Cracked teeth

A good one third of the population has a problem with clenching and grinding of their teeth.

Human teeth are subjected to enormous forces in the mouth and as a result cracking teeth is unavoidable, especially as we age. Cracked teeth are painful and can occasionally cause loss of the tooth.

To understand the various types of cracks and appreciate the variations in treatment options, a basic understanding of the tooth anatomy will be helpful

Cracks in enamel only are generally asymptomatic and require no real treatment. Almost all adults have cracks in the enamel of teeth. These are caused by eating hard foods, biting accidents, contact sports and aging. Some preventative measures include softening hard foods before biting into them and avoiding hard and brittle foods like peanut brittle, corn nuts and chewing ice.

Cracks in dentin cause sharp pain when biting especially when there is contact on the cracked portion of tooth. Contact with sweets also causes lingering pain. Cracks in dentin above the gum line are easily corrected by removing the cracked portion of tooth and placing a crown covering the tooth including the cracked defect.

Cracks in dentin extending below the gum line require a surgical modification of the surrounding bone away from the fracture line and a subsequent placement of crown. This combination of treatment can become questionable if crack extends deep down into the root surface, especially when exact extent of crack cannot be determined. Tooth removal and replacement with implant or bridge can be an alternative.

Cracks into pulp can be very painful and usually need immediate attention. Conservative treatment options are of limited value and generally involve removal of tooth and replacement with a bridge, implant or removable prosthesis. Sometimes, a root canal therapy is performed and root temporarily restored and observed for several weeks and if asymptomatic, restored with a more permanent crown. If pain persists, an extraction becomes necessary.

Only superficial cracks can be left with no treatment. Most cracked teeth require treatment as soon as pain is experienced. Early treatment can mean less invasive and less expensive treatment. 

If you are concerned about a fracturing or a cracked tooth, feel free to call our office for a no obligation 10 minute consultation. Call 909 627 6699 or visit www.smileartistrychino.com

First Aid for Dental Emergencies-Part 3

• Abscesses are infections that occur around the root of a tooth or in the space between the teeth and gums. Abscesses are a serious condition that can damage tissue and surrounding teeth, with the infection possibly spreading to other parts of the body if left untreated.
  
  Because of the serious oral health and general health problems that can result from an abscess, call the dental office as soon as possible if you discover a pimple-like swelling on your gum that usually is painful. In the meantime, to ease the pain and draw the pus toward the surface, try rinsing your mouth with a mild salt water solution (1/2 teaspoon of table salt in 8 ounces of water) several times a day.
• Soft-tissue injuries. Injuries to the soft tissues, which include the tongue, cheeks, gums, and lips, can result in bleeding. To control the bleeding, here's what to do:
1. Rinse your mouth with a mild salt-water solution.
2. Use a moistened piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes.
3. To both control bleeding and relieve pain, hold a cold compress to the outside of the mouth or cheek in the affected area for 5 to 10 minutes.
4. If the bleeding doesn't stop, see your dentist right away or go to a hospital emergency room. Continue to apply pressure on the bleeding site with the gauze until you can be seen and treated. 

Bruxism or Tooth Grinding

Approximately 50 to 96 percent of adults experience bruxism (tooth grinding), and 15 percent of children acquire this behavior. The habit can occur during the day or at night, and more often than not, goes unnoticed by the person doing it.

There are several reasons why we may grind our teeth, including an abnormal bite or crooked or missing teeth. However, the most common reason for teeth grinding is stress. It is well known that increased stress levels can have a negative effect on one’s overall health, and these days, with the pressures and stresses of everyday life, many people are noticing that they grind their teeth more often.

Since most cases of bruxism occur while you sleep, how do you know if you grind your teeth? You may wake yourself up due to the grinding sound or from the pressure of clenching your jaw. In other circumstances, someone else may be able to see or even hear you doing it. However, because most patients are unaware that they are grinding their teeth, symptoms such as waking up with a headache, toothache, or earache, as well as tenderness to the face, jaw muscles, and/or the teeth and gums are all possible signs of bruxism. During a routine dental check-up, your dentist or dental hygienist may detect worn-down teeth or worn-down dental work on fillings or crowns. Over time, grinding can wear away or fracture tooth enamel and may eventually loosen teeth.

Grinding teeth is a common occurrence for most people at one time or another. If you suspect that you are routinely grinding your teeth, consult with a dentist as soon as possible says Dr. Cherukuri, from her Chino; California dental practice.

For solutions, tune in next week!

Stress, Anxiety can lead to Teeth Grinding

Take a deep breath and relax. Stress and anxiety may bring some unwanted oral health concerns, such as teeth grinding—and you may not even be aware of it.

Also known as bruxism, teeth grinding is when you clench your teeth, or slide your teeth back-and-forth over each other. Often, it occurs unconsciously while you sleep.
Although it’s not considered a dangerous disorder, it can put pressure on the jaw muscles and tissues, and wear down your teeth, according to the National Institutes of Health. It may lead to jaw pain, headaches and earaches, and permanent damage to the teeth.

While there are various causes to teeth grinding, daily stress may be the biggest trigger for most people. Symptoms include sensitivity in the teeth, sore jaw and insomnia.

To treat teeth grinding, the NIH recommends reducing your daily stress and learning various relaxation techniques, such as meditation. Relaxing your face and jaw muscles throughout the day—to make a habit out of it—can also help.

Often, avoiding hard foods such as candies and nuts, drinking plenty of water, and massaging the muscles of the neck, shoulders and face can help relieve or reduce any pain.

However, there are other possible causes of teeth grinding. These include: sleep disorders; an abnormal bite; misaligned teeth; and in children, irritation in the mouth and allergies.

In such cases, dentists may provide you with a mouth guard to protect your teeth during sleep. Dentists may also recommend a muscle relaxant to be used before going to bed.

"Teeth grinding is generally a chronic condition that is best treated conservatively in its initial stages" says Dr.Cherukuri from her Chino, California practice.

For a free dental evaluation:

 Visit www.chinosmiles.com    or      Call 909 627-6699.

Occlusal Trauma: Effect and Impact on Periodontal Tissues

Occlusal trauma is defined as an injury to the tooth supporting attachment apparatus as a result of excessive occlusal forces.

Primary occlusal trauma is injury resulting from excessive occlusal foces applied to a tooth with normal support.

Secondary occlusal trauma is injury resulting from normal oclusal forces applied to teeth with inadequate periodontal support.

Combined occlusal trauma refers to injury resulting from abnormal occlusal forces applied to tooth or teeth with inadequate periodontal support.

Traumatogenic occlusion refers to a cause and is defined as any occlusion that produces forces that cause injury to the attachment apparatus.

Alterations of the periodontium  that have been associated with occlusal trauma will vary with the magnitude and direction of the applied force.  The changes may include widening/compression of the periodontal ligament, bone remodeling(resorption/repair), vascular dilation and permeability, thrombosis, root resorption and cemental tears.  Collectively, these changes have been interpreted as an attempt by the periodontium to adapt and undergo repair in response to  traumatogenic occlusion.

The majority of studies investigating this condition indicate that occlusal forces do not initiate plaque -induced gingival disease or connective tissue attachment loss (periodontitis)  Occlusal trauma in the presence of plaque induced inflammation may result in alteration of the normal pathway of inflammation and development of angular bony defects with intrabony defects but, in itself; does not cause gingivitis or periodontitis.
 Occlusal trauma accelerates the progression of pocket formation in the presence of ongoing destructive periodontitis. observed Dr Cherukuri 

Clinical and radiographic indicators are necessary to assist in its diagnosis. Proposed clinical indicators include mobility, occlusal prematurities, thermal sensitivity, wear facets, muscle tenderness, fractured teeth and migration of teeth. Radiographic indicators include widened periodontal ligament, altered lamina dura and evidence of root resorption and/or bone loss.  Increased tooth mobility is one of the most widely used indicators of occlusal trauma.

In the absence of existing inflammation, bony changes accompanying occlusal trauma may be reversed by discontinuing offending occlusal forces.  The importance of the role  of bacterial plaque in periodontal disease is undisputed but the influence of occlusal trauma on the attachment levels remains controversial.