Demi Moore revealed on The Tonight Show this week that she is missing her two front teeth. She said that stress caused her to grind and clench her teeth breaking off her upper central incisors. Although I did not do her dentistry, I wanted to share with you her photos and what modern dentistry can do. She appears to have porcelain crowns on all her teeth and a bridge across the front to fill in the missing teeth. Ms. Moore also probably had a bone graft and periodontal surgery to sculpt her gums.
Stress can indeed take a toll on people’s teeth. When people are stressed they tend to grind and clench their teeth. This causes them to wear their teeth down and crack and fracture them. It also caused pain and headaches. Stress also effects the immune system and our ability to fight gum disease. Periodontal disease causes bone loss around the teeth. When you are stressed, you also do not eat or sleep well and tend to neglect your teeth and gums. Combine clenching and grinding with weakened teeth and gums, and teeth are going to break for sure!
A small break can be repaired with a filling or crown. Sometimes a root canal is needed. If the tooth is fractured or broken down to the root, it cannot be saved and we need to extract it. Here is an example an upper premolar tooth that was fractured down the middle from grinding and clenching that I extracted.
A simple preventative solution to help protect your teeth while clenching and grinding during sleeping is a nightguard. A nightguard is a proactive step to protect your existing healthy teeth. A clear, thin removable device, your custom-made bite splint, is worn over your lower or upper teeth as you sleep.
Studies suggest those who grind and clench their teeth may experience up to 80 times the normal tooth wear per day compared to those who do not. The good news is that a simple bite splint can help offset the effects of this often-subconscious habit while protecting your teeth from daily wear and tear.
This patient today broke off his upper lateral incisor. We discussed the different restorative options. I told him I would try to save the root and build a tooth back up for him and place a crown. The tooth had a root canal many years ago. I drilled out the canal and cemented a titanium post inside the canal and build the tooth up. I prepared the tooth and made and cemented a zirconium crown over the build-up.
This first patient came to see me for this broken lower molar. He said he had 4 silver amalgam fillings placed in his lower molar over the last 10 years by various dentists and the tooth or filling and kept breaking. I told him he needs a crown. Here’s the pre-treatment x-ray, and photo of the broken tooth before and after removal of the old filling and decay, composite build-up and placement of the porcelain crown.
This next patient broke her molar biting into an almond. I removed the broken part and old amalgam filling and restored this tooth with a crown. Here’s the before and after photos.
This next patient broke her last molar and old amalgam filling biting on hard seed. Here’s this before and after.
This patient had a root canal but never returned to have the crown placed. She bit down on a nut and fractured her molar. The tooth was cracked down the roots and non-restorable. I extracted the tooth. She was not planning on having an implant and she elected not to have a bone graft.
This patient chipped his front tooth when he was bumped into while drinking at a restaurant. The glass he was drinking from knocked into his tooth, fracturing off the corner. I repaired it in 15 minutes with a cosmetic composite bonded restoration.