Best way to replace a tooth if you suffer from bruxism?

[MollyMc]

I've had an absolute nightmare with my teeth this year. I cracked a very visible premolar last Christmas through clenching at night ?.

My nhs dentist tried a sort of composite bridge at first, to fill the gap. It was painful throughout the first lockdown (probably because I was still clenching on it), and eventually had to be removed.
He then made me a Maryland bridge, which lasted approximately one month before it fell out (just before Christmas). Again, he suspects that I ground it off with night time clenching. He booked me in to re-attach it on January 5th, but I've just realised I've lost it ?
Obviously I will just have to pay for a new one (?). This is a nightmare- I will eventually be around £900 down and may still be in pain. The actual anchoring tooth is quite tender, and I suspect also takes a lot of punishment from my clenching.
What is the best way of replacing a tooth in these circumstances? Would an implant fail?
is a partial denture my best option? I hope not!

 

[MountainMama]

I've had an absolute nightmare with my teeth this year. I cracked a very visible premolar last Christmas through clenching at night ?.

My nhs dentist tried a sort of composite bridge at first, to fill the gap. It was painful throughout the first lockdown (probably because I was still clenching on it), and eventually had to be removed.
He then made me a Maryland bridge, which lasted approximately one month before it fell out (just before Christmas). Again, he suspects that I ground it off with night time clenching. He booked me in to re-attach it on January 5th, but I've just realised I've lost it ?
Obviously I will just have to pay for a new one (?). This is a nightmare- I will eventually be around £900 down and may still be in pain. The actual anchoring tooth is quite tender, and I suspect also takes a lot of punishment from my clenching.
What is the best way of replacing a tooth in these circumstances? Would an implant fail?
is a partial denture my best option? I hope not!

I clench at night and have cracked a few molars. I had them extracted and now have implants. Do you have a nightguard? That is the best way to avoid damage in the future.

 

[Niall Neeson]

Yip I agree with MountainMama, a good quality, well-adjusted splint for wearing at night offers your best protection against any of the fixed options (implant, Maryland bridge or conventional bridge). It will also protect the other teeth to reduce the chances of the same problem arising elsewhere (and therefore save you money in the process).

If you don’t have one already then that’s got to be part of the plan for any chance of longer term success moving forward.

 

[MollyMc]

Thank you both. I have a soft mouth guard that I wear every night. It only seems to help up to a point- sometimes I feel that I chew harder on it because of the texture. Should I be looking at a harder splint? I’m sure my dentist would be open to discussing this.
A previous dentist mentioned a Michigan splint- any thoughts on this?

 

[MountainMama]

Thank you both. I have a soft mouth guard that I wear every night. It only seems to help up to a point- sometimes I feel that I chew harder on it because of the texture. Should I be looking at a harder splint? I’m sure my dentist would be open to discussing this.
A previous dentist mentioned a Michigan splint- any thoughts on this?

I can’t advise on the nightguard type, but mine is a hard one with a softer lining inside.

 

[Niall Neeson]

Yeah, that’s common that the softer splints seem to actually encourage people to chew on it and the teeth/ muscles almost seem to find it satisfying. The hard material on the other hand deter it as the teeth do not find it comfortable. An accurately-adjusted Michigan splint would be your best form of protection, yes.