Connecticut Residents Grind Their Teeth Too!

February 25, 2015 by

A recent article in the Washington Post discussed teeth grinding and gave numbers suggesting that nearly half of the adult population in the Washington DC area either grind or clench their teeth.

The reporter apparently has never visited the stressed out state of Connecticut! Our experience in Orange treating thousands of patients has shown us that many Connecticut residents grind or clench too.

Teeth Grinding Photo on a Patient from Orange, CT

teeth grinding photo showing cracks and craze lines on front teeth

Craze lines or cracks on front teeth on one of our patients. This was from years of clenching at night.

The above photo is from a long time female patient in our office. She freely admits she is stressed – commuting into Manhattan a couple of days a week – as well as travelling across the U.S. for work. She has been grinding her teeth for many years. Even though we had recommended a nightguard, she did not follow our recommendation until she developed these cracks on her front teeth!

Bruxism (also known as teeth grinding)

Bruxism is defined as the involuntary grinding of your teeth, occurring most frequently while sleeping. According to the American Academy of Sleep Medicine, bruxism frequently occurs in highly determined people. And the research clearly shows that teeth grinding in adults is caused by and exacerbated by stress.

If untreated, bruxism can lead to:

cracked tooth from bruxism and grinding that needs a crown

A cracked tooth from years of nocturnal bruxism on our patient from Woodbridge. This tooth required a crown.

  • Visble wear on both the front and back teeth.
  • Broken or lost fillings.
  • Cracks so deep that the teeth require crowns and/or root canals. The photo to the right shows a crack that caused a tooth to need a crown.
  • Fractures leading to loss of one or more teeth so that dental implants are required.
  • Pain and/or dysfunction of the jaw muscles and temporomandibular joint (TMJ). These are collectively known as TMD (temporomandibular joint disorders).

In our office in Orange, we’ve seen it all – including all 5 findings in one patient!

wear of teeth from grinding and bruxism photo

Another Connecticut resident who grinds his teeth!

Treatment for Bruxism

Before we can even begin treatment, we need to establish that the clenching or grinding is still occurring. Many times patients will grind or clench their teeth for a period of time and then stop. But in most cases, the activity continues, especially for stressed out Connecticut residents.

NTI nightguard appliance for stressed Connecticut bruxers

NIT bruxism appliance for one of our patients.

The most common treatment option is a nightguard. As the name implies, a nightguard is custom fit protection for your teeth.

The nightguard to the left is one of many types we make. This is called an NTI.

One of the key mishaps that can occur is a “one size fits all” approach. There are many types of nightguards available, each for specific purposes. We spend a great deal of time analyzing our patient’s problems so that we make the correct type of appliance. Making the wrong type of nightguard can actually make things worse!

Once the appropriate appliance is made and used by the patient, the TMD symptoms will typically resolve, and the teeth are far less likely to break or fracture.

So, it doesn’t matter if you live in Connecticut or Washington DC. If you’re grinding or clenching, you need a nightguard. We are always available to discuss your symptoms and recommend the most appropriate solution.

Filed Under: Dental Information Tagged With: , , ,

Nail Biting Can be Hazardous to your Teeth

January 12, 2015 by
single tooth photo

You are more than just a tooth!

We treat every single one of our patients as unique individuals with unique needs. Many have healthy gums and teeth and rarely have any treatment needs. Others will come in needing fillings or crowns. Some will need their wisdom teeth out. Others will need dental implants.

Occasionally, a patient will come in with a unique and unexpected finding causing us to have to “think outside the box” to determine what is going on.

One patient came in just recently. Everything was unremarkable except for a very unique wear pattern with her front teeth. We spent over five minutes interrogating her in our attempts to find out what was going on! We finally identified the culprit:

Detailed photo showing wear of teeth from nail biting

Her front teeth showing a highly unusual wear pattern; the culprit is her finger! You can see how her fingernails fit perfectly into the newly created groove on her two lower front teeth.

On questioning, she admitted to obsessively biting her nails. This was a new habit as she had recently started a stressful graduate program. Not surprisingly, all 9 other digits looked exactly like this!

Why Nail Biting is Bad for your Oral Health

Even though it took us time to properly diagnose this patient, we were already well aware of the detrimental effects that nail biting (the technical term is onychophagia) has on your teeth. Some of these include:

  • Significant wear of the front teeth as seen above. If the wear is bad enough, it can lead to thousands of dollars in treatment needs.
  • Your nails are very unsanitary – it is estimated they harbor twice as much bacteria as your fingers. This can introduce new bacteria into your mouth. It can also lead to nail infections (see below).
  • Repeated nail biting can actually move your teeth. The forces are much stronger than braces.

Nail biting is bad for your overall health too. According to the American Academy of Dermatology, bacterial infections from nail biting can and do happen quite frequently.

How to Stop Biting your Nails

This is not necessarily easy. It comes down to two approaches:

  • Just stop yourself when you put your finger(s) in your mouth.
  • Buy one of the many over the counter products that you paint on your nails. They taste horrible! But they’re supposed to. That’s how they work. Just Google it or look at this one product.

We’ll post more photos from nail biting once we see more!

Filed Under: Dentistry and Medicine Tagged With:

Hockey Pucks Don’t Scare Us

December 7, 2014 by

It was just a routine day at the office for us. But not for our patient John. A senior at Amity High School in Woodbridge, John took a hockey puck to his front tooth! At first glance, it looked like a case of “man vs. hockey puck with the puck winning!” When John showed up at our office in Orange nearly 1 hour later, we collectively said “Not so fast Mr. Puck!”

Hockey Puck damage to front tooth before and after photos of dental work

Our patient John was cheerful but obviously distressed when he came in. We ultimately got him back to normal!

The photo above shows before and after shots of John. How did we do it? Did we mention that it was the Senior Prom in 36 hours?

Due to the extent of the fracture and the pain, we had to do an immediate root canal. Upon completion of that procedure, we did bonding to give John something to smile for the Prom. It worked.

For a fracture of this size, bonding is not the best long term solution. Cases like these require crowns. So, we prepared the tooth for an all ceramic crown. We did custom shading of the porcelain so it would match his other tooth completely. We were also able to close the gap slightly between his two front teeth. See a closeup below:

Before and after photo front teeth and hockey puck dentist with crown

Before and after photos. We did an all porcelain crown. Even at this closeup, there is no way you can tell it is a crown! Photos and dentistry by Dr. Nicholas Calcaterra.

John is now a student at UConn in Storrs and is very happy with his new tooth! And he is careful of hockey pucks. See you at your next cleaning John!

Filed Under: Clinical Success Stories Tagged With: , , , ,

Why Teeth with Root Canals Often Need Crowns

November 17, 2014 by

When we do a root canal on a back tooth, we nearly always recommend a crown. Many of our patients will naturally ask us why? Frequently, the last thing a patient wants to do after they have recently had a root canal is to then sit in the chair for a crown! We certainly wouldn’t want to either. So why?

A picture is worth a thousand words, and we think this photo of one of our patients tells a descriptive story:

broken or cracked or split tooth high quality photo

This premolar on one of our patients literally split in two! After the root canal, we had recommended a crown, but he declined. The patient lost the tooth and needed an implant. Photo and subsequent dentistry by Dr. Nicholas Calcaterra.

As described in the photo above, this tooth cracked into two pieces with a fracture going deep beneath the gum tissue. If he had a crown, this would not have occured. He lost the tooth and needed a dental implant.

Brittleness + Great Forces = Tooth Failure

When a tooth has had a root canal, it becomes brittle. It loses the ability to flex slightly under loads. In addition, there is less natural tooth structure remaining, typically because of a past history of dental decay. When you put that all together, you have a very weak tooth.

The jaw muscles, specifically the masseter, are generally considered to be the strongest muscles in the human body. In one test, the masseter was able to generate a force of 975 pounds!

When you apply a force of several hundred pounds to a weak and brittle tooth, the following will likely happen:

Fractured tooth high quality photo and picture

Fractured lower left molar. In this case, the tooth could be saved, but not without heroic efforts. Photo and subsequent dentistry by Dr. Nicholas Calcaterra

This lower molar fractured after root canal treatment. In this case, the tooth was able to be saved by doing a special procedure called crown lengthening and then placing a crown.

How Crowns Protect Teeth

dental crown photo showing a reflection in the mirror

This crown will slide over the tooth, protecting it.

A dental crown, often called a “cap”, is a custom fabricated combination of either porcelain or metal that covers the entire surface of the tooth above the gumline. When you chew, the powerful forces that hit the crown are then directed down the long axis of the tooth.

In addition, the chewing forces cannot exert a splitting force onto the tooth, because the entire tooth is covered. As a result, catastrophic fractures like the ones seen above are avoided.

The photo to the right shows a crown for one of our patients. It will fit completely over the tooth. Not only will it prevent fractures but it will make the tooth look much more natural and esthetic.

Below are before and after photos of we preserved two badly broken down teeth with crowns:

Before and After photos of all ceramic and porcelain dental crowns

The above teeth had large silver fillings and both fractured. We were able to protect them with beautiful all ceramic crowns! Photos and dentistry by Dr. Nicholas Calcaterra

We hope that the narrative and the photos show you that teeth can break. And when they do break, the results can be catastrophic! So if/when you need a root canals on a back tooth, you should strongly consider getting a crown if your dentist recommends it.

Filed Under: Dental Information Tagged With: , , , ,
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