A 50 year old gentleman came in looking to get an old cap glued back as it was repeatedly falling out. He was aware of grinding his teeth at night and this is what had caused his teeth to wear down so much so that the nerves of most of his teeth were almost exposed. His teeth were sensitive and had a worn out appearance.
Finding the “Why”?
A “Bite Analysis” revealed that in fact it was his wisdom teeth at the back that was the cause of the problem. They were “interfering” in his bite. He was unaware that he was trying to remove this interference by grinding at it during sleep. This constant grinding had caused “hyperactivity” of the jaw muscles. This became a vicious cycle which resulted in continuous grinding and clenching during sleep. This was the cause of the old cap repeatedly getting dislodged.
Nocturnal grinding and clenching of the teeth can cause extreme damage to the teeth, jaw joints, muscles of the jaw and the jaw bone, especially if it is a long standing habit. This behaviour if intercepted at the right time can save a lot of damage from occurring.
The treatment in this case was removal of the cause. The wisdom teeth were removed and all exposed surfaces were covered with a combination of composite and ceramic caps. Root canal treatment was not needed as the work was mainly “additive” in nature and not “subtractive”. Preservation of natural tooth structure was of paramount importance. Thus the vitality and strength of the underlying teeth was maintained.
I would like to add at this point that had the damaged teeth been treated without finding the “Why” i.e. the cause, the fillings and caps would have repeatedly broken. Once a bruxer/ clencher always a bruxer/clencher! My job is to make sure that when the patient clenches and bruxes, the forces are distributed in such a way that the caps don’t dislodge or break.
The by-product of this workflow was not just a beautiful smile but a functional bite that would serve the patient for many years to come!