RESORPTION

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.

Overgrowth of Bone

I have been practicing dentistry since 1973 and over the years I have noticed that many patients have overgrowth of bone in the jaw. Dentists refer to this overgrowth as exostosis or tori. They can be found on the upper jaw or lower jaw structures. It can be on the tongue side of the jaw or the cheek side and appears as a knot of bone growing laterally. These overgrowths are benign and usually cause very little problem. The main difficulty with these knotty outgrowths is irritation from hard foods which can cause them to become quite sore. They also present a problem during routine dental impression taking as the impression tray can hit and irritate these areas. They usually take many years to develop but are an ongoing and enlarging anomaly. In some cases, when they appear on the cheek side of the jaw, they can actually cause facial changes.

       While it is hard to find the exact cause of these lesions, most dentists believe they occur in response to stimulation of the bone from extreme bite pressures. Some of the same bone outgrowths can occur in other areas of the body like the foot. My wife has a bone outgrowth on her left toe. I believe there is a common ground with both the outgrowth of bone on the foot and mouth. When you look at her left foot and ankle it is apparent that it tips in putting extra pressure on the left toe. I believe this extra pressure stimulates more bone growth and creates the lesion. In the mouth when excess pressure is delivered into the bone by extreme clenching or grinding forces, I believe the same phenomenon occurs.

        There are a great many pathologies or problems related to clenching and grinding, but this is one that is frequently overlooked. Treatment for these lesions is surgical and can be quite painful. When this condition is first noticed the best course of action may not be excision but prevention of the lesion enlarging. The most practical treatment to prevent worsening is wearing a guard or device that goes between the teeth and helps to minimize these destructive forces. These guards are mostly worn at night.

          Over the many years that I've practiced, I've seen numerous devices -- some professional, some over-the-counter -- to treat problems with clenching and grinding. The professional devices, of course, are better but they're also very expensive costing hundreds of dollars. The over-the-counter devices, while less costly, are flimsy and ill-fitting. Recently a new device called GrindReliefN has come to the over-the-counter market. Smaller and easier to wear, it has a central power bar that causes the principal forces to come between the upper and lower front teeth at the mid-line. This pressure creates a nerve stimulus that affects the muscles of contraction reducing the intensity by 60% or more. It is the first and only device I have seen that performs as well or better than the professional devices but at a fraction of the cost. More information on this device can be found at www.GrindReliefN.com.

Migraine Headaches

Migraine headaches are a huge problem. 30,000,000+ people in the United States suffer from migraine headaches. There are many causes for migraine headaches but the three main categories are dietary, environmental and physical. Dietary causes relate to foods people eat that just did not agree with them and can trigger a migraine. Second is environmental. When people are around certain things that they may smell or come in contact with, it may have a toxic effect on their body that can trigger a migraine headache. Third is physical. Brain vessel abnormalities or neoplasms are in the mix but are certainly rare. Certain activities that we do or overdo may cause headaches. Also listed in this group of physical problems is stress. Very nebulous, how can stress cause headaches? People are subjected to stress more and more, it's overwhelming and it's everywhere, but how does the stress cause a headache?

I have been a practicing dentist for over 40 years. More than 30 years ago I developed a problem with severe or migraine headaches. They began to cluster that was occurring two or three days in a row. I had no idea what could be causing this problem and was worried. I went to the hospital and had an MRI done and they could find no reason for the problem. I was not aware that I might be clenching or grinding my teeth and I had no pain in my jaws or teeth. Finally, one day I experienced some pain in my left TMJ. I decided to make a device or guard to prevent my teeth from clenching and grinding. Not only did it help with the pain in my jaw, but it also seemed to prevent the headaches and also prevented the shoulder and neck pain I was experiencing.

How can clenching the muscles in the jaw cause pain in the neck or shoulders and headaches? I call this phenomenon musculoskeletal reflex balancing and I have experienced this in other areas of my body. For example, I pulled some cartilage in my rib cage one morning and by the end of the day, the pain had traveled 180° to my back, right in back of the injury. Conversely in another incident, I injured my back, and the next morning I had a muscle spasm, a counterbalancing spasm in my abdomen, and actually popped a muscle there. If you clench or grind your jaw muscles hard enough, you will get a reflex balancing, triggering shoulder and neck muscle contraction and even headaches.

As a result of this experience I became very interested in the subject, and took numerous courses to study Temporomandibular Joint Syndrome (TMJ) pain and joint pathology. I began to investigate the various types of appliances or guards to help with problems related to joint pain and jaw pain. The standard dentist-provided guard is a horseshoe device made for the upper or lower teeth covering all the way back to the last tooth. I then began investigating a device called the Nociceptive Trigeminal Inhibition (NTI). This is a very small device covering only the front two or three teeth. It can be fitted on the upper front teeth or the lower front teeth and has a bar or ramp which hits the mid-line of the opposite teeth. I found that this is the only device that has FDA approval for the treatment of migraine headaches. In fact, one study they did showed 80+ percent of migraine headache sufferers had improvement when wearing their device. This device, however, has to be made by a dentist and costs hundreds of dollars.

Over the last several years, I have been working on a device called GrindReliefN. This device uses the mechanism of anterior mid-line focus to relax the muscles, however, instead of just hitting the upper or lower mid-line, it hits both at the same time. Therefore, it has double the mechanism of action. Also this device is slightly larger than the NTI covering up to the bicuspid area. It is sold online and now in some retail outlets at a fraction of the cost of the NTI. The patient can form it at home with the aid of online video instructions. We have numerous testimonies about how this device has saved people the pain and suffering of shoulder, neck pain and migraine headaches when nothing else has worked. If you're sick of the pain and medications treating this pain, then GrindReliefN is worth investigating.