Along with thumb sucking, childhood teeth grinding is one of the top concerns anxious parents bring to their dentists. It’s so prevalent, though, many providers consider it normal behavior—the sleep-disturbing sound it can generate is often the worst consequence for the habit.
But that doesn’t mean you should brush aside all concern, especially if the habit continues into late childhood. Long-term teeth grinding could eventually damage the teeth and gums.
Teeth grinding (or clenching) is the involuntary movement of the jaws when not engaged in normal functions like chewing, speaking or swallowing. The action often produces higher than normal chewing forces, which over time can accelerate tooth wear, cause fractures, or contribute to loose teeth, all of which could increase the risk of dental disease. While it can occur at any time it’s most common among children during nighttime sleep.
While stress is the usual trigger for teeth grinding in adults, with young children the causes for the habit are more complex and less understood. Most doctors hold to the theory that most pediatric teeth grinding arises during shifts from lighter to heavier, rapid-eye-movement (REM) sleep. The child’s immature neuromuscular chewing control may engage involuntarily during this shift. Teeth grinding is also prevalent among children who snore or mouth-breathe, or who take anti-depressant medication.
But as mentioned before, there’s usually no cause for concern unless the habit persists beyond about age 11. If the habit isn’t fading, you should speak to your dentist about ways to reduce it or its effects. One way is with a custom-made night guard worn during sleep. The smooth, plastic surface of the appliance prevents teeth from making solid contact with each other during a grinding episode.
You might also seek treatment from an ear, nose and throat (ENT) specialist if your child is having issues with airway obstruction, which could also relieve teeth grinding. And children experiencing stressful situations or events may find relief both emotionally and physically from psychological therapy.
At younger ages, you can safely regard your child’s grinding habit as normal. But if it persists, it’s worth looking for ways to reduce it.
If you would like more information on your child’s teeth grinding habit, 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 “When Children Grind Their Teeth: Is the Habit of ‘Bruxism’ Harmful?”
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
If you occasionally experience small sores in the softer tissues of your mouth, you may have aphthous ulcers or better known as canker sores. While rarely a health concern, they can be painful and annoying particularly when you’re eating and drinking.
These breaks in the skin or mucosa (the lining membranes of the mouth) usually occur in the thinner tissues found in the cheeks, lips, under the tongue or in the back of the throat. They tend to be most painful (especially while eating acidic foods like citrus or tomato sauce) between the first few hours of appearing and for a couple of days afterward, and will often occur during periods of anxiety, stress or after a minor injury. The sores will normally heal and fade within a couple of weeks.
Although occasional outbreaks of canker sores are quite common with most people, 20-25% of people (more often women) have a recurring form of painful outbreak known as recurrent aphthous stomatitis (RAS). Another variation called herpetiform aphthae, similar in appearance to herpes simplex virus sores, is characterized by smaller clusters of ulcers. While the specific causes for canker sores are still unclear, there’s some correlation between them and abnormalities with a person’s immune system, as well as with other systemic conditions like gastrointestinal disorders or vitamin deficiencies.
The basic treatment for canker sores is to first soothe the pain and promote quicker healing. Many over-the-counter medications are available for mild cases that numb the area temporarily and provide a protective covering while the sore heals. For more severe cases, there are also prescription medications (like steroids) that can be applied topically or through injection.
While canker sores are not contagious and usually benign, there are some situations that call for a dental examination: sores that haven’t healed within 2 weeks; increasing occurrences and severity of the sores; and never being completely free of a sore in the mouth. These may indicate some other condition, or be an occurrence of cancer or a pre-cancerous condition.
If you have any concerns, be sure to schedule a visit. We’ll be glad to evaluate any occurrence of the sores and recommend the best course of treatment to ease the pain and annoyance.
If you would like more information on canker sores or other types of mouth ulcers, 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 “Mouth Sores.”
If you’re brushing and flossing daily, as well as seeing your dentist at least every six months, you’re doing the top things needed to maintain your dental health. But all your hygiene efforts could be undermined if you’re not eating a dental-friendly diet. Simply put, there are foods that protect and promote dental health and those that increase your risk of dental disease.
Diets in the latter category are typically high in added sugar and low in natural food fiber. The largest sources of these are processed sugars from sugar cane or beets and high fructose corn syrup. With just a little knowledgeable label reading, you can find sugar and its various aliases added to thousands of processed food items including pastries, candies, sodas and energy drinks.
Heavy consumption of processed sugars also contributes to dental disease. Disease-causing bacteria thrive on sugar as a food source, which fuels both their growth and their production of oral acid. Elevated acid levels can dissolve the minerals in tooth enamel faster than saliva can keep up. Softened enamel opens the door to tooth decay, while increased bacterial growth can lead to periodontal (gum) disease.
A diet, however, low in added sugar and high in fiber can have the opposite effect. Although fresh fruits and vegetables contain natural sugars, they also have indigestible parts called fiber that slow the digestion of any sugars and allow the body to more efficiently process them. With the higher quantity of vitamins and minerals found in unprocessed foods, the overall effect of this diet is a decrease in your risk for dental disease.
Speaking of dental-friendly foods, we should also give honorable mentions to certain dairy items like cheese and milk that stimulate saliva production and are rich in calcium needed for tooth strength. Another beneficial category is both black and green tea, which contain antioxidants to fight disease and fluoride to strengthen enamel.
Adopting a low-sugar/high-fiber diet can have a profound impact on your overall health. Over time, you’ll also reap dental health rewards with stronger teeth and gums and a lower risk of tooth decay and gum disease.
If you would like more information on diet and oral health, 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 “Nutrition & Oral Health.”
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating gum disease, 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
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