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A Tale of Two Root Canals

(Why Not Wearing a Night Guard Can Lead to Root Canal Therapy)

Root Canal

It all started during the Christmas holidays last year. The patient began getting a headache and pain on the right side of their face that felt like it was TMJ pain or maybe a sinus infection. A number of days later they noticed a swelling in the gum around one of the teeth on the upper right. Immediately they knew that that the tooth had a problem. A few months earlier it had been cold sensitive but, when they went to the dentist an x-ray had revealed no decay. After noticing the swelling, they returned to the dentist and now it was evident that the tooth had an abscess (infection). The tooth had a root canal and all was well again.

A few months later this same patient was at dinner with friends and noticed a lower left tooth was extremely sensitive to cold. Also, it hurt when he bit on it. The tooth had been occasionally sensitive to biting hard foods for years but, he had lived with it. Immediately, he suspected that he would need another root canal. This patient almost never get cavities, brushes and flosses like a pro, and gets regular checkups. So…Why did he need two root canals within a few months? The answer is the destructive sleep habit known as Nocturnal Bruxism (grinding at night while sleeping).

Or story’s hero had been very lucky to have a low decay rate. Except for a few small fillings when he was in his teens, he had hardly had a cavity in over 10 years. He did however (as his wife had told him often), clench and grind his teeth while sleeping. The dentist had made him a night guard but, sometimes would forget to wear it.

Clenching and grinding at night can damage the teeth in many ways. It causes a slow loss of tooth enamel that over time can destroy far more tooth structure than cavities in most patients. During night clenching and grinding the patient can grind at 8 to 10 times the force they use to eat during the daytime. It also can contribute to gum recession as the excessive force causes the bone holding the teeth and gums to slowly recede. People who mostly clench can develop vertical cracks in the teeth. Over time these cracks can make their way to the “nerve” and become a channel for bacterial infection.

Root Canals

In this patient’s case, he had two teeth develop infections completely due to cracks caused by clenching and grinding in his sleep. Much of the damage had been done before he regularly started wearing a night guard. Then it had reared its ugly head years later. However, his patient was lucky. These cracks can be so bad that the tooth needs to be extracted.

So, if you know that you clench or grind your teeth, it is very important that you wear or start wearing your night guard. The long term effects of clenching or grinding include not only cracked teeth, but also severe loss of enamel, aesthetic problems, TMJ disorders and gum recession.

Don’t hesitate to contact me with any questions, email or call me at (301) 679-6121.

Sincerely,
Dr. Nicholas