Night Clenching & Partial Denture

[SallyUK]

Hi
After a few months of dealing with an acute infection effecting my incisor and canine tooth I am to have the canine extracted and a partial denture. Dentist can’t be sure of source of infection as root canal on incisor not completely sorted the issue as I have a fistula between the teeth and advised the situation now chronic.The canine is slightly mobile with bone loss between the teeth......

I have everything crossed this clears the infection, been advised removing the incisor is the next step if not.

I am worried about this infection, how it got there and want it gone. However I have a niggling feeling that night clenching has something to do with this situation. I have spoken to my dentist about my bite changing on and off on that upper quadrant, muscle imbalances from clenching. I’m pretty sure that the clenching got worse either due to this infection or before it, either way I know it’s linked as I was literally bashing these two teeth together. As the infection has cleared somewhat the canine tooth has moved back a bit, my bite has also continued to be on and off. This canine has a very old crown and it has a high ridge at the back. I’m thinking it’s niw ‘in the way’...

Anyway I am wondering about what a missing tooth and partial will do to this dynamic? I haven’t mentioned this to my dentist yet as only just thought of this. I’m worried about the remaining teeth on that side. My dentist has offered a mouth guard and I was about to get it before this episode but he seemed to think it might not help much and I will continue to clench in various combinations, he said that an occlusion issue was no longer thought to be the main factor and adjusting bite can make things more complex.

I am now thinking I disagree, it makes sense to me that clenching might make the teeth move a bit, even if they go back, and the clenching continues trying to find the bite.... will having a denture make this worse? Can I have a mouth guard too? How will that work over a denture?

I’m desperate not to loose anymore teeth and they are all crowned in this upper quadrant, thinking about it, this area is the worst in my mouth, with restorations and up and down gum pockets, not major but it’s the area that is most vulnerable.

I’m trying to be proactive in my thinking to feel a bit more in control, I’m super scared of treatment and of things just getting worse. No understanding of how his infection started and where it’s coming from has freaked me out. But I’m willing to bet my layman gut instinct that an old restoration and clenching has something to do with i and along with my own efforts to stop I want to make sure the dental situation is as good as it can be with this in mind.

Can clenching compromise teeth to the point of infection?
Is occlusion important to consider in clenching?
Can you have a mouth guard and a partial denture?
I’ve had first impression for denture, if my bite is currently off due to slightly out of position crowned canine will the denture be right?
If my dentist isn’t as interested as me in looking at occlusion as a factor is there somewhere I can go for a second opinion? Orthodontist?

 

[Judythecat]

Not a dentist, but I am a clencher. I never sleep without a night guard, and mine essentially moves my jaw so it's in the correct position. My bite was previously way out of alignment.

My front teeth don't meet when I wear the guard. I initially had a flexible upper guard, and now I have a rigid lower one. If you are having issues on the top, I'd imagine you would be provided with a lower guard, or vice versa.

I also have a flexible partial denture which replaces a missing lower molar. I don't sleep with it in, so it has no impact on my night guard.

 

[SallyUK]

Not a dentist, but I am a clencher. I never sleep without a night guard, and mine essentially moves my jaw so it's in the correct position. My bite was previously way out of alignment.

My front teeth don't meet when I wear the guard. I initially had a flexible upper guard, and now I have a rigid lower one. If you are having issues on the top, I'd imagine you would be provided with a lower guard, or vice versa.

I also have a flexible partial denture which replaces a missing lower molar. I don't sleep with it in, so it has no impact on my night guard.

Hi Judy. I'm not sure what I need but I know that my jaw and teeth are struggling to find correct bite and I'm tired of it. Once the tooth that's moved after the infection is sorted I want to stop any more damage. Did your regular dentist do the partial and the guard for you? I think I want to press my dentist on this, he doesn't respond much when I mention my bite, maybe he knows he can't do anything right now.....

 

[Judythecat]

Hi Judy. I'm not sure what I need but I know that my jaw and teeth are struggling to find correct bite and I'm tired of it. Once the tooth that's moved after the infection is sorted I want to stop any more damage. Did your regular dentist do the partial and the guard for you? I think I want to press my dentist on this, he doesn't respond much when I mention my bite, maybe he knows he can't do anything right now.....

Yes. She originally got me the flexible guard, but the consultant I am under at Max-Fac then said I needed a rigid one. She had to get approval from the health board to do it on the NHS, otherwise it was going to be around £200 for the flexible one - and she actually just charged me lab fees for the rigid one.

I got the denture privately, but still at my own surgery/dentist which is mixed NHS/private. I initially had nothing in the gap (for about ten years) but it is not visible unless I yawn really widely. I could have had a standard plate, but I paid £300 for the wee flexible partial which is tiny and just joins to the next door teeth with gum coloured acrylic - it doesn’t go right round my mouth or anything.

I was smashing up my back teeth with clenching, so my situation is possibly a bit different. I had no idea I was doing it at the time, until I cracked a huge filling, went in, and my dentist spotted I had knackered other teeth too. I’d had a checkup about four months before then with no issues, but had a period of extreme stress. She diagnosed me immediately and suggested the guard, which took a few weeks between impressions, health board approval, and lab. (I would have paid privately if the health board said no, obviously.)

I wonder if your dentist is waiting until things settle down, and doesn’t want to throw anything else into the mix while you are having problems?

 

[MountainMama]

My bite is also way off after the two extractions I had. I still have a ways to go with my my dental work, and my dentist had mentioned getting a night guard made after we are done with all my dental work. I also clench at night, and as we have discussed, also have infection that doesn't seem to want to go away.

My dentist said to use an over the counter night guard in the meantime, but I have had fits with them. I have tried 3 different ones, and they all cause different issues in other teeth.

My endodontist said I could get one made now, it would just have to be remade again after all my dental work is done. They are expensive, so I really can't do that.

 

[Judythecat]

Actually, my dentist had to sign a thing saying there would be no further dental work for six months for the health board approval to have mine made. Sally, are you an NHS patient?

 

[SallyUK]

Hi MountainMama
We could be related! All these things interlink - complete nightmare. Never in a million years did I expect all this.

Hi Judy
My dentist is private - I am not sure what the cost would be I am paying a fair amount for the partial denture and to be honest I don't even know what type! I am going to have another impression taken on Tuesday and I have a lot I want to ask him. It makes sense that the guard would be best made when things are settled.......... but there is the element of things not settling because of clenching. I am doing ok today - had a session of accupuncture!

 

[MountainMama]

SallyUK,

The best luck I have had with the night guards that you can buy over the counter are the ones that are flexible and you boil, then form to your teeth. Right now, I am using one on my lower teeth, since my upper is where the infection is. I really made sure it was fit against my teeth, then I cut it so that there was an indention in the front where my front teeth are (infection area), so that the guard does not touch those teeth. The guard is rubbery, so when I clench, it has give and doesn't hurt my teeth. So far, it is the best of the three I have tried. The harder ones provide support, but when I clench, it just makes my teeth ache in the morning. I will use this one until everything is sorted out. I have my apico tomorrow, so I hope that puts out one fire.

 

[Judythecat]

Glad you’re doing okay and taking care of yourself. When I was in the worst of my teeth nightmares I kept a list of questions on a note on my phone to make sure I remembered what I wanted to ask.

The private cost for my flexible guard was about £200, the rigid one was more. I am lucky to be an NHS patient. My surgery is mainly private, but I have gone there since I was a child so have been able to remain NHS. I know they occasionally take on NHS patients - maybe it’s only when the current ones die off!