What is Bruxism?

Grinding of teeth, also known as, Bruxism occurs in children as well as adults and generally takes place during your sleeping hours.

What if your child id grinding  his or her teeth?

Children often grind their teeth when new teeth are coming in, this is not uncommon, nor is it a problem. In most cases, it’s mild and usually stops once the teeth are erupted. However, in more severe cases, your child could develop a malocclusion, which could lead to TMJ (tempromandibular joint) problems, or a need for orthodontics. If you have any concerns about your child’s bruxism, be sure to mention it so that Dr.Shlafer can check for excessive wear and discuss treatment options that may need to be implemented to prevent a serious problem.

What about Bruxing in adults?

Adults may grind their teeth at night due to: malocclusion or stress. The result of bruxism can be: worn spots (attrition) that can lead to —malocclusion (if you don’t already have it); sensitivity; brittle teeth that may require crowns; TMJ problems and of course the unsettling noise that grinding  teeth make is disruptive to your partners sleep.

How can Bruxism be treated?

Sometimes, the damage caused by bruxism must be addressed first. Any malocclusion, sensitivity, brittle teeth, or TMJ problems would be discussed with Dr.Shlafer to make sure they are resolved and that the subsequent treatment for bruxism prevents a recurrence of those problems. Further damage from bruxing can be prevented with a night guard that is worn while you sleep. This guard is comfortable and easy to wear. Give us a call if you are concerned and want to stop the damage caused by bruxism and avoid more serious problems.

Unfortunately not all dental fears are easy to overcome. Some people can spend their whole lives being fearful of dental care. There are some common fears that hold patients back from scheduling dental appointment. Here are a few:

• The Drill—-Many patients do not like the high pitched whirring sound of the drill—we have headphones for patients to wear to listen to soothing music and block out the sounds around them.
• A Bad Dental Experience—A bad experience can be enough to cause a person to avoid the dentist. We find it helps patients to discuss those concerns, what didn’t go well and what would they have liked to be done differently. This allows us to plan the appointment specifically to avoid those same pitfalls.
• A Painful Teeth Cleaning— Patients tell us they have had painful hygiene visits, during and for days after the appointment due to the hygienist “scraping” their teeth. We have two very gentle and highly experienced hygienists that can help with anesthesia and the use of an ultrasonic cleaner which sprays water, taking the place of hand scaling. Patients find this technique so much more comfortable. We always work with our patients to find the most comfortable solutions.
• The Anesthetic Injection—-There are couple parts of the injection that may cause anxiety and fear in a patient. FEAR of the pain of the injection—the pinch associated with it–Dr.Shlafer numbs the area with a topical anesthesia prior to the injection so that pinch is avoided. FEAR of being numb–some people hate the feeling of losing sensation in a part of their lip and gums. Dr.Shlafer has many anesthetics to choose from which can create a short term or long term numbing depending on the procedure. Discussing this in advance with the patient and allowing them to be part of the decision making helps tremendously.
• Getting Teeth Extracted—Many patients find this scary, the idea of having a body part removed can leave people feeling unsettled. Dr.Shlafer does not extract teeth unless there is no other option, again we want to work with our patients to prepare for this appointment and do everything we can to reduce the anxiety. This may include some type of sedation to help patients be comfortable throughout the appointment.
• Embarrassment—People may be afraid to come in because they are embarrassed over their the poor condition of their teeth or feel they have been away so long, surely they will have a lot of work to do. Dr.Shlafer does not judge and is not concerned with what happened in the past, if you are here now–we will focus on what we can do to help.
• Having A Panic Attack—Many patients are afraid that they will panic while the dentist is trying to work. We have several patients with this condition, which once we are made aware of,we can help you manage it–the most effective way is some type of sedation. It takes some discussion to determine what creates the panic for you and then we develop a plan to work around it.
• Not Having Control–Patients may feel they have no control over the procedure or what is happening. Dr.Shlafer always discusses the procedure so you will know what to expect and patients are encouraged to raise their hand if they need to ask a question or need him to stop.
• Gagging—Many patients do have a strong gag reflex which creates the fear of gaggig or choking during a procedure. Again, this is why we discuss the procedure and what to expect prior to starting and using Nitrous Oxide (or as patients refer to it–laughing gas) to relieve this. There are certain procedures which we can prepare for, like taking x-rays or taking an impression where most commonly patients will need help.

There are many reasons that patients fear going to the dentist. It is always best to let us know what causes your fear so we can work together and devise a solution to help you have the most comfortable visit  ever.

Worn Teeth—Why should I be concerned? When the enamel of a tooth is worn away, the tooth often becomes sensitive and may be more susceptible to decay. If the tooth has worn down significantly, a crown may be necessary to save the tooth.

Tooth enamel may be worn away in several ways. One or more of the following factors may cause premature wear:

Attrition—Attrition is the gradual loss of enamel through”wear”. A small amount of attrition may be caused by normal speaking and eating, but this doesn’t typically produce excessive wear. More extreme cases of attrition are typically caused by bruxism, the grinding or teeth against teeth. Bruxism typically occurs at night while a person sleeps, so often you are unaware of what is happening.

Abrasion—- Abrasion is wearing away of tooth enamel by a foreign object. Common causes of abrasion are:

• Brushing to hard or to long
• Fingernail biting, chewing on pens or pencils, holding needles or pins between your teeth, chewing ice, etc.
• Oral piercings–patients with pierced lips and/or tongue often wear away the enamel on the adjacent teeth from the jewelry rubbing on a daily basis.

Erosion—-Erosion is the chemical wear of tooth enamel. Typically  this kind of wear is caused by an acid. Citric acid is one of the most common agents. Citrus fruit–lemons, limes, oranges, grapefruit all contain citric acid, as do most soft drinks and citrus juices. Some candies also contain citric acid. Coffee and tea also contain corrosive acids. Bulimic individuals also expose their teeth to very strong stomach acids.

Occasional exposure to most dietary acids is rarely a problem, but repeated exposure to high levels of these acids can cause premature wear. Some common habits to avoid are:

• Regularly sucking on lemons and limes
• Regularly eating or sucking on candies, especially “sour” candies as they often contain sugar and citric acid.
• Drinking several soft drinks daily, even “diet” soft drinks
• Drinking several glasses of lemonade daily
• Drinking several cups of coffee or glasses of tea daily

Even if you only occasionally eat or drink acidic foods, it’s a good idea to at least rinse your mouth with fresh water when you are finished to reduce the amount of time your teeth are exposed to the acids. If you are concerned, Dr.Shlafer can examine you and determine if you have premature wear of your enamel.

Invisalign is quickly becoming one of the most popular options for people who are looking to obtain straight teeth without the use of traditional braces. Many patients wonder, “Is Invisalign right for me?” If you have ever asked yourself this question, the following information may play a role in helping you decide.

Invisalign is an orthodontic system used to straighten your teeth using a series of clear retainers, also known as aligners, rather than the traditional brackets, bands, and archwires that are normally used. Here’s some factors to consider:

1. The costof orthodontics is generally considered to be expensive. Invisalign may cost more than traditional braces due to the fact you may be in treatment longer before teeth are moved into their correct position. Also, keep in mind that because Invisalign is not made in the dental office, losing or breaking an Invisalign retainer will add additional costs for the patient. Patients that require Invisalign treatment may be required to wear traditional clear braces for a short period of time before they are able to advance to the Invisalign retainers. On average,  treatment costs can start at $5000.
2. Your speech.  The idea of  the Invisalign system being discreet is very appealing to people. For some patients, these retainers may cause a temporary speech impediment, due to the extra  bulk on the back of the teeth caused by the retainer. Most patients report that their speech returns to normal 1-2 weeks  after wearing the Invisalign retainers.
3. Remembering to Wear the Retainers.  Wearing your retainers as prescribed by your dentist is the most important aspect of your treatment. Patients are required to remove the retainers when  brushing, flossing, and before eating. Sometimes patients will forget to replace the retainers after eating, mealtime can  be a high risk time frame to loose your retainers.
4. Grinding and Clenching Your Teeth. Patients that grind or clench their teeth may find that their Invisalign retainers can take a real beating. Grinding on the retainers may cause the biting surfaces to wear thin, and eventually cause a hole in the material. If you normally wear a night guard and/or have TMJ (tempromandibular joint) issues, this is definitely something you will want to discuss and have evaluated with your orthodontist.
5. Coffee and Tea Drinkers. If you can’t forego your cup of morning coffee or tea (or additional cups throughout the day), you may  find your retainers begin to pick up the stain from those beverages. Also, the temperature of the beverage may affect the shape of the retainers, causing them to warp and not fit correctly.

Only you and your orthodontist can determine together if you are an ideal candidate for Invisalign. If you have questions regarding Invisalign, Dr.Shlafer will speak to you about the orthodontists we recommend to care for our patients.                                          

 Q: Can I straighten my teeth without traditional braces?

A: Many adults yearn for straight teeth but are reluctant to undergo orthodontic treatment because of the look and feel of traditional braces. (see photo) The Invisalign orthodontic system was introduced to dentists and orthodontists as a means to straighten teeth without using traditional braces. If you have written off the idea of orthodontics because you are not thrilled with the thought of wearing traditional braces, now may be the time to learn about Invisalign.

Having straight teeth is a dream for many people, due to the fact that obtaining orthodontic treatment may mean bulky, and noticable brackets. The Invisalign system may be the answer you are looking for.

The Invisalign system moves teeth into their desirable position in the same way that conventional braces move teeth during orthodontic treatment, but without the use of bands, brackets, and elastics. Invisalign involves the use of a series of removeable clear retainers that are worn over a period of one to two years. This type of orthodontic treatment is a much more  palatable way for patients to straighten their teeth. You may be wondering if Invisalign is right for you, Dr.Shlafer can discuss more details with you at your next visit. Let us know how we can help.       

Everyone wants to keep their teeth as sparkling white as possible, especially after a teeth whitening procedure. Prolonging the effects of a teeth whitening system keeps your smile brighter longer. Less frequent teeth whitening follow-up is possible when patients follow these 3 rules: keep teeth clean, avoid staining and use your whitening products properly.

Dental Care After Whitening:

Routine brushing and flossing is the easiest way to keep teeth clean and healthy. Patients may want to consider using a fluoride toothpaste after whitening teeth too. To ensure the cleanest teeth possible, maintain your recommended hygiene schedule and follow your home care routine diligently.

Post-Whitening Oral Hygiene:

Should you floss before or after brushing?  Dr.Shlafer recommends flossing after every brushing session. Curve the floss around teeth, up and under the gum line and move it back and forth to loosen any residual food that could cause bacteria and staining to develop. Patients can also keep teeth clean with a fluoride mouthwash, which is able to reduce bacteria in the mouth by half.

Reduce Teeth Staining:

Another step towards keeping teeth white is to avoid staining in the weeks following a whitening procedure by limiting food and drinks that have a high staining potential. Dark foods, like curry and soy sauce will stain teeth. Cigarettes and any type of tobacco will also reduce the quality of the whitening treatment. Avoiding coffee, wine, tea and sodas will also help keep teeth whiter. If you are unable to avoid these types of staining drinks, try using a straw to limit exposure.

With Dr.Shlafer’s cosmetic dental treatments in Detroit metropolitan area you can not only take advantage of teeth whitening services, but also restore broken teeth, fill gaps, reduce discolorations and be happier with the overall appearance of your smile. If you have been considering whitening your teeth, call for a complimentary evaluation and we can review the whitening options we have available.

Sedation dentistry is a solution for people who feel more comfortable being completely relaxed during their dental procedure. This can be helpful for patients that may have had a previous bad experience and now have high anxiety. Oral sedation dentistry is an alternative to full sedation which requires an anesthesiologist to monitor your breathing and heart rate. This is a great way to receive the dental care you desire, when  fear may be getting in the way of achieving the smile of your dreams.

The most common method of oral sedation dentistry involves the patient taking an oral medication about an hour prior to their appointment. For these types of appointments patients would be required to pre-arrange transportation. Another method uses nitrous oxide, also know as “laughing gas” this can be used alone or in conjunction with oral medication.  When   nitrous oxide alone is used, the affects wears off in a few minutes and patients can drive themselves home. Dr.Shlafer will work with you to determine the proper type of sedation for you.

Anxiety and Fear of Dentists:

Anyone who experiences anxiety or fear of dentistry would benefit from oral sedation. Patients with dental phobias may have had a traumatic experience as a child, have a bad gag reflex, or have extremely sensitive teeth and gums. These are common reasons patients avoid the dentist. As most people know, avoiding the dentist can cause plaque build-up which can lead to other health problems like stroke and cardiovascular issues. Regular visits can prevent cavities from progressing into  more serious and extensive dental procedures.

With Dr.Shlafer’s help, patients can work toward ending their overwhelming fears of dental treatment with our effective, gentle and safe sedation options. A complimentary visit to our office may also help those with anxiety by meeting our warm, caring staff and getting acquainted with our safe sedation options. Our oral sedation options allow you get the care you need while remaining calm and totally relaxed.

According to the American Cancer Society, more than 28,000 cases of oral cancer are diagnosed annually, with more than 7,000 of these cases resulting in death. Oral cancer may occur on the mouth, lips, tongue, salivary glands, and throat.

Since oral cancer often begins with an asymptomatic stage during which symptoms may not be obvious, it is often painless initially and therefore difficult to detect.  The following signs do not necessarily signify cancer, are not all inclusive and may signify other dental conditions, they may be associated with early signs of cancer. Since oral cancer treatment is usually successful when performed in the early stages, any abnormal change in the mouth, gums, tongue, or surrounding area should be evaluated by Dr. Shlafer immediately.

Possible Signs of Oral Cancer:

• Continuous pain in the mouth
• Sores and bumps inside the mouth, including ragged, ulcerous lesions
• Difficulty moving mouth and jaw
• Bump in the neck
• Pronounced pain in one ear
• Undiagnosed bleeding from tongue, gums or cheeks
• Numbness in a specific area of the mouth

For a definitive diagnosis, you can start with an evaluation by Dr. Shlafer. He will examine your mouth and evaluate your medical history to formulate an initial diagnostic impression. You may be offered a Vizilite cancer screening test and possibly asked to return to the office in 2 weeks to determine if a biopsy is needed. Dr. Shlafer will guide you through this process.

The most common symptom of TMJ disorder is pain in the chewing muscle or jaw joint.  TMJ pain is usually described as a dull ache in the temporomandibular joint and surrounding areas, such as the ears, neck and shoulders. Some patients experience no pain, but still have jaw functionality difficulties.

Other symptoms of TMJ disorder include:

—Pain or soreness in the jaw that is more prevalent in the morning or late afternoon.

—-Clicking or popping when opening and closing the mouth.

—-Swelling on the side of the face.

—-Sensitive teeth in the absence of dental problems.

—–An earache in the absence of an infection.

—-Difficulty opening and closing the mouth.

—-Upper and lower teeth that do not align properly.

—–Stiffness or a ”locked” feeling in the jaw when talking, yawning or eating.

—–Jaw pain when biting or chewing.

—–Recent changes to your bite.

—–Frequently waking up with headaches.

Who Diagnoses TMD?

TMD patients may see multiple health-care professionals in their quest for relief; including their primary care physicians, ear, nose and throat specialists; neurologists; pain specialists; and chiropractors.  The main reason many other physicians become involved  is because facial pain can be a symptom of such conditions as sinus infections, certain headaches, or tooth decay, and the source of the pain needs to be sorted out.  Dr.Shlafer has had extensive experience in this area and can diagnose and treat temporomandibular disorders, bringing many patients the relief they seek.

Some Common Causes of  TMD

Academic Stress and Bruxism–This is common in teenagers and college students, who are know to pull an “all-nighter” before a big exam or to stress out about their grades. That stress can lead to tooth grinding (bruxism) that wears down the teeth, as well and TMD.

Poor Posture—If you frequently slouch or hunch over, you may be throwing more than just your back out of whack. You may also be pushing your jaw out of alignment, according to the  Academy of General Dentistry, poor posture puts the spine in a position that stresses the jaw joint. In particular, the lower jaw shifts forward,causing the upper and lower teeth to misalign and the skull to move back on the spinal column. If not addressed, pain and inflammation in the muscles and jaw joints will develop when the mouth opens and closes.

Stress and Clenching—Clenching your teeth while worrying about your problems can place a burden on you temporomandibular joint. Stress manifests itself in such behaviors as clenching the teeth.

Super Sizing—Opening too wide to bite into super size sandwiches could cost you more than you bargained for! Taking bites that are to big to chew could lead to jaw and muscle pain and aggravate an already sore jaw.

Dr.Shlafer can examine you to determine if a structural disorder exists withing the joint itself, or if there is an interference in the bite–such as uneven teeth–that are affecting the joints ability to close properly, causing TMD.

There are a variety of TMJ symptoms and the severity and affects tend to vary from one patient to the next. The American Dental Association (ADA) cites the tempromandibular joint (TMJ) as one of the most complex joints in the body. Involved in it’s function are several muscles, ligaments and bones. The joint itself is comprised of a disc between a ball and socket, and that disc cushions the forces on the joint, enabling the jaw to move and function normally. Any conditions that prevent these components from working properly may cause a TMJ disorder.

CAUSES OF  TMJ DISORDER:

There are several TMJ disorders which can result from multiple causes. According to the Academy of General Dentistry, trauma to the jaw or jaw joint-such as a jolting injury to the head, face, or neck—sometimes play a role in TMD (temporomandibular disorder) and in most instances the cause is unknown.

The most common factor contributing to TMD is a bite problem affecting the joint itself. Interferences in the structure of individual teeth may force displacement of the lower jaw, leading muscles to reposition the joints out of their sockets to force the upper and lower teeth to fit together. Also, wear and tear on the teeth caused by aging, teeth grinding and clenching, or activities outside of normal function—called para function—which may cause uneven surfaces on the teeth, leading to interferences in the bite and improper jaw closure.

Anatomical factors within the joint or surrounding muscles also may interfere with the bite and cause TMD. Some TMJ disorders may be caused by arthtitis and dislocation, while other instances result from disease. For example, low-level infections and auto-immune disease are among the possible causes of TMD. In addition, some people may be genetically predisposed to TMD.

If you are having pain in your joint area, which can be triggered by stress, resulting in overuse of the jaw muscles (such as clenching or grinding of teeth) have Dr.Shlafer evaluate you.