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Dr. Peel
Dr. Peel, Dentist
Category: Dental
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Experience:  General dentist with 20+ years of experience.
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I have bruxism, I find it to be severe. I wear a mouth piece

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I have bruxism, I find it to be severe. I wear a mouth piece at night for the most part, but I feel that it's too far past the point. I realize that the mouth piece isn't treating the bruxism, it's just preventing more tooth break down. I have grinded a large amount of my enamel down, what exactly can be done about this. I wanted to get an idea before I went to the dentist so I know my options.
Submitted: 12 months ago.
Category: Dental
Expert:  Dr. Peel replied 12 months ago.
Hello , my name isXXXXX and I will try my best to provide you with the answer to your question.

Grinding can be caused by many things and to cure it you would have to find what it causing it in your case. You are absolutely right about the mouth guard. It is mainly a device to prevent damage and treat symptoms but it does not generally cure the underlying cause.

Some things that cause grinding and options for help are:

1. Stress. This is a very common cause and particularly with young people transitioning to colleges or the job market. If it were stress related I would advise counseling, yoga, massage and the like to reduce your stress level. Exercise and a positive attitude help.

2. Drug use . Amphetimines like adderol can be responsible. Options if this were the case would be to change or stop these kinds of medicines/drug usage.

3. Bad bite relation. This is a common problem and patients seem to want to 'grind' in a better occlusal relationship because the one they are in is uncomfortable. This might be what you are experiencing and the options would be occlusal adjustment, restorative work like fillings, onlays or crowns depending on the damage done to the teeth already.
I would not recommend occlusal adjustment at your age because it is extremely difficult to get right and takes a specialist to do.
Another option would be to have orthodontics. If you have any crooked or missing or crowding that will effect your bite in many ways.

I hope this helps . Please ask more if I can help you further.
Customer: replied 12 months ago.

I had braces so my teeth are straight, so my bite is fine and my teeth are not crooked. I was aware of the stress and am not on any medication. I feel it is stress related but at this time in my life, being in school and working, I don't see relieving stress as an option at this time point in my life. I was more questioning correcting the damage, so was crowns the only option?

Expert:  Dr. Peel replied 12 months ago.
Hi Jamie,

Crowns are an option once the underlying cause is treated. If you get crowns now you could just as easily damage them and in fact, as they can be stronger than natural enamel, you can rock them to a point that the periodontal membrane is stressed . What that could do is undermine your gum and bone support.
I would try to address the stress issues by some means first and then begin restorative measures. Crowns alone will not stop bruxing and in fact , could make things worse.
If you like you can send me pictures of what you are concerned with and I can offer an opinion.
Customer: replied 12 months ago.

I don't if you are able to see anything by this phone but this is as good of a photo as I could get at this time.

Expert:  Dr. Peel replied 12 months ago.
Hi Jamie,
Well your teeth look very straight and from this picture I can't really tell if there is any damage. The posterior teeth are difficult to see. There seems to be some wear but it is hard to see how much from here.What I will say is that at your age I would not get crowns but would stick to a night guard appliance and stress relief activities. I know you are worried but sometimes these things are transitory and to do something extreme could make matters worse.

I would get a clinical check up with a good and conservative dentist and see if there is a better appliance that you may be able to wear more than just at night. There is an exercise that helps some people which is:

clench your teeth and hold for 5 seconds (count slowly) then relax for the count of 10. Repeat this three times and do this twice a day or whenever you feel stressed. It relaxes the muscles of mastication and lessons that feeling to grind in some patients.

This is definitely a thing to move slowly on and not rush into. There are no quick fixes and to start with extreme work could take months and cost a bundle. It is way too early to take that path in my opinion.
Dr. Peel, Dentist
Category: Dental
Satisfied Customers: 941
Experience: General dentist with 20+ years of experience.
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Customer: replied 12 months ago.


Thank you very much.

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