Dr. Sowell's Corner
Topic of the Month
What stops people from keeping their teeth a lifetime in today’s environment? Dentistry has made tremendous strides in controlling dental disease. In 1960, the average 60 year old person in the United States had 8 teeth left in their mouth. In 2000, the average 60 year old patient had 20 teeth left. The major factors where educating patients, treating periodontal disease (gum disease) and lowering the decay rate. This was achieved by controlling the biological or bacterial environment around the teeth.
Today we still loose teeth, but the main factor is wear. Teeth are lasting much longer, but their condition is deteriorating from the forces that are generated by clenching and grinding. One night of clenching and grinding is eqilivant to 100 days of chewing food. So you ask, why do we clench and grind and wouldn’t I know it? The answer is stress causes it and since it is a silent action, you would not know it. It is very rare for a person to be aware of it, if they are, the problem is very extreme. Government projects forecast our generation to live to be 90 years old. There is the problem, we are keeping our teeth longer and we are getting more stress in our society. The result is teeth are being destroyed well before we are 90 from clenching and grinding. You say, how does this happen?
Each night a person goes through a sleep cycle every two hours. We start in shallow sleep, then go into REM (rapid eye movement) sleep phase, then into Delta (deep sleep) phase and finally back into shallow sleep. It is during this shallow sleep phase that we wake-up at night for various reasons, including going to the rest room. In an 8 hour sleep period we go through 4 cycles. Clenching and grinding occurs between REM and Delta sleep phases. In REM sleep we remember our stressful events of the day and the lower jaw begin to clench and grind as an autonomic neurological response. For the average person 70-80% of clenching and grinding occurs at night, although some people it is 50/50 night to day. A dentist determines a severity by the evidence of wear and grooves on a person’s teeth. If a patient is not convinced by what they see, we have a device that we attach to their cheek at night and it will measure the electrical activity in their muscles that move the jaw. The outer surface of the tooth is enamel, which is the hardest substance in the human body, once a person wears through the layer the dentin layer is exposed which is more yellowish in color. The dentin is 7 times softer than enamel, so once this happens the tooth begins to disintegrate much faster.
For years I have made a full arch Tanner appliance for my patients to wear at night to slow this process down. It also helps patients with muscle pain and joint breakdown (TMJ). It will not stop the clenching and grinding, but it will decrease the muscle activity 40% and protect the teeth from the disfiguring effects of clenching and grinding. The concept is wonderful, but there is one limiting factor – patient compliance. If the patient does not wear it, it has no benefit. For years I have learned that patients who are light sleepers or gaggers, that they have a hard time wearing the appliance since they wake-up at night and do not sleep well. The problem has been engineering a smaller appliance that has the same benefits of decreasing clenching and grinding and not so small that a patient could swallow it at night. I am excited to tell you I have developed such an appliance. I call it the S- appliance. It is made of thin clear material and covers only the front 6 teeth. Patients love it and we make it in our office laboratory. I still love the traditional Tanner appliance for patients who sleep well, but for my light sleepers and people who object to the Tanner appliance, the S-Appliance is an excellent alternative.
Although, patients have to wear these appliances to keep from losing their teeth, having short square shaped teeth and needing dentistry redone more frequently, they are much better than the alternative. Clenching and grinding causes teeth and porcelain to wear, crack, splint, chip, smiles to be crooked, notch the roots (abfractions), contribute to gum recession, kill nerves in teeth, implants to fail, break teeth at the gum line and eventually tooth loss. Patients who wear these appliances nightly have restorations that last twice as long as patients who do not on average. All of our patients who get a smile make-over get one of these appliances to keep their smile beautiful for years to come. Now with Dr. Sowell’s development of the S-appliance, it is more convenient and comfortable that ever.
Hygiene Hangout
Our office is dedicated to taking special care of all of our patients and their individual needs. For our patients with veneers and porcelain crowns, a unique polishing paste is used to restore luster and shine without damaging or removing the glaze. We use special plastic instruments on all implant supported crowns. Metal instruments may leave small scratches on the titanium implant surface which can contribute to plaque accumulation below the gum line. We recommend patients bring their Tanner or S Appliance to their hygiene appointments to be cleaned in a special cleaner that removes tarter and stain. By maintaining a clean appliance, you are decreasing the bacterial count in your mouth and increasing the longevity of the appliance. For our patients who are stressed out (who isn’t stressed?) we are now offering face and neck aromatherapy messages to help relax while in the dental chair. Lastly, we now have warm, moist hand towels for our patients at the completion of their appointments.
I look forward to seeing you at your next hygiene appointment!
Happy Valentine’s Day,
Melissa
Corn Dip
- 3 cans niblets corn, drained
- 1 large can chopped green chiles
- 1 bunch green onions chopped
- 2 cups grated colbey jack cheese
- 1 cup mayo
- 1 cup sour cream
