A recent patient complained of a tooth that hurt when he bit down on hard foods. There was no cavity. There was no crack in the tooth, and nothing unusual showed up on x-rays. The tooth was not sensitive to hot, cold, or sweet, and it never started hurting suddenly or woke him at night.
There was no abscess or swelling of the gums around the tooth, no sensitivity to brushing, and no bleeding as a result of brushing. Nor was there any new dentistry done to the tooth that might be suspect. The bite pressure on the tooth was also normal when he closed his teeth together.
And yet, there was pain when chewing food on that side. I lightly tapped the tooth and there was a mild response. I told him he was grinding his teeth at night without being aware. After all, who knows what you do in your sleep at night because you’re asleep, right?
I had him bite very hard on a piece of marking paper, and there was a little extra contact compared to the other teeth biting. I adjusted the bite slightly and recommended a soft poly vinyl lower custom night guard, that I could make, to act as a shock absorber for his biting and clenching at night.
The problem was, he was doing enough grinding at night to cause inflammation of his tooth nerve, which reacted painfully when he bit on something hard. I recommended three or four days of anti-inflammatory medications to bring the inflammation down. When he returned for a followup visit his tooth was feeling fine.
He came to see me and didn’t wait. As soon as something seemed wrong he acted. Had he waited, this simple problem might well have resulted in the nerve dying, and the tooth needing a root canal and a crown. He would have endured long, expensive treatment in comparison to what we did.
So, if something seems wrong, or strange, or “funny” go with your instincts and give us a call. Trust your instincts, you’re probably right. Use the links to the right to learn about more “interesting conditions” in the dental world!