Why was Emergency Dentist Only One to Recommend Night Guard?

I’m really frustrated after a recent visit to the emergency dentist. I’ve been dealing with a couple of tooth problems. In the first case, I was sent to the endodontist for a root canal, but the pain didn’t fully go away and I developed sensitivity to sweets. My dentist sent me back again and the endodontist said there was nothing wrong endodontically, but that maybe I had a crack in another tooth. I had this checked out again and was told it was nothing, but they offered to crown the tooth “just to be sure.” I refused and decided to try to live with it. A few weeks later, I was in a lot of pain, so I went to an emergency dentist and was told that my pain was due to grinding and she recommended that I have a night guard made. Both of the other doctors knew that I grind my teeth and they said nothing. The night guard has been great. Even my sensitivity to sweets was cured right away. It bothers me that the emergency dentist was the only one to catch this, though. What happened?

-Franco

Dear Franco,

Your story is missing bits. You saw two different dentists- a general and an endodontist and both acknowledged that you grind, but neither suggested that you get a night guard? That doesn’t make any sense. What did you say when they said that you grind? The whole point in mentioning that they think you grind was likely a lead-in to suggesting that you get the night guard, so it’s very odd that they stopped there. Is there any chance they’ve previously recommended the night guard and that maybe you refused it at the time or told them that you’d do it later, perhaps not seeing the value in it at the time? If you’re curious, it’s probably worth placing a call to your regular office, just to verify that they’ve never recommended one.

Secondly, grinding can damage your teeth in a lot of ways. Looking only at the teeth, and not the TMJ problems, you can wear down your teeth or you can loosen them. When the grinding wears down your teeth, you may experience sensitivity. The only fix for this is restorative work. You have to build the tooth back up, usually with a crown. As far as loosening them goes, your teeth have ligaments and when you pull on them, they stretch. They can even snap and break. All that grinding can loosen your ligaments and cause the tooth to become loose. Then, you’re opening yourself up to periodontal issues, infection, and exposing the root of the tooth, or killing the tooth. Out of all these things, the only two that generally result in sensitivity to sweets are root exposure and missing enamel.

To get rid of the sensitivity, you’d likely either need to use desensitizing toothpaste or add a layer to the tooth, to replace what you’ve ground away or to protect the exposed area. A night guard prevents and protects, but it can’t undo damage you’ve already done. In other words, wearing a night guard wouldn’t be an instantaneous solution to your sensitivity to sweets. However, it can prevent you from damaging the enamel further and will protect any restorative work you’ve had done.

This blog is sponsored byElgin dentist, Dr. Steve Sirin.