or jaw joint dysfunction. In some extreme cases, it could cause tooth fracture.

If you grind your teeth, your dentist may be able to help by creating a custom-made occlusal guard that can reduce biting forces while you're wearing it. You might also minimize teeth-grinding by quitting tobacco and other lifestyle changes, or getting a better handle on stress management. And if you're also diagnosed with obstructive sleep apnea, getting treatment for that condition will not only improve your overall health, it could help put an end to your teeth-grinding habit.

If you would like more information on bruxism, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”

A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.

The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.

First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure.  We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.

After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.

After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.

Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.

Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.

If you would like more information on treating tooth decay, 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 “Root Canal Treatment: What You Need to Know.”

Which would you rather have — the flu or a root canal procedure? Nearly 80 percent of people recently surveyed by the American Association of Endodontists wisely chose the root canal. If this takes you by surprise, then let us bring you up to date on root canal treatment today. It’s nothing like the experience that once made it the butt of jokes and a benchmark against which other “undesirable” experiences were measured.

The term “root canal” actually has two meanings. It is part of the pulp-filled chamber at the center of every tooth containing nerves and blood vessels that keeps teeth vital (alive). It’s also the endodontic (endo  = inside; dont = tooth) procedure that treats inflammation and infection in this tissue. Common causes of pulp problems are traumatic damage (for example a crack, chip, or root fracture), deep decay, or gum disease.

The first sign of a problem is typically pain — ranging from acute and intense pangs when biting down, to lingering discomfort after consuming hot or cold foods, to a chronic dull ache and pressure, or tenderness and swelling in nearby gums. The primary pain may abate as the nerves in the pulp die, but the infection will continue, compromising the affected tooth, jeopardizing the health of the surrounding tissues, and often triggering secondary pain.

Pain-Relieving, Tooth-Saving Treatment
Endodontic treatment, by contrast, is no more uncomfortable than having a cavity filled. The tooth and surrounding area are numbed with a local anesthetic before the procedure begins. In order to access the diseased pulp, a small opening is made in the biting surface of the tooth. Tiny instruments are used to remove the pulp, clean and disinfect the root canal(s) and pulp chamber, and prepare the empty tooth interior to receive a biocompatible filling material to prevent bacteria from returning. A permanent crown may be placed over the tooth at that time, or a second visit may be needed. A crown (cap) is important to the tooth's long-term strength and functionality.

For a day or two following treatment you may experience temporary sensitivity, which often responds to an over-the-counter medication like ibuprofen. Occasionally, prescription medications, including antibiotics, may be needed.

All in all, doesn’t saving a tooth sound easier and more constructive than coming down with the flu?

If you would like more information about root canal treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “A Step-By-Step Guide To Root Canal Treatment.”

A "toothy grin" might be endearing, but not necessarily healthy. More of the teeth showing may mean your gums have pulled back or receded from the teeth. If so, it's not just your smile that suffers—the parts of teeth protected by the gums could become more susceptible to disease.

There are a number of causes for gum recession. Some people are more likely to experience it because of genetically thinner gum tissues. Over-aggressive brushing could also contribute to recession. But the most common cause by far is periodontal (gum) disease, a bacterial infection triggered by dental plaque accumulating on teeth mainly as a result of inadequate hygiene.

There are some things we can do to help heal and restore recessed gums, most importantly treating gum disease. The number one goal of treatment is to uncover and remove all dental plaque from tooth and gum surfaces, which can take several sessions and sometimes minor surgery if the infection has reached the tooth roots. But removing plaque and tartar (calcified plaque) is necessary to stop the infection and allow the gums to heal.

For mild recession, this may be enough for the gums to regain normal coverage. But in more severe cases we may need to help rejuvenate new tissue with grafting surgery. In these highly meticulous procedures a surgeon uses microscopic techniques to position and attach donated tissue to the recession site. The graft serves as a scaffold on which new tissue growth can occur.

While these treatments can be effective for reversing gum recession, they often require time, skill and expense. It's much better to try to prevent gum recession—and gum disease—in the first place. Prevention begins with daily brushing and flossing to prevent plaque buildup, as well as regular dental visits for more thorough cleanings. Be on the lookout too for any signs of a beginning gum infection like swollen, reddened or bleeding gums and see your dentist as soon as possible to minimize any damage to your gums.

Caring for your gums is equally as important as caring for your teeth. Healthy gums equal a healthy mouth—and an attractive smile.

If you would like more information on preventing gum recession, 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 “Gum Recession.”

Dental implants are by far the best way to replace missing teeth. But they do more than improve your smile: they can restore your ability to eat, chew and talk properly, especially if the teeth replaced are in the back of your mouth. What’s more, they can improve the entire look of your face by restoring facial height and cheek support lost because of the missing teeth.

There is, however, one obstacle to overcome before receiving dental implants — a lack of sufficient bone at the implant site. Bone loss usually occurs when teeth have been missing for some time. This is because when we chew the forces generated by the teeth stimulate continual bone growth to make up for older bone that has dissolved (resorbed). This stimulation doesn’t occur after teeth are lost, which slows the rate of bone growth. Over time the amount of healthy bone diminishes.

Without enough bone for support, implants can’t be placed properly. Fortunately, some of the bone can be regenerated through techniques that place bone grafting material at the site to stimulate and serve as a scaffold for new bone.  The new bone will eventually replace the graft.

For missing upper back teeth with bone loss, we can take advantage of facial anatomy to grow the bone needed for implants. This area of the face is where the maxillary sinuses, air spaces lined with a tissue membrane, are located on either side just above the upper jaw. After determining their exact size and location through detailed x-ray imaging, we can surgically access the area inside the mouth just above the missing teeth.

The sinus cavity is an area where bone growth can occur by placing a bone graft between the floor of the sinus and the sinus membrane. Sometimes bone growth enhancers are used to stimulate and speed up regeneration. The procedure can usually be performed with local anesthesia (much like a routine tooth filling), with only mild discomfort afterward for a few days managed by an anti-inflammatory drug like ibuprofen and a decongestant for sinus swelling.

After six to seven months, we re-evaluate the area to see if sufficient bone has returned for implant surgery. If so, you will be well on your way to achieving a new look and better function through dental implants.

If you would like more information on building new bone through sinus surgery, 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 “Sinus Surgery.”