Tuesday, May 10, 2016

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.

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