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Wear and Repeated Fractures

Clench and Grind - Bruxism

Excessive wear and repeated fractures are alarm bells indicating a “clenching and grinding” habit. More importantly, the teeth are failing due to the excessive workload. When a person is unaware of this problem and if it hasn’t been properly diagnosed and left untreated, it can cause many more and often very destructive tooth and restoration/filling failures. This increase in dentistry is frustrating to say the least! A common approach is to repair the problem once it has happened, whereas at Harley Dentistry we would rather try and prevent the excessive wear and fractures in the first place.

Clenching and grinding is extremely common. Most commonly, you do this when you are asleep. There is significant variation from individual to individual and we will have to assess how this appears and what happens for you. In general, the problems affect the following three general areas:

1. Muscles i.e. chewing muscles. The effects for the chewing muscles range from mild to severe. The first signs are usually thickening or building up of the chewing muscles through to tiredness and fatigue and sometimes pain within the muscles.

2. Jaw joint – TMJ or temporomandibular joint. This is the joint where the jaw attaches to the skull. It is a very complicated joint, the most complicated in the body in fact It can rotate, pivot and twist and in extreme opening actually slides and partly dislocates! Damage to the joint is often noted but fortunately, is relatively uncommon to be painful. There can be some limit in functioning, but again, it is unusual for it to impact too severely on your life!

3. Damage to our teeth. Obviously, with “clenching and grinding” you are clenching and grinding your teeth. At Harley Dentistry we make the correct diagnosis of the cause and make treatment recommendations how to repair the damage and reduce its impact.

Successful treatment is a combination of individual tooth protection, bite alteration with protective devises like “Dahl” appliances. These are minimally invasive and prevent extensive and expensive treatment like crowns and are relatively economic. As the original wear and grinding has often occurred over many years, time is on our side. A suitable direction for present reparative treatment and on-going treatment can be built into your overall treatment and make it much more manageable for the patient both physically and of course financially.

Bite Correction - Orthodontics

There are two areas of bite correction.

1. Traditional orthodontics, usually carried out in teenage years for “bad bites” or crooked teeth and are corrected by an orthodontist. Ninety percent of their cases are primarily for improved cosmetics but can cross over into function in limited situations. We have a working knowledge of orthodontic problems and we usually refer to an orthodontist to carry out treatment for these situations.

2. Altered, worn or damaged bites are the worn and altered bites due to long term dental problems/treatment. Having teeth extracted and not replaced causes problems. The teeth often move, and of course when one tooth is extracted, its chewing partner no longer has any function. This in turn means that the rest of the mouth has to take up the extra stress and strain from the loss of that chewing pair. Along with excessive wear, the bite can change so that it is much more destructive. A better and more balanced bite will dramatically alter the long term outcome. This is rarely done by orthodontics but is more likely to be corrected with the repair of a tooth or teeth and their fillings as part of an overall “big picture”.

In reality, it is the previous damage to the teeth that cause most of the problems. Often people think or are told that they have a “heavy bite” or it is just a weakness in the teeth or fillings that cause the fractures. This is not always the case and a careful examination and diagnosis is required.
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Harley Dentistry
344 Otumoetai Road
Otumoetai, Tauranga  3110
Phone: (07) 576-3104
New patients: (07) 576-3109
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