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Teeth Grinding "Bruxism"


Pytanie

Our son has been grinding his teeth for years, to the point where they say nerve is exposed. The dentist has recommended he have his teeth pulled. Mom wants to know if this should be done?

Odpowiedź naszych ekspertów

"Bruxism" or grinding of the teeth, is very common within our CdLS population. At 30+ years old, the problem has most assuredly been a longstanding one. Various dental mouthguards or night guards can help if the grinding is related to specific times during the day or night. To wear a mouthguard 24 hours a day would not be an answer for any patient. If grinding is at night or is strongest during the evening, then wearing the appliance would be of considerable help. If the nerves were exposed, I would be very surprised. Usually the nerves shrink away from the offending pressure of the grinding. They will protect themselves by fleeing the area and walling off sensitivity by laying down calcified tissue to separate the grinding surface from the nerve. Exposed nerves would send one up to the roof in excruciating pain.

Extracting the teeth might be an alternative, but unless self-inflicted damage is occurring to the tongue, cheeks, lips or other soft tissues, I would not automatically consider this rather aggressive approach to bruxism. One should also talk to the patient's physician to see if any muscle relaxation medications might help to relieve the tension and grinding.

DM/TK 7-13-10

Regarding nerve exposure, root canal therapy can be completed on his teeth if he has had good periodontal health prior to considering extractions. I would like to see radiography films prior to this extreme. If he is cooperative enough for this, then a Panorex xray or a small series of xrays would be helpful. If he is uncooperative, then sedation would be necessary for this and then definitive treatment could be rendered (that being preferably root canal therapy so he can retain his teeth).

If his present dentist is not comfortable with this treatment recommendation, then a pediatric dentist who works in conjunction with an endodontist and anesthesiologist would be recommended. It is necessary to coordinate many people's schedules to pull it off. Extractions are easy, fast, final, not always best for patient if conditions are OK otherwise, so more information is needed to verify situation

DC/ TK 7-13-10

SEE ALSO: Teeth Exfoliation
Teeth Grinding 1
Teeth Growth
Teething

Zatwierdzone przezClinical Advisory Board (CAB)
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Zalecenie(a)

Feeding and Dental Difficulties

R12
U każdej osoby z CdLS ze znaczącymi i przedłużającymi się trudnościami w odżywaniu zespół specjalistów powinien rozważyć (tymczasowe) założenie gastrostomii (chirurgicznego dostępu do żołądka przez powłoki brzuszne) jako uzupełnienie karmienia doustnego.
R13
U osób z CdLS, u których występują nawracające infekcje dróg oddechowych, należy wykluczyć refluks i/lub aspirację (wdychanie do dróg oddechowych) ciał obcych.
R14
Podniebienie powinno być dokładnie zbadane po postawieniu diagnozy. W przypadku wystąpienia objawów (podśluzówkowego) rozszczepu podniebienia, wskazane jest skierowanie do specjalisty.
R15
Przegląd stomatologiczny i czyszczenie zębów powinny odbywać się regularnie; może być konieczne dokładniejsze badanie stomatologiczne lub leczenie w znieczuleniu.

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Please take note that the Ask the Expert service is comprised of volunteer professionals in various areas of focus. Answers are not considered a medical, behavioral, or educational consultation. Ask the Expert is not a substitute for the care and attention your child’s personal physician, psychologist, educational consultant, or social worker can deliver.

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