CBS Early Show has segment on Teeth Grinding

http://www.cbsnews.com/stories/2009/10/09/earlyshow/health/main5373802.shtml?tag=cbsnewsTwoColUpperPromoArea

(CBS) Stressed out at work? Your teeth might be getting the brunt of your worrying. Dentists all over the country are reporting that they're seeing more patients suffering from teeth grinding - and they're attributing it to the recent economic woes.

CBS Medical Correspondent Dr. Jennifer Ashton shared some warning signs for teeth grinding and some possible treatments for it with Early Show co-anchor Harry Smith.

According to Ashton, teeth grinding (or bruxism) isn't just limited to the teeth, and can affect surrounding areas.

Some of the telltale signs that you might be grinding are:

• Headache
• Oversensitive teeth
• Sore facial muscles
• Jaw pain
• Damage to the inside of the cheek

Dentists are noticing increases from 20 percent to a doubling of bruxism cases, and they suspect the economy's to blame.

Teeth grinding can be caused by stress and anxiety. It often occurs during sleep and can be caused by an abnormal bite or missing or crooked teeth.

According to The New York Times, one dentist reported 20-25 percent increase over a year. Another said teeth-grinding cases have doubled in the past 18 months.

Sometimes people find out they're grinding their teeth because their wife or husband hears it at night, but for others, it can be silent.

According to the American Dental Association, many people are unaware that they grind their teeth because they do it while they sleep.

ADA: Teeth Grinding (Bruxism)

Bruxism often occurs at the early part of the night and can disturb sleep partners. The clenching and grinding may be audible. Others make no sound while bruxing their teeth and do not realize they are doing it until a dentist discovers unusual wear spots on their teeth.

Teeth grinding can do all kinds of damage to your teeth. It can fracture or loosen your teeth and it can wear down the cusps of your teeth down to flat stumps.

Repairing this damage (treatments include bridges, crowns, root canals, dentures and implants) can be very costly. Some patients could also develop TMJ (temporomandibular joint syndrome). In severe cases it can affect your ears and result in hearing loss.

So, what are some ways you can combat the wear-and-tear on your teeth?

MOUTHGUARDS, WASHCLOTH:

• FREE: Relax your jaw muscles at night by holding a warm washcloth against your cheek in front of your earlobe.

• LEAST EXPENSIVE: OTC MOUTH GUARDS ($20) You can buy them at your local drugstore, but dentists say they might not fit your teeth properly and you could grind through them a lot more quickly.

• MODERATELY EXPENSIVE: CUSTOM NIGHT-GUARDS (starts at $350-$1000) You will have to go to the dentist for a custom fitting. Studies have shown that they can break the grinding habit.

NOTE from Dr. Zach: Our mouthguards are near the very bottom of this range in price - they are a great value.

• EXPENSIVE: BOTOX ($500 a treatment, every five months or so) Some dentists are starting to use this for extreme cases. It's off-label use and is for extreme cases of teeth-grinding, and it should be done by clinicians who know how to use it.


Our View: I wrote an entry on night guards that you can read here: LINK

I think night guards are an excellent investment for your teeth considering all the damage i see from grinding. It can be difficult for people to notice their teeth wearing down when they see their own teeth every day. Most of the time I only get patients asking about mouthguards when they have pain. Mouthguards can do an excellent job of saving your teeth and preventing expensive treatment to repair the ill effects of bruxism.

Coincidence? Independence Examiner writes about mouthguards.

I've written about mouthguards on here somewhat recently, there have been two articles in the Independence examiner lately about the Wood Bat Tournament player who we helped that sustained an oral injury during a baseball game, and now the Examiner writes an article about the importance of mouthguards too! I agree they are important.

Here is their article:

http://www.examiner.net/health/x772305218/Be-sure-to-protect-their-mouths-during-sports

By Lori Boyajian-O'Neill

Special to The Examiner

Posted Aug 17, 2009 @ 10:49 PM

---

Independence, MO —

As sports have become more violent there has been an increasing rate of injuries to the face.

There are between 650,000 and 2 million sports-related dental and oral injuries annually. Many sports, including football, require mouth guards for protection, but most do not. What do you know?



True or false

1. Mouth guards protect against concussion.

2. Missouri high school soccer requires mouth guards.

3. Missouri high school baseball requires mouth guards.

Mouth guards are intended to protect teeth from fracture and avulsion. They also protect lips, tongue and gums.

A properly fitted guard should stay in place during physical activity, be easily removed and not interfere with breathing or talking according to the American Dental Association.

There are 3 types of mouth guards: stock; boil and bite and custom-fitted. Stock guards are one-size-fits-all devices which are ready to wear.

Unfortunately, they are the least protective and most poorly-fitted of any of the guards. Stock guards are, however, the most inexpensive and easily found for less than 5 dollars. ‘Boil and bite’ guards are very malleable when heated in boiling water making them easily formed to teeth. They fit very well, if directions are followed. Boil and bite guards offer good protection and are moderately priced, usually less than 20 dollars. The most expensive, but most protective, are custom-fitted guards.

These are formed and fitted by a dentist and are better than any off the shelf version. Also, they can often last through several seasons.

Although not required, the use of a mouth guard in basketball and any contact and collision sport is strongly urged by most sports medicine societies. High school softball, a fall sport in Missouri, does not require mouth guards.

However, all players should consider using them. It is frightful to see a line drive speeding toward the face of a girl playing third base 25 feet or closer to the batter.

First basemen (women?!) and batters are also at high risk. There are guards designed specifically for girls and women with smaller and narrower gums than boys.

There have been many assertions that mouth guards prevent concussions. They do not.

There is no good scientific evidence to support these claims. There is no question they protect teeth and mouth.

If you participate in any contact or collision sport, ask your dentist about mouth guards, even if your sport does not require it.

Common sense should prevail over any particular sports-specific rule. An ounce of prevention is certainly worth a pound (or thousands of dollars) at the emergency department or dentist’s office. Athletes are more beautiful when they have all of their teeth and no stitches.

It’s not wimpy to wear a mouth guard, its smart.

Be a trendsetter.



Answers

1. F 2. F 3. F

Follow Up Article in Independence Examiner about Meiners Dentistry

This article was written by our young patient Zach Levy's mother on his experiences while in Independence for the Wood Bat Tournament:

http://www.examiner.net/letters/x695083591/During-a-moment-of-crisis-Independence-cared-helped

By Karen Levy

Submitted to The Examiner

Posted Jul 29, 2009 @ 11:02 AM

---

St. Peters, Mo. —

We were in from St. Louis for the recent Wood Bat Tournament in Independence, and a tipped ball shattered the tooth of my son, Zach Levy, the catcher for the Spartans.

As he spit blood and caught his balance, people ran for ice as I ran to see him. The Fike team was up to play next and their coach – Dr. Matt Hagerty, a dentist – ran to Zach. He said the nerve of the tooth was showing and said for us to get him to someone quickly. I said I was from out of town and asked for directions to the hospital.

He took me to a room at the park, and they calmed me down. The dentist made some calls and said, “I can’t take care of your son because our team is about to go out, but my partner across the street just said he will take you if you want.”

I was very nervous about not knowing these people but felt good with how we had been treated so far, so we went one exit away to Noland Road, walked into Dr. Donald Meiners’ dental office, and they were standing at the door waiting for us. I almost cried to see they stopped what they were doing at the end of the day to stay for complete strangers and rushed Zach right in to the chair.

We had two office workers giving my husband and I water, patting our shoulders to calm us. The doctor, his son (a dentist with the same practice, also named Zach), and the assistant all rushed to examine my son Zach. They never even asked us once about our dental or medical insurance info. As far as they knew, we didn’t have any, they were only concerned with one thing – caring for and fixing my son.

I have never had such wonderful and quick attention from any health-care provider, even when my two kids tore their ACLs. I couldn’t believe how absolutely kind, caring, gentle and professional they were. Long after the care was being provided they asked if we had any insurance, which we do, and even so they were not concerned if we were good for our bill. Wow – I couldn’t believe the dollar value was not a concern at that time.

The doctor called us in the room with Zach as they did all the examining work and explaining our next steps to repair his teeth. He cracked the other front tooth also. The office sent us off with snack for Zach, and set aside time at the end of the day on Friday to continue the repair and bond a new tooth. Unbelievable – the good people at the ballpark, the dentist coach of Fike who set this all up and gave initial care to Zach, then the incredible kindness and care we received from Dr. Meiners.

We were treated by all as travelers and, everyone pulled together to care for my son so well. People at the park have asked me over and over how Zach, or that catcher with the broken tooth, is doing. Also, Zach hit the walk-off home run on field 1 just prior to the second doubleheader game at field 2 where he was hurt.

Karen Levy and her family live in St. Peters, Mo.

Meiners Dentistry Recognized in Independence Examiner

By Matt Gerstner

The Examiner

Posted Jul 15, 2009 @ 12:31 AM

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Blue Springs, MO —

Zach Levy went from one extreme to the next in a few innings.
Levy, catcher for the Central Spartans of St. Peters, Mo., an American Legion team visiting for the Wood Bat Invitational, started the tournament off with a walk-off homer to give the Spartans a win over Warrensburg Post 131.
A few innings later, he was being rushed to the nearest dentist.
In the second game of their doubleheader, the Spartans took on the Lansing (Kan.) Post 411 Cavalry. Levy would only make it to the sixth inning. He would leave the game with two broken front teeth, one of which was completely shattered.
“It was kind of outrageous,” Levy said. “It just caught me way off guard.”
The pitch was fouled back. But instead of hitting Levy’s glove, it hit his facemask. The mask then broke, sending the metal bracket into Levy’s mouth, busting his lip, nose, and teeth.
“It just threw my head back,” he said. “I kinda felt these rock particles in my mouth and hoped it was dirt or something. But I felt around my mouth with my tongue and realized my tooth was gone.”
Levy didn’t know what had happened.
“I was shocked at first. I was pretty dazed.”
Luckily for him, Blue Springs Post 499/Fike assistant coach Matt Haggerty came to the rescue. Haggerty just happens to be a dentist when he’s not coaching the bases for Fike.
“I went over and looked at the kid and saw a red hole where the tooth was cracked – and I knew that wasn’t good,” Haggerty said.
That red hole was the tooth’s nerve ending. That sent Zach’s mother, Karen, completely over the edge.
“He couldn’t do anything. He couldn’t drink water because the nerve ending was showing,” she said. “We didn’t know what to do. We’re from out of town. We didn’t know anybody.”
Haggerty led them into the tournament room and iced the mouth of Levy. Although he couldn’t do anything, because Fike was scheduled to play next, Haggerty did know somebody that could.
“I called Drs. Zack and Don Meiners in Independence – a father/son dentist team. They said to get him up there and they performed a root canal. I heard they were really great to the young man,” Haggerty said.
Karen, although distressed, was elated to see the Dr. Donald Meiners and his staff standing at the door, waiting for them.
“I almost cried to see they stopped what they were doing at the end of the day to stay for complete strangers and rushed Zach right into the chair,” she said. “They never asked once about our dental or medical insurance information. As far as they knew, we didn’t have any. They were only concerned with one thing: caring (for) and fixing my son.”
Zach was surprised by the amount of care he got as well.
“It was unbelievable,” he said. “We just walked right in and they took care of me.”
Meiners was just happy to help.
“I said, ‘Let’s help out this kid.’ And that’s what we did,” he said. “Dana Callahan, Lori Lappert, all my staff, they did a great job in helping out the family.”
Karen was stunned at the lack of concern for the business side of the situation by Dr. Meiners.
“It wasn’t until long after the care was being provided they asked if we had insurance, which we do, and even so, they were not concerned if we were good for our bill,” Karen said.
“That’s kind of the way we work around here,” Dr. Meiners replied.
After the storm of pain and worry had calmed, Zach thought of his team. Being the only catcher on the team, he assumed the worst.
“I thought we would’ve had to forfeit or cancel the tournament.”
That was not the case.
The next day, the Central Spartans took the field against Hi-Boy Drive In/Post 340, with Zach starting at catcher.
“I had a temporary filling and wore a mouthpiece and played the next game,” he said.
After the Spartans game on Friday, the Levys went back to Dr. Meiners office for what turned out to be their last visit.
Levy returned for the rest of the tournament, but not without getting a few new nicknames from his teammates.
“They called me Lloyd Christmas from Dumb and Dumber, they called me Chip,” Levy said, chuckling. “They had some laughs with me.”
Levy is considering a career in hockey now, as well.
“I’m thinking about it,” he said, jokingly. “I definitely felt like a hockey player.”
The Levys are now home, and Zach is “feeling great.” But Karen will always remember the kindness she and her son were shown in Eastern Jackson County.
“People at the park asked me over and over again how Zach, or that catcher with the broken tooth, is doing,” Karen said. “It was just so amazing to see the amount of care and attention we received.”

Sports Mouthguards - Protect Your Teeth!

In many sports a mouthguard for the teeth is either required or encouraged.

There are several types of mouthguards on the market.

The most popular type of mouthguard is referred to as the "boil and bite" mouthguard made at home by purchasing a cheap rubber mouthguard, boiling it in water and biting into it to make a mold of your teeth.



Dentists can also make mouthguards using a mold of the teeth



A dentist-made mouthguard is a great idea for all types of sports. Football, basketball, soccer, hockey, and even sports like skateboarding or martial arts.

Well made mouthguards are comfortable. Comfortable mouthguards get used, and no mouthguard is effective if it is torn up, uncomfortable, or does not cover and protect the teeth.

Protect your teeth from tooth grinding!

Those that experience symptoms tend to seek out treatment and normally get a biteguard made to alleviate the problem.

However, the half that don't have symptoms don't perceive a problem because the damage to the teeth occurs so slowly over time that when looking in the mirror you don't notice from one week or month to the next. These people don't seek treatment and often turn down a recommendation to get a biteguard due to lack of perceived need.

Even furthering the problem is the fact that many dental insurances won't cover a biteguard so treatment is denied due to cost and we slowly watch people's teeth erode away.




Biteguards are custom made for your mouth by using dental impressions. At the first appointment we take an upper and lower impression. Then it takes a couple days to get the biteguard made and then there is about a 30 min appointment to seat the biteguard and ensure it fits snug and is harmonious with your bite.



Biteguards also have the added bonus as working as a retainer for your upper teeth as well. An investment in a biteguard is you have signs of tooth wear is a wise one. Biteguards may not be cheap, but they can be a FRACTION of the cost to fix worn down front teeth years later.

Bad Habits That Destroy Teeth

1) Soda Sippers/Swishers - low volume soda drinks that consume it slow. Typically people who do this may take 1-4 hours just to consume one can/bottle. The amount of time teeth are exposed to acid in soda sippers can break down enamel rapidly. If you are going to consume a soda, energy drink, or sports drink just consume and be done with it. But constantly bathing your teeth in acid over the long term will destroy them and cause cavities.

2) Brushing Too Hard / Toothpaste Abuse - if you constantly are changing toothbrushes or if you buy medium or hard bristle brushes, or if the bristles on your brush splay out to the sides, you are brushing too hard. The combination of this bad habit + the use of today's abrasive whitening toothpastes can lead to forced gum recession, sensitive teeth, and even enamel breakdown. Seems that in general people that do this have an obsession with a clean feeling in their mouth and that feeling is derived from abusing the gums. There is also a feeling that if they brush harder their teeth will be whiter, when actually the opposite occurs because as you wear away enamel, teeth get darker.

3) Fingernail Biting - Another bad habit that destroys the enamel on the front teeth and wears the teeth down. Teeth weren't designed to chew nails, and over time the nails keep growing back, but the teeth just get worn down never to grow back again.

4) Ice Chewers - Crunching on something hard that is at an extremely different temperature than the body is really hard on teeth. It's even harder on dental work, especially white fillings and sealants.

5) Pen/Pencil Chewers - Just like with fingernail biting, your front/side teeth take a beating when you do this. Doing anything teeth weren't designed to ultimately harms them.

6) Popcorn kernel crunchers - several people out there like to crunch on the slightly popped or un-popped popcorn kernels. This isn't much better than chewing on rocks. These things are EXTREMELY hard and I've seen several cracked molars on people with that habit.

Why do I need X-rays?

A large number of dental problems occur in areas we cannot physically see.
1) Between the teeth
2) Beneath the roots of the teeth and in the bone surrounding the teeth.
3) Inside of a tooth

To properly diagnose problems that occur in those areas we need to see those areas, which can only be done with x-rays.














X-Rays allow us to do a thorough job checking your teeth. Without them we can only see the tooth surfaces that are visible. Many problems with the teeth originate in areas that we cannot see.

The #1 area for cavities on back teeth is on the biting surfaces of the teeth, which we can see visually. But the #2 area for cavities is in between the teeth. Those only become visible when the decay inside the tooth is large and has eaten away a big portion of the tooth.

On front teeth the #1 area for tooth decay is in between the teeth.

Meiners Dentistry has gone all digital on all types of x-rays now.

The benefits of that are:

#1) Low Radiation needed to capture the same quality of image that we used to get with film.

#2) Fast results. It doesn't take 5-7 minutes to process the x-rays anymore.

#3) It means we've gone "green" - no more chemicals used to process the x-rays, and less waste.

White Fillings vs. Silver Fillings

You have choices today when it comes to getting cavities in teeth filled. White fillings aren't new. In fact they've been around for a long time, but the technology used to chemically bond them to your teeth keeps improving all the time. The actually white filling material (composite resin) itself has also gotten stronger with advancements.

Many people think that they have done away with the old silver filling material - not true!

Here are some pros and cons to silver vs. white fillings:

White Fillings:

Advantage:

- looks like your tooth! - probably advantage #1, they really look GREAT!

- chemically bonds to the tooth to seal the filling in (silver fillings are just "packed in)

- repairable if some chips away because new material can stick to the old material

Disadvantage:

- not as strong as silver filling material (metal is still stronger than resin)

- more expensive than silver material (materials are more expensive, and they take longer to do)

- need an absolutely dry surface (no saliva or blood) to place the material for it to be successful. This can make using it very challenging on a lower tooth in the back of the mouth near the tongue, on an antsy child (or adult), or in other hard to reach areas.

- In an effort for dental insurance companies to reduce benefits (this is for BACK TEETH ONLY), if you select a white filling on a back tooth, many insurance companies will downgrade your benefit to a silver filling (because they are less expensive).

Example: The standard dental insurance pays 80% on regular fillings.

So let's say a White Fillings is $120 and a silver filling is $100

If you get a white filling, the insurance pays 80% of the $100 silver filling fee instead of on the $120 White Filling fee.

Your co-pay would be $20 on the silver filling, but would be $40 on the white filling.

Silver Fillings:

Advantage:

- less expensive

- faster procedure

- long lasting

- not as sensitive as white fillings are to moisture, meaning they can be placed easily on kids with active tongues, and hard to reach areas.

Disadvantage:

- doesn't look good

- does not bond to the teeth

- not easily repairable (usually needs total replacement)

- silver filling material still contains a small percentage of mercury. Some people will proclaim this is a problem, but this material has been around for a very very long time with a lot of positive results.

- the small percentage of mercury does allow the filling material to expand and contract (like mercury in a thermometer), which if a filling is large, can weaken the tooth over time. It seems like I see more broken teeth with large silver fillings in them than anything else.

Lead and Bacteria found in Dental Crowns made overseas (we don't use overseas labs)

Many of you have seen stories about lead in toys that came from China. Now there are other reports surfacing of lead and bacteria found in dental crowns and bridges made in China.

To give a little background. Dental Crowns and Bridges (as well as dentures and partial dentures) are not made by dentists, they are made at dental laboratories. Some dentists use labs right here in our metropolitan area (like we do), some use labs in other parts of the country. The problems spoken of in these articles are about crowns made in other countries, most commonly China.

Here are some of those stories:

http://www.myfoxchicago.com/myfox/pages/News/Detail?contentId=6078693&version...

http://www.dispatch.com/live/content/health/stories/2008/02/28/DentalLead.ART...

http://wwwphp.dispatch.com/vplayer.php?clip=2008_02_27_Denist_Work_To_Test.wmv

At Meiners Dentistry, we have ALWAYS and will continue to ALWAYS use local dental labs in the metropolitan area where we know the individuals making the dental prosthesis personally. We support the local economy, and would not participate with foreign laboratories in the name of cutting costs to increase profit margins.

We are proud of the relationships we've established our local dental labs, and feel they provide products with the finest workmanship and materials available. There's no question it costs us more, but it is the type of quality we would want for our own mouths, and those of our family, friends, and patients.