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Problems from night time clenching

User Level:
Patient
Posted by: sherylherr  (5 years ago)
I have a tendency to clench my teeth occasionally while sleeping. I have a mouth guard, but because it's sporadic, I normally don't wear it unless I wake up one day with some symptoms... in which case I'll wear it for several days/weeks and then I'm usually fine for quite some time.

Several weeks ago, this happened. However, over the past few weeks the pain hasn't gone away. Then I began to develop a severe sensitivity in my upper right gum line/cheek area consistent with the next to last upper molar (I no longer have my wisdom teeth). In the past few days, the tooth sensitivity has become non existent. However, I have a hard "bump" in the upper part of my gum, close to where my cheek meets. It is sensitive to touching. However, I'm able to chew/eat fine. The bump covers the span of the next to last molar and the one in front of it.

I've been swooshing with salt water and peroxide and my dentist provided me with PerioGard for a previous gum problem so I've been using that as well. I'm unable to get in to the dentist until early August.

Is this something that needs immediate attention? Could it be something serious. When I try to search, I get a lot of information on abscesses, but the symptoms (bad taste, low grade temp, bad breath, tooth sensitivity) don't really seem to fit.

Does anyone have any wisdom they can provide for me?
User Level:
Dentist
I have a tendency to clench my teeth occasionally while sleeping. I have a mouth guard, but because it's sporadic, I normally don't wear it unless I wake up one day with some symptoms... in which case I'll wear it for several days/weeks and then I'm usually fine for quite some time.

Several weeks ago, this happened. However, over the past few weeks the pain hasn't gone away. Then I began to develop a severe sensitivity in my upper right gum line/cheek area consistent with the next to last upper molar (I no longer have my wisdom teeth). In the past few days, the tooth sensitivity has become non existent. However, I have a hard "bump" in the upper part of my gum, close to where my cheek meets. It is sensitive to touching. However, I'm able to chew/eat fine. The bump covers the span of the next to last molar and the one in front of it.

I've been swooshing with salt water and peroxide and my dentist provided me with PerioGard for a previous gum problem so I've been using that as well. I'm unable to get in to the dentist until early August.

Is this something that needs immediate attention? Could it be something serious. When I try to search, I get a lot of information on abscesses, but the symptoms (bad taste, low grade temp, bad breath, tooth sensitivity) don't really seem to fit.

Does anyone have any wisdom they can provide for me?


Your clenching may have cracked a tooth that later abscessed. You need to have it checked out.

This is a reason you should be wearing your mouth guard every night. You are probably grinding even when you do not wake up with pain.
Posted 5 years ago
User Level:
Patient
Posted by: sherylherr  (5 years ago)
You sure hit the nail on the head with that one. The dentist has confirmed that I have cracked the original filling. He is suggesting a root canal followed by a crown.
I've been wearing my mouth guard nightly since all of this started, but then the other day I woke up and the same molar on the opposite side of my mouth (left side, next to last - excluding the wisdom tooth) starting to behave the same way. But this tenderness and swelling is on the roof of my mouth. I'm fearing that it's another abscess. Are you more susceptible to additional abscesses after one? If I'm wearing the mouth guard nightly and still getting the same issues, what other options are there?

Also, I've been doing a little bit of research, and I'm wondering if an implant would be a comparable treatment plan to the root canal/crown? It looks like the cost would be close to the same.
User Level:
Dentist
You sure hit the nail on the head with that one. The dentist has confirmed that I have cracked the original filling. He is suggesting a root canal followed by a crown.
I've been wearing my mouth guard nightly since all of this started, but then the other day I woke up and the same molar on the opposite side of my mouth (left side, next to last - excluding the wisdom tooth) starting to behave the same way. But this tenderness and swelling is on the roof of my mouth. I'm fearing that it's another abscess. Are you more susceptible to additional abscesses after one? If I'm wearing the mouth guard nightly and still getting the same issues, what other options are there?

Also, I've been doing a little bit of research, and I'm wondering if an implant would be a comparable treatment plan to the root canal/crown? It looks like the cost would be close to the same.


This is the difficult decision: one never knows how far a crack goes underneath the gum. Occasionally, cracks in teeth are so deep they cannot be saved even with a root canal. The dentist may be able to tell when he starts the root canal. Occasionally, I have to abort root canals because I find cracks that doom the tooth.

I still think, barring a catastrophic fracture, it is better to save the tooth with root canal and crown rather than extract it, graft the site, and do an implant. People grind their teeth tend to put lateral forces on implants, which causes progressive bone loss around an implant.

You are not more prone to abscesses, you are more prone to cracking your teeth, which results in abscesses.

There is also the possibility of it being a periodontal abscess on the left, especially since you have your wisdom tooth.

How to stop women from grinding a clenching? If I only knew, I would stop my own wife from doing it. The best we have is night guards right now. She also has to wear it while driving, as this is such a source of stress for her.
Posted 5 years ago
User Level:
Patient
Posted by: sherylherr  (5 years ago)
I'm sorry. My wisdom teeth are gone. I had them all removed several years ago because they were impacted.
My concern now then is that he'll start a root canal and realize he can't do it and then i'll have to pay for both.

My other concern is that my grandmother, mother, and two aunts have all told me that they've had root canals that "didn't take" and they ended up having to have the teeth pulled anyways.

Is something like this hereditary? I don't want to pay a big pricetag for something that's going to fail and then have to pay another big pricetag if i can skip the middle option all together.

I still have quite a large infection in my mouth (I would say at or close to pingpong ball size). Does this make me more at risk for anything leading up to the root canal or it's success/failure? I'm on another course of antibiotics at this point (500mg TID for 10 days).
User Level:
Dentist
I'm sorry. My wisdom teeth are gone. I had them all removed several years ago because they were impacted.
My concern now then is that he'll start a root canal and realize he can't do it and then i'll have to pay for both.

My other concern is that my grandmother, mother, and two aunts have all told me that they've had root canals that "didn't take" and they ended up having to have the teeth pulled anyways.

Is something like this hereditary? I don't want to pay a big pricetag for something that's going to fail and then have to pay another big pricetag if i can skip the middle option all together.

I still have quite a large infection in my mouth (I would say at or close to pingpong ball size). Does this make me more at risk for anything leading up to the root canal or it's success/failure? I'm on another course of antibiotics at this point (500mg TID for 10 days).


The failure rate for root canals is about 6% and there is no hereditary component that anyone knows about for failure. If one fails, we can still do an apicoectomy and retrofill, which has about an 80% success rate.

The swelling means you have necrotic, rather an alive and inflamed pulpal tissue inside the root. The protocol is:

1. Lance the swelling and achieve drainage.
2. Start the root canal and do not finish it. Instead, fill the inside of the tooth with calcium hydroxide for three to four weeks to help eliminate the bacterial load from the dentin.
3. Finish the root canal.

If this is done, and the tooth is restored, the chance of failure is very small.
Posted 5 years ago
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