One rare problem that I have been seeing more of lately is external resorption of the tooth. On x-ray examinations this can first appear to be decay but it is different. Decay is related to a bacterial invasion and the resulting lesion is soft. External resorption has a similar appearance however the lesion is hard when felt with an instrument. While tooth decay may be treated by mechanically removing the decay and restoring the tooth, external resorption is much harder to deal with.
These lesions are usually a result of trauma. I have seen it occur when people were exposed to an accident and blunt trauma is impacted onto the teeth. However; recently I’ve discovered another trauma that can be a causative factor in this destructive eating away of the tooth structure. Severe clenching or grinding of the teeth can put pressure into the teeth and surrounding structures and initiate this disease process.
There are cells surrounding the roots which are called odontoclasts. These cells come in to play when a permanent tooth erupts under the primary tooth. The root of the primary tooth is eaten away by these odontoclasts. Of course this is the normal process that allows primary teeth to be shed and permanent teeth to erupt.
The cells are normally dormant around permanent teeth. However; once trauma is exposed to the root and surrounding structure, they can awaken and cause damage on permanent teeth. Again this looks like decay but is a different process and much harder to eradicate. Once it gets started, it is very difficult to stop these cells from destroying teeth. Usually the only treatment is eventual extraction of the tooth.
In these very stressful times we live in, I have seen an epidemic incidence of clenching and grinding of the teeth. An overwhelming majority of people do this although many do not know they are doing it. This can occur during the day or night, but mostly it happens at night. Other symptoms of clenching or grinding is jaw pain, shoulder and neck pain and headache pain. Resorption of the tooth however is more silent; people usually don’t know until the dentist diagnoses or the resorption goes into the nerve and is painful.
The best way to prevent this problem is to use some type of a guard or device that goes between the teeth and helps them stop coming together with such extreme force and traumatizing the teeth. In my 40+ years of dental practice I have seen many types of devices both professional and over-the-counter. The most common devices are large horse shoes which cover all of the teeth either on the upper or lower. There are also some devices which are posterior pads covering mainly the molar teeth. The professional devices are better than over-the-counter devices but can cost hundreds of dollars. Over-the-counter devices are ineffective and short-lasting.
Recently a new device has been introduced into the marketplace — GrindReliefN. While some dentists are making this device for their patients, it is sold mainly online and in some retail stores. It is the only over the counter device that meets or exceeds the performance of the professional devices. Smaller and easier to wear, it covers only the front 6 to 8 teeth, either upper or lower. Easy to fit with online video instructions, it may be formed and reformed as many times as the patient would like. While the small size is a plus, the biggest feature is a central power bar which exerts pressure on the upper and lower front teeth at the mid-line. This creates a nerve reflex or biofeedback which affects the muscles causing them to contract with at least 60% less force. A simple pencil test can demonstrate how the GrindReliefN device works. Take a pencil, put it between your back teeth and bite down, and you’ll find that you can put a lot of force into it. Put the same pencil between your upper and lower front teeth at the mid-line. You will find you’re just not able to apply nearly the same force. More information can be found on this affordable and effective device at www.GrindReliefN.com.