Teeth can take a lot of force over a lifetime of biting and chewing, thanks to enamel, their outer layer made of the strongest substance in the human body. Unfortunately, they’re not invincible: it’s even possible for you to break or “fracture” a tooth while biting or chewing normally.
Although such a fracture might seem to occur out of the blue, it’s usually related to a condition known as cracked tooth syndrome. It usually occurs in three stages: in the first, miniscule cracks in the outer enamel known as craze lines develop. They’re not immediately dangerous since they only involve the enamel surface; but left untreated they could deepen and progress to the next stage, a larger crack that penetrates the tooth’s underlying dentin.
If allowed to grow, this crack in turn can lead to the third stage, a full fracture that could extend down to the root. A fracture can put the tooth in danger of loss, especially if its inner pulp becomes exposed. To avoid this worst case, it’s best to treat the tooth at the earliest stage possible when craze lines are just developing.
There is a difficulty, though, with detecting craze lines — they’re small, too small to detect normally with x-rays. We, therefore, rely on other methods such as using an instrument called an explorer to feel for cracks, having the patient bite on a stick or rubber pad to replicate pain symptoms or using fiber-optic lighting with special dye stains to highlight possible cracks. Endodontists, specialists in root canals, can use microscopic equipment that’s quite adept at detecting craze lines.
There are also some signs you can be on alert for that might indicate a craze line or crack. If you feel a short, sharp pain — a “wince” — when chewing and releasing food, you could have a crack that hasn’t yet affected the nerves. If a true fracture occurs, the pain will intensify and you may notice pieces of the tooth coming off. If the crack extends to the root, the pain will become greater and more chronic.
It’s important then that you see us for any recurring pain symptoms as soon as possible. If it’s a crack, the sooner it’s treated the better your tooth’s chances for survival.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
Teeth grinding and other biting habits are more than a nuisance — they can generate twenty to thirty times the forces of normal biting. Over the long term, this can cause significant damage to teeth and supporting gums and bone.
This particular kind of damage is known as occlusal trauma (meaning injury from the bite). In its primary form, the habit itself over time can injure and inflame the jaw joints leading to soreness, swelling and dysfunction. The teeth themselves can wear down at a much faster rate than what normally occurs with aging. And although less common but even more serious, the periodontal ligaments holding teeth in place to the bone can stretch and weaken, causing the teeth to become loose and increasing the potential for tooth loss.
There are a number of techniques and approaches for treating excessive biting habits, but they all have a common aim — to reduce the amount of force generated by the habit and the associated problems that result. A custom occlusal guard, often worn while sleeping, helps lessen the force by keeping the teeth from making solid contact with each other. Tissue soreness and swelling can be relieved with anti-inflammatory drugs like aspirin or ibuprofen, muscle relaxants or physical therapy. In cases where stress is a main driver, behavioral therapy and counseling may also be helpful.
Biting forces are also an issue for patients with periodontal (gum) disease. In this case even biting forces within normal ranges can cause damage because the diseased gums and bone have already been weakened. If gum disease is a factor, the first priority is to treat the disease by removing built up plaque. Plaque is the thin film of bacteria and food remnant that’s both the cause and continuing growth of the infection, as well as tartar (calculus) from all tooth and gum surfaces.
A thorough dental exam will reveal whether a tooth grinding habit is playing a role in your teeth and gum problems or if it’s magnifying the damage of gum disease. In either case, there are appropriate steps to stop the damage before it leads to tooth loss.
If you would like more information on teeth grinding or other biting habits, 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 “Loose Teeth.”
People who’ve lost all their teeth have benefitted from a solution that’s been around for generations: removable dentures. These appliances have helped millions of people chew and eat food, speak, and smile confidently.
But for all their benefits (including affordability) there’s still some things you need to do to get the most out of them like cleaning them daily or having us check them regularly for damage and wear. And, there’s one thing you shouldn’t do: wear them around the clock. Not removing them when you sleep at night can harm your oral health and reduce your dentures’ longevity.
Dentures are fitted to rest on the gums and the bony ridges that once held your natural teeth. This exerts pressure on the underlying bone that can cause it to gradually dissolve (resorb). This loss in bone volume eventually loosens your denture’s fit. If you’re wearing them all the time, the process progresses faster than if you took them out each night.
The under surfaces of dentures are also a prime breeding ground for bacteria and fungi. Besides unpleasant odors and irritation, these microorganisms are also the primary cause for dental disease. Research has found that people who sleep in their dentures have higher occurrences of plaque, a thin film of bacteria and food remnants that cause periodontal (gum) disease. They’re also more prone to higher levels of yeast and the protein interleukin-6 in the blood, which can trigger inflammation elsewhere in the body.
To avoid these and other unpleasant outcomes, you should develop a few important habits: remove and rinse your dentures after eating; brush them at least once a day with dish or anti-bacterial soap or a denture cleanser (not toothpaste, which can be too abrasive); and take them out when you sleep and place them in water or an alkaline peroxide-based solution.
Be sure you also brush your gums and tongue with an extra soft toothbrush (not your denture brush) or wipe them with a clean, damp washcloth. This will help reduce the level of bacteria in the mouth.
Taking these steps, especially removing dentures while you sleep, will greatly enhance your well-being. Your dentures will last longer and your mouth will be healthier.