Typical appearance in snoring/grinding little patients: chipped teeth or sharp and jagged edges from grinding, crowding/tight teeth which leads to the patient being more cavity prone (as seen on the bottom front), deep bite appearance in which the top teeth almost completely cover the bottom teeth, and an under-developed lower jaw. In crowding cases like this, we can start treatment when they are as young as 4 years old. We absolutely can! Our dentists are able to perform an exam to determine if your child would be a good candidate for a myofunctional appliance. Proper appliance wear would help treat the cause of the snoring and grinding symptoms. Your child would get a good nights sleep, while also protecting their precious first set of teeth and promoting proper facial development.
Snoring and grinding are tell tale signs of sleep disordered breathing or improper nasal breathing (mouth breathing). When the patient’s airway is narrow, they will breathe predominantly through the mouth rather than through the nose. It is also a sign of poor facial development. Many children breathe through their mouths. Mouth breathing exposes the tonsils to toxins, allergens, and pollutants and can stress out the nervous system. Mouth breathing also disrupts the feedback to the upper jaw, leading to the downward, backward growth pattern seen in long-faced children with eye bags. Conversely, nasal breathing cleans, warms and humidifies the air and causes a relaxation response. Myofunctional therapy can be used to open the airway by posturing the jaw and tongue positioning. This treatment helps regulate the airway and allow adequate oxygen flow and proper growth and development of the jaws and facial structure. Since the lockdown order of March 2020 due to the COVID-19 pandemic, there has been a significant increase in grinding and clenching teeth nationwide. These behaviors are related to stress. At our office, we have been prescribing nightguards for patients who were never diagnosed as grinders/clenchers before. Our patients who already had nightguards have ground right through them and have needed replacements.
Many of our patients have started coming in with symptoms of grinding/clenching such as sore jaw in the morning, headaches, tightness in the jaw/temples, ear aches, tender teeth when biting, chipped teeth/fillings/crowns, torn up inside of the cheeks from cheek biting, sensitivity to cold/sour. It is important to protect your teeth, because it's the only set you've got! If anyone has told you they have heard you grinding your teeth at night, or if you are experiences any of the above symptoms, it is important that you get fitted for a nightguard. We do not recommend any OTC/DIY nightguards, and have seen negative results from patients who have gone that route. Some patients have noticed their teeth moving or becoming wiggly from ill-fitting nightguards, or appliances that are not equilibrated to the opposing teeth. This can lead to tooth mobility, trauma, and potentially tooth devitalization or tooth loss. At your next appointment, let your dentist know if you think you may be grinding/clenching your teeth. What is an immediate denture? When a patient has many teeth that are non-restorable and require removal, this type of denture can be placed IMMEDIATELY after extraction of the teeth. This means that the patient will not have to leave the office with teeth missing. This is in contrast to removing teeth, waiting 4-6 months for bone healing and stabilization, followed by denture fabrication. Advantage: Your new teeth are ready on the day of surgery, and you may eat with it - simpler, smaller foods at first Disadvantage: The bone is healing underneath and is changing its anatomy following surgery, which may affect the fit of the denture over time. The patient above is an 81-year old with extensive history of smoking and poor hygiene. His lower teeth have been compromised by severe periodontitis (gum disease) and gross caries (cavities). He already has an upper complete denture. The prognosis of the lower teeth is deemed NON-RESTORABLE. Recommended treatment is full lower teeth extraction in conjunction with a lower immediate denture. Impressions of his upper and lower jaw were taken, which are sent to our dental laboratory. They then create stone models of his dentition. The lab creates a try-in denture, in which some of the teeth are set in wax and acrylic to try in the patient's mouth and confirm fit. This try-in denture fit the patient's upper teeth and his bite perfectly. After confirming the fit of the try-in denture, the lab removes all teeth on the stone model, which simulates the planned tooth removal. They set the REMAINING teeth onto the denture and fabricate the FINAL denture to be delivered on surgery day. Surgery day. After extracting all the non-restorable teeth, the lower immediate denture is immediately placed. This patient will leave our office with a full set of teeth! Post-operative instructions:
1. Sleep with the denture in place to compress the surgery site and help with healing/recovery 2. NO SMOKING FOR AT LEAST 3 DAYS - to prevent dry socket formation and reduce chance of infection 3. Eat soft, simple foods that are easy to consume, like soup or mashed vegetables 4. Sore, painful spots may develop, like a new pair of shoes that are too tight. Continue to use the denture so that a sore spot becomes visible; your dentist will now know exactly where to adjust the tight spot 5. It takes practice getting comfortable with your denture. Practice speaking and eating so your mouth and tongue can adjust |
AuthorDr. Mat and Dr. Jen will occasionally post cases or pictures from our office! Archives
August 2023
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