Stress Ravaging Men's Teeth

This is from the Chicago Tribune. I thought it was a well written article.

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Stress can turn your hair gray, send you racing to the kitchen to look for chocolate and send you to the emergency room with chest pains. Now you can add dental problems to the list of the bad things stress can do to you.

"Stress can lead to teeth grinding and jaw clenching, and that can lead to serious dental issues," said Jeffrey Weller, a Chicago dentist and founder of Weller Aesthetic & Restoration Dental Care. "People came into my office with serious destruction; cracked teeth, jaw pain. Their jaws click, and they can barely bite."

"Men, especially, are literally wearing out their teeth," Weller said, adding that stressed executives are the newest wave in patients seeking cosmetic dentistry. Women, according to Weller, may be under similar stress, but because of their more delicate muscle structure, they are less likely to cause as much damage.

"Men typically want pain relief, but there's no question they also like the cosmetic effect," Weller said. Cosmetic dentists are using combinations of crowns, veneers, bonding and implants to correct bite problems and reverse years of damage. The secondary result of a better-looking mouth is giving patients something else to smile about.

"Once people started whitening their teeth, it opened the door for the dentist to suggest more cosmetic procedures," said Anna Velten, marketing coordinator for the American Academy of Cosmetic Dentistry. "We're seeing it a lot more in men and even seeing more men on the cover of our journal."

Avoidance behavior

Dentists also say that men are much more likely to wait too long to seek help than women, so by the time they do go to the dentist, they have far more tooth destruction. "Men go for years with worsening jaw pain," Weller said. Many men never went to the dentist at all, agreed William Cohen, a Glenview dentist and accredited member of the AACD. "People are better educated about dental issues now," he said.

Both dentists agree that women look in the mirror and are more self-conscious about what they see, while it is just in the last few years that men have become attuned to the benefits of cosmetic dentistry. Both dentists also credit the TV show "Extreme Makeover" for much of the interest in cosmetic dentistry as well as the Baby Boomer generation, which wants a younger look.

A study done by the AACD in 2006 concludes that people with good teeth and a nice smile were considered more attractive and more intelligent. So, Weller said, is it any wonder that his office's full-mouth restorations, which can include porcelain veneers, crowns and implants, has increased tenfold. For patients who cannot afford the full-mouth rehab, which can cost up to $40,000 and is not covered by insurance, just fixing their bite can minimize the damage, ease the pain and make them look better.

Jason Kole, an emergency room doctor at St. James Hospital in Chicago Heights, went to Weller for routine dental work. "I was having a lot of jaw pain and severe headaches, Kole said. "I had been grinding my teeth since before medical school, but it had gotten worse, and the enamel was worn down." Kole said that the grinding improved dramatically after Weller changed the dynamics of Kole's jaw, a process that took a year.

Piecemeal isn't best

Weller said he tries to get patients who need full-mouth rehab done in four to five appointments, which can last from three to five hours, over 45 days. Because the nature of the work makes it difficult to fix one tooth at a time, a longer appointment works better.

Don Ratcliff of Scottsdale, Ariz., wasn't trying for the Hollywood look, although he had porcelain veneers on his front teeth. However, about three years ago his dentist discovered his back teeth were worn down from grinding, and Ratcliff was told he would eventually need dentures. "It was functionality for me," he said.

"Men react great when I talk to them about the functional aspect," Weller said. "I talk to them about the wear and tear, not about looking better. Once they understand, they are OK with cosmetic work." Cohen too said a patient often will come in for routine work that leads to a discussion of a chronic condition that can be fixed with cosmetic work.

"This is a life-changing procedure," Cohen said. "People who were self-conscious because of the appearance of their mouth come out of their shell. We take before and after photos, and you can see it in their eyes; they're a different person."
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Some tools of the trade

Crowns -- Grinding your teeth, an improper bite, age, fillings and tooth decay can contribute to wearing down, cracking or breaking of teeth. Dental crowns cover the entire visible surface of the affected tooth and add strength, durability and tooth stability. In other instances, crowns are used to replace actual missing teeth. Crowns are anchored to the teeth on either side, with a bridge section connecting two crowns. Instead of bridges, single-tooth dental implants may be used that eliminate the need for supporting the crowns.

There are three basic types of crowns: gold; ceramic; and ceramic-veneered gold. Gold and metal-ceramic crowns are extremely durable and normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic crowns are used primarily for front teeth, because they can best resemble the natural tooth color.

Veneers -- Veneers often are used as an alternative to crowns. Veneers are thin pieces of specially shaped porcelain or plastic that are glued over the front of teeth with little or no anesthesia. They are used to fix teeth that are severely discolored, chipped, have small holes or pits, are misshapen or crooked. They also can repair uneven spaces. Veneers do not stain and last 10 to 15 years. They usually cost less than crowns.

Bonding -- Dental bonding is a procedure in which a tooth-colored resin is applied and hardened with a special light that "bonds" the material to the tooth to restore or improve a person's smile. Bonding is an option that can be considered to repair decayed, chipped or cracked teeth, improve the appearance of discolored teeth, close spaces between teeth, make teeth look longer or even change the shape of teeth. Little advance preparation is needed for dental bonding, and anesthesia is often not necessary unless the bonding is being used to fill a decayed tooth.

The surface of the tooth will be roughened and a conditioning liquid applied. These procedures help the bonding material adhere to the tooth. The tooth-colored, puttylike resin is then applied, molded and smoothed to the desired shape. An ultraviolet light or laser is then used to harden the material. The procedure takes about 30 to 60 minutes per tooth to complete. Typically, bonding material lasts from 3 to 10 years before needing to be touched up or replaced. Generally, bonding can range in cost from $200 to $400 per tooth.