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Question:
Teeth Clenching and Receding Gums: After months of pain in one of my upper back teeth, a visit to a dentist found that I have receding gums, exposing multiple teeth and increasing sensitivity.
Apparently, for me, this is caused by clenching my teeth at night, and it was recommended I get a night guard. Would this really help my gums to stop receding?
Also, I do not have insurance and many people have told me to get a sports-type over the counter guard, rather than spend over $500 having one made. Would this be as effective?
I want to make the right decision, because at 27 years old, I am too young to see my gums recede any further. ... Visitor from WA
Answer:
Yes, clenching can cause pain, sensitivity, and gum recession. Teeth are like china. If a lot of stress is put on them, they will crack at the weakest area, which is the gumline.
Tooth cracks at the gum will cause the gum to recede and eventually cause fractures into the tooth right above the recession. These are called abfractions. There is periodontal surgery called gum grafting that can repair the recession. It is quite expensive.
I don' mean to frighten you, but this kind of pressure can actually break the teeth by fracturing a cusp. I will guess that your dentist can see hairline fractures in your teeth now.
You need some kind of protection as soon as possible. I would recommend a professionally fitted night guard. This will at least distribute the forces over all your teeth so that you will minimize the recession, and, hopefully, not allow you to crack a tooth or multiple teeth.
If a tooth cracks above the gumline, it can usually be restored by a crown. However, if it cracks into the nerve it will need a root canal and a crown. If it cracks under the gum it could need bone and gum surgery to expose the new margin of the tooth, then a crown and possibly a root canal.
Sometimes cracked teeth cannot be restored and need to be extracted.
I hope that this makes the $500 for a night guard look like a small investment to save you from much more severe problems. If this cost is impossible, you might try a sports store night guard. Every one of my patients who has tried one of these has come back for a custom made and fitted night guard, but you are better off with this than with no protection at all.
Also, you might ask your dentist about an NTI occlusal appliance. This stands for Nociceptive Trigeminal Inhibition, and is a clenching suppressor. It is a small device that fits over the front upper (NTI) or front lower (NTI-tss) teeth to keep them apart at night and also suppress clenching.
Good luck with this. Looks like you're doing effective research.
Corinne Scalzitti, DMD, MAGD
Austin Reconstructive Implant Dentistry
3900 RR 620 South
Austin, Texas TX 78738
(512) 263-3330
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