Three levels of destructive power: 1) Mild 2) Moderate 3) Destructive
Different levels grinding-clenching prescribe different appliances: 1) Mild = soft biteguard 2) Moderate = hard nightguard 3) Destructive = orthotic
Different Tools for each level: 1) Mild = appliance 2) Moderate = nightguard & conservative therapies 3) Destructive = orthotic & orthopedic team & 11 different tools
Sensitivity is early hint of destructive grinding: Escalate level care if sensitivity persist: 1) Sensitivity toothpaste 2) Sensitivity varnish 3) Occlusal adjustment 4) Nightguard Appliance 5) Referral Orofacial Pain Specialist before they destroy chewing system
Let's do some simple logic for Atypical Toothache: 1) If frequent repetitive tooth discomfort is not cavities or gums disease, only disease left is destructive grind 2) After 2-3 restorative procedures on a tooth, think about referral Orofacial Pain Specialist 3) Continue treat symptom, TOOTH DISCOMFORT, or treat cause, DESTRUCTIVE GRIND 4) Diagnostic testing at "OROFACIAL SPECIALIST, determines cause "ATYPICAL TOOTHACHE" 5) Prevent patient wasting tooth structure and money by treating cause pain
Diagnosing Grinding/clenching: 1. Wear 2. Tori 3. Recession 3. Cracks 4. Sensitivity 5. Bone Buttressing 6. Mobility 7. Broken crowns 8.. Cervical erosion 9. Bone loss 10. Failed implant 11. Toothache 12. Microfracture 13. Broken filling 14. Chip teeth 15. Broke teeth. 16. Root canals 17. Post open bite 18. Asymmetry 19. Disc displace 20. Tension HA 21. Arthritis TMD 22. Restricted open 23. Atypical Earache 24. Trigger Points 25. Enlarged Masseter 26. Decrease airway 27. Broken retainers 28. Worn bite guards 29. Scallop tongue 30. chip front teeth 31. Open contact 32. Moving teeth 33. Post operative pain 34. Margin breakdown 35. Snoring 36. Esthetics destroy 35. Enlarge M. Pterygoid
Destructive Parafunction Damages all 4 structures of chewing system: 1) TEETH 2) JOINT 3) MUSCLE 4) BONE SUPPORT
The third disease, “destructive parafunction” is movement disorder for which dentistry has little to offer against its destructive power.
In fact the dental profession has fallen to "Titanic Thinking"= mankind will invent a crown that can't be destroyed, so meet the Zirconia crown. The destructive grinding will destroy joint and muscle since it can't destroy crown.
Nightguard should be prescribed first to protect crown-bridge-implants against destructive grind-clench. For mild to moderate grinding, the nightguard is typically done after restorations.
Consumer & Dental bias with grind/clench
Level grinding verses type appliance
Destructive forms Behavior:
Things to remember: 1) Manage destructive parafunction before you buy expensive dental care 2) Orofacial pain specialist is only specialty that treats/manages movement disorder 3) Utilizes 11 tools to manage movement disorder 4) Utilizes orthotic to reduce power destructive grind/clenc 5) No appliance cures destructive grind 4) If destructive grind destroys teeth, it will destroy your work ? 5) Dentist have no training movement disorder 6) Mild grinding/clenching should be treated by dentist 7) Dental appliances treat early grinding 8) Anxiety is fuel for increase grind/clench
DESTRUCTIVE PARAFUNCTION CAUSES: 1) Most restorative failures 2. Lost teeth after age 50 3. Cost in Billions 4. Is 2/3 revenue dentistry
GRIND ON THIS:
HIDDEN DESTRUCTION
Names for Destructive Grinding: 1) Movement disorder 2.. Grind/Clench 3) Restless mouth syndrome 4) Bruxism 5) Gnashing
How can you loose your teeth ? 1. Cavities 2. Gum 3. Grind/clench 4) Trauma
Why does dentistry have such a problem with grinding ?
Dentist
Orofacial Pain Specialist
Why do you need an orofacial specialist for destructive parafunction
SIGNS DESTRUCTIVE PARAFUNCTION 1) Chewing system malfunction: pleasure eating, poor nutrition, mechanical efficiency 2) Muscle damage: trigger points, enlarge muscle, muscle pain, cramping 3) Joint damage: tear lateral ligament disc, displaced disc, restricted open 4) Early Wear teeth: baby tooth wear, 1st molar wear, were anterior teeth 5) Mod/Sev Wear: loss 6 mm enamel, flatten occlusion, missing teeth, 6) Recession/bone loss: w/o infection, mechanical loss, sensitivity, expose root, cervical erosion 7. Bone enlargement: palatal or mandibular tori, buccal bone buttressing maxilla & mandible
Dentistry & Parafunction: @@@@
Look for Early warning signs: child & teen:
Atypical Toothache: damage to outside nerve
A. How can a tooth hurt after root canal ?
1. Inside nerve is treated w/ root canal
2. Outside nerve is still very much alive
B. Why does tooth hurt after root canal
1. the outside nerve is damage by clenching/grinding
2. Occlusion can aggravate outside nerve
3. Outside Ligament stretch & compress 100 time hour setting off nerve
5. This nerve travels in same bundle of inside nerve to same area brain
6. The brain cannot discriminate difference outside vs inside nerve
7. Tooth still hurts after root canal, choice: outside nerve or crack
C. How you can cause the same type pain ?
1. Tap on your front tooth for 3 minutes = sensitivity
2. Tap on your front tooth for 5 minutes = discomfort
3. Tap on your front tooth for 7 minutes = pain
Outside nerve Analogy: kick a mailbox post every day, the dirt loosens, and rain washes dirt away,
Three levels of destructive power: 1) Mild 2) Moderate 3) Destructive
Different levels grinding-clenching prescribe different appliances: 1) Mild = soft biteguard 2) Moderate = hard nightguard 3) Destructive = orthotic
Different Tools for each level: 1) Mild = appliance 2) Moderate = nightguard & conservative therapies 3) Destructive = orthotic & orthopedic team & 11 different tools
Sensitivity is early hint of destructive grinding: Escalate level care if sensitivity persist: 1) Sensitivity toothpaste 2) Sensitivity varnish 3) Occlusal adjustment 4) Nightguard Appliance 5) Referral Orofacial Pain Specialist before they destroy chewing system
Let's do some simple logic for Atypical Toothache: 1) If frequent repetitive tooth discomfort is not cavities or gums disease, only disease left is destructive grind 2) After 2-3 restorative procedures on a tooth, think about referral Orofacial Pain Specialist 3) Continue treat symptom, TOOTH DISCOMFORT, or treat cause, DESTRUCTIVE GRIND 4) Diagnostic testing at "OROFACIAL SPECIALIST, determines cause "ATYPICAL TOOTHACHE" 5) Prevent patient wasting tooth structure and money by treating cause pain
Diagnosing Grinding/clenching: 1. Wear 2. Tori 3. Recession 3. Cracks 4. Sensitivity 5. Bone Buttressing 6. Mobility 7. Broken crowns 8.. Cervical erosion 9. Bone loss 10. Failed implant 11. Toothache 12. Microfracture 13. Broken filling 14. Chip teeth 15. Broke teeth. 16. Root canals 17. Post open bite 18. Asymmetry 19. Disc displace 20. Tension HA 21. Arthritis TMD 22. Restricted open 23. Atypical Earache 24. Trigger Points 25. Enlarged Masseter 26. Decrease airway 27. Broken retainers 28. Worn bite guards 29. Scallop tongue 30. chip front teeth 31. Open contact 32. Moving teeth 33. Post operative pain 34. Margin breakdown 35. Snoring 36. Esthetics destroy 35. Enlarge M. Pterygoid
Destructive Parafunction Damages all 4 structures of chewing system: 1) TEETH 2) JOINT 3) MUSCLE 4) BONE SUPPORT
The third disease, “destructive parafunction” is movement disorder for which dentistry has little to offer against its destructive power.
In fact the dental profession has fallen to "Titanic Thinking"= mankind will invent a crown that can't be destroyed, so meet the Zirconia crown. The destructive grinding will destroy joint and muscle since it can't destroy crown.
Nightguard should be prescribed first to protect crown-bridge-implants against destructive grind-clench. For mild to moderate grinding, the nightguard is typically done after restorations.
Consumer & Dental bias with grind/clench
Level grinding verses type appliance
Destructive forms Behavior:
Things to remember: 1) Manage destructive parafunction before you buy expensive dental care 2) Orofacial pain specialist is only specialty that treats/manages movement disorder 3) Utilizes 11 tools to manage movement disorder 4) Utilizes orthotic to reduce power destructive grind/clenc 5) No appliance cures destructive grind 4) If destructive grind destroys teeth, it will destroy your work ? 5) Dentist have no training movement disorder 6) Mild grinding/clenching should be treated by dentist 7) Dental appliances treat early grinding 8) Anxiety is fuel for increase grind/clench
DESTRUCTIVE PARAFUNCTION CAUSES: 1) Most restorative failures 2. Lost teeth after age 50 3. Cost in Billions 4. Is 2/3 revenue dentistry
GRIND ON THIS:
HIDDEN DESTRUCTION
Names for Destructive Grinding: 1) Movement disorder 2.. Grind/Clench 3) Restless mouth syndrome 4) Bruxism 5) Gnashing
How can you loose your teeth ? 1. Cavities 2. Gum 3. Grind/clench 4) Trauma
Why does dentistry have such a problem with grinding ?
Dentist
Orofacial Pain Specialist
Why do you need an orofacial specialist for destructive parafunction
SIGNS DESTRUCTIVE PARAFUNCTION 1) Chewing system malfunction: pleasure eating, poor nutrition, mechanical efficiency 2) Muscle damage: trigger points, enlarge muscle, muscle pain, cramping 3) Joint damage: tear lateral ligament disc, displaced disc, restricted open 4) Early Wear teeth: baby tooth wear, 1st molar wear, were anterior teeth 5) Mod/Sev Wear: loss 6 mm enamel, flatten occlusion, missing teeth, 6) Recession/bone loss: w/o infection, mechanical loss, sensitivity, expose root, cervical erosion 7. Bone enlargement: palatal or mandibular tori, buccal bone buttressing maxilla & mandible
Dentistry & Parafunction: @@@@
Look for Early warning signs: child & teen:
Atypical Toothache: damage to outside nerve
A. How can a tooth hurt after root canal ?
1. Inside nerve is treated w/ root canal
2. Outside nerve is still very much alive
B. Why does tooth hurt after root canal
1. the outside nerve is damage by clenching/grinding
2. Occlusion can aggravate outside nerve
3. Outside Ligament stretch & compress 100 time hour setting off nerve
5. This nerve travels in same bundle of inside nerve to same area brain
6. The brain cannot discriminate difference outside vs inside nerve
7. Tooth still hurts after root canal, choice: outside nerve or crack
C. How you can cause the same type pain ?
1. Tap on your front tooth for 3 minutes = sensitivity
2. Tap on your front tooth for 5 minutes = discomfort
3. Tap on your front tooth for 7 minutes = pain
Outside nerve Analogy: kick a mailbox post every day, the dirt loosens, and rain washes dirt away,
1) Food Inflammation perpetuates chronic pains
2) Requires improvement in cardiovascular system