How do I save my teeth from weak enamel and grinding?

November 2, 2006 1:02 AM

TeethFilter: I have weak enamel and tendency to grind. How do I save my teeth?

Took care of my teeth great when I was a kid, ate few processed foods, no cavities. Hit 20 give or take, my back wisdom teeth came out weird and started trapping food, creating a large cavity on a bottom molar. Had root canal (which I never capped, I think i'm going to lose the tooth since decay is still growing under the filling and practically the whole thing was drilled out to get to the root). Now I treat my teeth terribly, don't brush often enough, eat garbage food that I know mess my teeth up even more.

Dentist has told me in the past I have weak enamel, and a lot of my back teeth feel like they have cavity decay, but it's just bits coming off.

I also grind my teeth a lot in my sleep, or otherwise clench from subconscious stress both waking and sleeping.


Besides brushing flossing and eating better again (which I'm hoping to do), how do I save my teeth from grinding? I don't want to wear a mouthguard at night, I don't think I can change my lifestyle to stop worrying. And how do I counter the effects of weak enamel? (Does that EnamelOn Toothpaste really work? Long term rehabilitating results?)

I'm 23 and my front teeth probably don't show any terrible signs aside from slight yellowing, but I have a terrible feeling things are going to take a dive within the next 5-10 years, judging how my back teeth are starting to make me feel.

Help?

posted by pinksoftsoap to health & fitness (23 answers total)

Mouthguards work. Really, they do.

Otherwise I think you've already laid out a plan for better teeth. Eat better, brush better.

Quit smoking if you do presently. Take vitamins if you don't already.
posted by Pollomacho at 1:08 AM on November 2, 2006

You can also ask your dentist (I'm surprised he didn't offer it anyway) fluoride prescription toothpaste. My SO's father is a dentist, and he sends us Oral B NeutraCare, which is 1.1% fluoride, versus regular toothpaste, which is .24%.

You use it once a day (usually at night, because you can't rinse your mouth out or eat/drink anything for 30 minutes afterward). The only downside is that it's expensive, but then again, so are dentures.

You might also seriously consider changing your diet. For example, sugary sodas are so so so bad because the sugars literally stick to your teeth. Maybe drink more milk or chew sugar-free gum between meals to help clean your teeth.

A few other things — I know people who get quarterly teeth cleanings (instead of biannually). You could also try brushing 3x a day instead of two.
posted by Brittanie at 1:26 AM on November 2, 2006

I am not a dentist - but I have been bank rolling one.

You need a bite splint to save your teeth - spend the money and get a good one, as you'll be wearing it every night - dentist will mould your upper teeth and have a snug fitting splint made - cheap or over the counter bite splints can cause other problems (plus, they're generally uncomfortable).

Have your teeth properly cleaned to remove all the scale build up, then get a flouride treatment - which will strengthen your enamel.

After brushing and flossing - use GC Tooth Mousse as an additional treatment to help strengthen what tooth enamel you have left.

Speak to your GP about who you should seek to advise you on why you're actually grinding. If you drink a lot of coffee, do cocaine, or lead a generally stressful life - these all lead to the grinding scenario. There are myriad reasons for grinding - I've heard calcium deficiency among other diet related issues can also be to blame - try and minimise the cause.

I've just spent over $3000 on one fucking tooth - getting it crowned, then it dies, having a root canal (took 3 visits to drain the infection over 6 months), now I have to have the crown replaced - and all because of grinding. Multiply this by the 30 odd teeth you have in your head, and a bite splint suddenly looks like a very good deal.
posted by strawberryviagra at 1:44 AM on November 2, 2006

IF you do get a splint, get a good one! And if you can, get it died dayglo orange rather than have it left clear - you will probably lose it under the bed for the first couple of weeks, and a clear splint on carpet can be hard to find.

I had a great splint for a couple of years, which I lost while travelling. I replaced it with a substandard one recently, and I usually spit it out after a couple of hours.

The first thing I'm gonna do when I get back home is get a new splint. On top of the beneficial effects on my teeth, it helped neck pain and headaches I never knew the cause of, and stopped me waking up dreaming my teeth were being knocked out.

Oh, how I miss my old occlusal splint!
posted by claudius at 2:43 AM on November 2, 2006

Resolve the stressful situations in your life, or at least try and change your outlook on them. I know from personal experience that stress is a major causal factor of teethgrinding.
posted by dropkick at 3:54 AM on November 2, 2006

To keep track of a nightguard (and clean it), store it during the day in a denture cleaning solution.
posted by Carol Anne at 5:06 AM on November 2, 2006

Nthing the nightguard. I have weird gaps in my teeth due to another issue, but they were getting worse because my grinding was changing my bite, so I got one. It took a few weeks -- you have to get molded, then wait for the actual nightguard, but it's been so worth it. After about a year, I can feel where I've worn down the plastic. It's pretty shocking, actually.

My dentist gave me a carrying case for my nightguard and I've never lost it. She suggested the carrying case because apparently dogs love to eat them.

They are pricey, but it's possible that your insurance will pay for at least part.

Also, if you're having pains in your ears, you might find that the nightguard helps with that, too. Turns out the grinding causes them sometimes.
posted by sugarfish at 5:52 AM on November 2, 2006

Double Nthing the nighttime mouth guard.

I grind my teeth horrifically in my sleep (according to other people who have slept in the same room). My teeth are pristine except for one cavity where the enamel wore down. Guess when I got that? From the year or so when I stopped wearing my mouth guard at night!

Get a proper one from the dentist, not a cheapie solution from the drugstore. Your teeth are one area where you really want to invest good money.
posted by cadge at 6:34 AM on November 2, 2006

Spending the big bucks for a night guard is not the only option. My dentist sold me three expensive ones - the first lasted a long time, the next two I chewed through in my sleep within a couple weeks - then I switched dentists. My new guy suggested trying a regular rubber mouth guard for sports. They're cheap ($2-15) and easily replaceable. But the main reason why I like the cheap ones is that my mouth changes over time and I can reshape it to fit. I can also whittle it down so it's comfortable. I usually remove about half of the material by the time I'm done cutting it down.

Maybe you do need the real thing, but you might want to try a cheap one first.
posted by booth at 6:45 AM on November 2, 2006

Seriously, get a mouth guard to wear while you sleep. Get it from the dentist. If you're wary of wearing one on the top, you can get ones fitted to your bottom teeth that supposedly make it easier to breathe/talk/etc.

It WILL help immensely.

I have crappy genetics and crappy enamel which equals crappy teeth. No matter what I do. Flouride will probably help, as will flossing. But you may just have to resign yourself to a life of cavities/crowns/sensitive teeth/yellow teeth.
posted by misanthropicsarah at 6:47 AM on November 2, 2006

I have to second Booth's comment on trying the cheapie ones too. My father's a dentist and had several of the custom ones made for me, and I chewed through them pretty fast. Luckily, I was just paying the lab cost, but I would've felt pretty silly if I had gone through them retail.

I haven't tried the sports models, but they sell mouthguards for $20 at the drug store that work really well. They're definitely too thick, like booth said, but they can be cut down rather easily. And if you follow the instructions, the fit's just as good.
posted by condour75 at 6:56 AM on November 2, 2006

I'm looking into the NTI-TSS device, which is a smaller bite guard designed to fit vacuum-wise (i.e. a tight fit over a smooth surface tends to form a small vacuum that keeps item sticking to item) to your front teeth.

I don't know how much they are, but I hear from $300 - $800 depending on dentists and lab costs. They're made of acrylic and can be patched when needed. Apparently if one's biting with front teeth there's a physiological tendency to put less force on the molars, which are often victims of the tooth grinding enamel-harm.

You may also wish to look into alternative treatments for bruxism, like acupuncture or chiropracty.
posted by kalessin at 10:08 AM on November 2, 2006

Er, duh, a link to the NTI-TSS device's maker (or one of them).
posted by kalessin at 10:08 AM on November 2, 2006

Chew gum during the day, as much as you can.
posted by Monkey0nCrack at 11:27 AM on November 2, 2006

Cheap sports-like guards work! The trick is getting a good fit when you get it. Plop in some very hot water for 30 seconds, and then bite the hell out of it.
posted by ernie at 11:42 AM on November 2, 2006

MonkeyOnCrack - why? do you have some kind of reference for that?
posted by strawberryviagra at 1:22 PM on November 2, 2006

I think the reason Monkey said that is because chewing gum helps stimulate saliva production and saliva helps wash away/kill bacteria that can cause decay. But it has to be sugar-free, because otherwise those bacteria thrive on sugar.

Supposedly, making out also helps stimulate saliva production.
posted by Brittanie at 2:21 PM on November 2, 2006

Sorry — I forgot to add that there is also the mild abrasive factor if you chew a gun that has a bit of baking soda, etc. in it, which helps remove plaque.
posted by Brittanie at 2:22 PM on November 2, 2006

I stopped grinding my teeth at night when I began taking a multi-B vitamin and a calcium+magnesium supplement.
posted by oneirodynia at 4:28 PM on November 2, 2006

Coming from a similar position, I can sympathise.

IANAD, but I can repeat what my dentist told me: the cheap(er) sports mouth guards don't really cut it for serious nighttime clenching, because you're not guaranteed a good fit. (Although since other posters recommend it, it's hardly going to cost you much to try it.)

In addition to the physiological effect kalessin mentioned above, a properly-fitted mouth guard helps distribute the force evenly, among all your teeth, causing you less pain and discomfort. A poorly-fitted (e.g., just boiled in water and bitten) mouth guard won't necessarily have as good a fit, and you'll still be concentrating your clenching-force.

I bought the guard my dentist recommended, and let him fit it, and it has been the most peace-giving money I have ever spent. (Headaches: vanished! Neckache: vanished! Face-ache: vanished.)
posted by insipidia at 5:16 PM on November 2, 2006

(I am not a dental professional, but I spent the last three years working in a dental office, I ask *lots* of questions, and I've had really bad jaw problems for almost ten years, which I've controlled through a number of ways I'll end up listing, plus a few that I won't.)

You have to be really careful with the cheapo guards - if you don't fit it exactly right, you could do more harm than good by forcing your jaw to change position. Definitely get one that's made by your dentist, and don't forget to ask about coming in for adjustments.

One thing that helped me get into the habit of flossing more regularly was finding a brand that I really liked and leaving a couple packages around my house, like by my bed and by the computer. Until I started using Butler Gum's Eez-Thru Floss, I could never do a proper job because it just shredded and got caught and felt uncomfortable. Crest's Glide dental floss is also pretty popular at my dental office, but I don't like it's texture as much.

Be aware that those of us who grind are also at risk for early gum recession, and it's possible to lose your teeth without ever getting a cavity, so you really do want to do everything possible.

(If you smoke, quit. It's pretty much the worst thing you can do for your mouth, besides meth.)

If you're not able to brush your teeth after eating every meal (for example if you have lunch on the go), try to end the meal with a fibrous vegetable and rinse your mouth out with water. I know I've seen the stats quoted somewhere, about how it's noticeably effective, although still not as effective as brushing your teeth or using mouthwash. On the Candian Dental Association site they also recommend chewing sugarless gum, but as you have a tendency to grind, you should avoid all sticky foods including gum. For me, quitting gum was one of the hardest things, but it made a noticeable improvement in my pain levels.

I see a massage therapist regularly who is experienced with TMJ patients, but depending on your city that might be very hard to find. When I lived in another area of my city, I saw a physical therapist who also had experience with TMJ patients. Both of them have been able to teach me a number of techniques for keeping my face relaxed and give me more mobility (for a while I went through phases where I ate mostly soup and soft foods) and less clicking.

You might find that microwaveable bean bags, placed around your jaw, for ten or so minutes before bed will help you relax and help you from grinding too much. Your dentist might also prescribe a muscle relaxant to be taken at night before bed, for a short-term. Sometimes this helps to break a cycle.
posted by sourlime at 8:00 PM on November 2, 2006

Again, I'm not saying that a cheap mouth guard is the "right thing." But in my experience the guards my dentist made for me were less flexible than the softer cheap ones. And the cheap ones I can reboil and refit if they get uncomfortable. (I should do that with mine now. I trimmed more material from it the other day and it's got some rough edges.) In fact, my first real one was slightly off somehow and caused me discomfort so I didn't wear it every night.
posted by booth at 5:36 AM on November 3, 2006

I am not a dentist.

You are asking a question that only your dentist can answer. If you don't trust your dentist, or are not satisfied with the response from that office, a change in dentists is necessary.

You may not need fluoride. You may need braces. You may not have decay in your posterior teeth. You may have any number of conditions and concerns that we are totally unable to identify and address. Metafilter does not have access to your radiographs, your dental charts, your medical history, even your photographs and your attitudes about your teeth.

I used to manage dental offices and we took those getting to know you packets very seriously. Answer those questions honestly and ask your own questions. There is very little that dentists have not heard.

If you have a dentist that you trust and haven't been getting in for your cleanings as often as prescribed, please go and get back on track with that. Follow the home hygiene instructions and go back to the office as suggested.
posted by bilabial at 8:27 AM on November 3, 2006