Dentistry question: I am a savage night-grinder. Should I have my bite reshaped to help with my bruxism?
I saw a new dentist to get my hard acrylic occlusal splint (night guard) repaired. This is the third time it's been patched, and the next time I wear through it I will probably need a new one. The dentist suggested occlusal equilibrium treatment, which is grinding down bits of my teeth to reshape my bite. According to him, my bite is a poor fit and it is causing a whole host of problems, from bruxism and the related damage and soreness, to lower teeth that don't touch the top ones and therefore protrude unimpeded, exposing sensitive areas near the gums. As part of orthodontic work when I was young, I had four premolars removed and the teeth further pulled up. This, he says, contributes to my poor bite and has left the repositioned teeth tilted at an angle, again exposing sensitive areas and causing my poor teeth to actually bend under the force of my bite.
I have an appointment on Monday to discuss the procedure. It sounds like it could be great! My reshaped bite, according to my dentist, would distribute stresses evenly as I bite or chew, protecting my teeth. I'd have more range to a comfortable bite instead of the restrained position I always close in. I'd clench less during the day, feel less stress and maybe not have to wear the night guard. It could be cheaper in the long run than having to replace night guards. (The guard, even with insurance, is the most expensive thing I own. The cheap boil-and-bite kind didn't help.)
However, there are a few things I'm worried about. Unlike, say, getting a filling, there's no guarantee the treatment will solve my problems. It's a permanent removal of small bits from my already damaged teeth. The dentist seems to really be enamored with the procedure--many of my coworkers have gone to him and he has suggested the same thing. The list of possible benefits is so long that it seems like a cure-all. I did a little research and found one source
saying that there isn't much evidence to support occlusal intervention, and another source
saying a poor bite isn't the primary cause of bruxism anyway, and that I should reduce stress, cut out caffeine, and develop better sleep habits first.
I wondered if any Mefites have had experience with this treatment, good or bad. I might seek out a second opinion, so if anybody knows a Chicago dentist who's good with bruxism, I'd be glad to hear about that too.