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Monday, October 16, 2017
It all started during the Christmas holidays last year. I began getting a headache and radiating pain on the right side that felt like it was a TMJ episode or maybe my sinuses acting up. A few days later I noticed swelling in the gum around my upper right first molar. I immediately knew that that tooth had died and abscessed. A few months earlier it had been cold sensitive but an x-ray revealed no decay. I went to one of my trusted colleagues who specializes in root canals and he did a great job.
A few months later I was out to dinner with some of my dental laser training colleagues and noticed a lower left molar was extremely sensitive to cold and started to hurt when I bit on it. That tooth had been occasionally sensitive to biting hard foods for years. I knew it had a small crack in it but it only had a small filling and no active decay, so I lived with it. I knew right away I needed root canal number two for the year. I almost never get cavities, brush and floss like a pro, and get regular check ups. So..... why did I need two root canals within a few months? The answer is the destructive sleep habit known as Nocturnal Bruxism.
I have been very lucky to have a low decay rate. Except for some small fillings when I was a teenager I have hardly a cavity in decades. I do, however, clench and grind my teeth while sleeping. I did not realize this until I was in dental school and learned about nocturnal bruxism, which is the non-functional grinding of teeth while asleep. In recent years I have tried to wear my night guard regularly but would forget sometimes.
Bruxism can damage the teeth in many ways. It causes an insidious loss of tooth enamel that over time can destroy far more tooth structure than decay in most patients. It also can contribute to gum recession as the excess forces cause the supporting bone and gingiva to slowly drop down the root surface of the tooth. People who primarily clench such as myself can develop vertical cracks in the teeth. Over time these cracks can make their way into the dental pulp (the "nerve") and become a passage for bacterial infection.
In my case I had two teeth develop infections completely due to these cracks caused by clenching and grinding in my sleep. Much of the damage had been done before I regularly wore a night guard and reared its ugly head years later. I was lucky, however. These cracks can be so bad the the tooth needs to be extracted.
If your dentist diagnoses that you grind your teeth it is very important that you start wearing a night guard. The long term effects of bruxism include not only cracked teeth, but also severe loss of enamel, aesthetic problems, TMJ disorder, gum recession, and can make periodontal disease worse.
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