Dental mouthguard that doesn’t cover front teeth?

Saffythecat · 18 June 2018 at 8:33PM

I am a clencher and have needed a load of work on my back teeth over the last year. In the last six months I have also had pain in an upper front tooth, which has no decay, shows no issues on x-ray, and is responsive to cold and electric testing. It has never been filled or previously caused any problems. To my horror, the tooth has become slightly mobile (my dentist says just on the verge of being grade 1, but not quite). I have no gum disease, and never have had, although I am prone to a little bit of inflammation between the upper molar and neighbouring wisdom tooth.

I have been seen by my own dentist, a hygienist, and a maxillo facial consultant. I have also had an MRI scan, and a whole head x-ray. The MF consultant said he thought I was clenching the tooth into my night guard and basically rocking it in its ligament. (This makes sense to me, as if I clench my teeth without the guard, the front teeth wouldn’t meet and the bottom teeth would tuck behind the top ones.)

I am due to get fitted for a new guard, but wondered if there was a different type? The one I have looks like a bit like a clear denture but without the roof of mouth part, and covers my upper teeth only. It was custom fitted via my dentist. I am due for a review at MF next week and wondered if there were other options I should ask about? I am willing to spend whatever it takes to stop the pain and save the tooth.

The bruxism has been due to stress, and the situation causing the stress has been resolved just in the last few weeks, so I am hoping the clenching eases. I’ve always taken very good care of my teeth at home, and never missed checkups at the dentist, so the whole situation has caused me a lot of worry and distress.

Thanks for reading - I know no-one can diagnose over the internet, and that I am getting excellent care, I am just looking for any other options.

Toothsmith · 19 June 2018 at 10:42AM

It's not really for you to know the ins & outs of all the many types of bite guards there are - that's for the people with the dental degrees and the consultants who have built up a vast experience of all the different types.

Your consultant has identified a potential problem with the one you have had originally, his findings will be communicated with your dentist, and he will probably have recommended a different type of guard.

Although there are a fair few different appliances for doing this sort of thing, many of them are broadly similar, and groups of them certainly will do the same sort of thing.

Personally, I generally only use a couple of types of guard, and they generally do the vast majority of cases I see. I know how those types work, and I'm pretty good at adjusting them correctly.

If someone came in having been recommended, or googled a type I'd only seen pictures of, but had no experience of, then my first job would be trying to convince the patient that one of the types I usually use (and know about) would be better than the one Dr Google says!!

Let them look after you!

Edit - it doesn't really matter if the guard covers your front teeth or not anyway - so long as it is correctly adjusted to prevent the full force of the bite from going through that tooth - so don't panic if your new one still covers these teeth

JEN22 · 19 June 2018 at 11:29AM

I have the exact problem so bad that I have regular botox injected into my cheeks

I have just had another hard guard fitted by my dentist that covers the bottom teeth the sensitivity has become a lot less. I was wondering if sensodine rapid toothpaste would help me too?

Saffythecat · 19 June 2018 at 3:13PM

Thanks, Toothsmith - I appreciate your response. I am honestly not trying to do the dentist's job for her. I am just so sick of being in pain, and worried half to death about it all. While I know I am getting expert care, I also feel a bit like I'm being punted around (eg, the MF consultant requested the MRI scan, and I was told the report would go to my GP, who has had nothing to do with any of this, and seemed really annoyed when she had to call me to say she had no idea about what the results meant) and just generally a bit lost. I've gone from being someone who was never scared of the dentist and proud of my teeth (lots of orthodontic work in my teens) to being really anxious, so I feel like the better informed I am, the better able I will be to advocate for myself.

Jen, they actually do Botox in my dentist's place, but she's never recommended it to me.

Toothsmith · 19 June 2018 at 9:17PM

To answer the last point - doing Botox for facial aesthetics, and doing it for jaw problems are leagues apart. To do it for problems like TMJ is highly specialised, and someone trained in only facial aesthetics shouldn't be having a go at it. Having said that, it is probably in a dental practice (although more likely a specialist referral practice) that you are most likely to find someone so trained.

Back to the mouthguard bit, I didn't mean to sound too 'we know best' about it - but TMJ problems and their treatment is a hugely complex area. I don't consider myself to have a 'good' understanding of them, and I've been in practice for ages, and on numerous courses!!!

What I know has helped the vast majority of my patients with mild/moderate problems, but complex cases are very hard to treat, and proper 'specialists' are very hard to find. Treating it needs experience.

This is a decent place to look

https://bsos.org.uk/for-patients/

Saffythecat · 19 June 2018 at 10:43PM

Thank you, Toothsmith. My dentist doesn!!!8217;t actually seem to think I am a severe case - I was only referred to MF because of a weird shadow on the x-ray which had totally vanished when it was redone at the hospital, the consultant called it something like an artefact. The MRI was because I have had a weird pins and needles sensation along my chin and lip since the lower left molar I clenched to its death was extracted last summer. (It had been heavily filled prior, then a root canal where she couldn!!!8217;t find all the canals, and I couldn!!!8217;t afford the specialist. By that stage I just wanted it out because I was having horrible referred pain along all my lower teeth which are !!!8220;virgin!!!8221;.)

I am just so worried about the mobile tooth, and that it!!!8217;s going to fall out, which my dentist seems totally unbothered by. I know I should just be guided by her. (She said she would eat a pack of surgical gloves if it did, and that she has patients with grade 3 mobility who have kept their teeth for years.)

I really do appreciate the care I am getting, and actually brought a huge box of M&S biscuits in when I was in last to say thank you. Possibly the wrong thing for a dental surgery, but the receptionists are always discussing the treats they will have with their coffee!

JEN22 · 20 June 2018 at 4:02AM

I see a surgeon who does the botox in my jaw privately. I have pain with grinding on teeth sensodine rapid has helped plus a solid mouth guard. I am in the process of getting a metal smaller guard made for m lower jaw too

Toothsmith · 20 June 2018 at 9:48AM

I can't help feeling, Saffy that 'letting go' a little bit would not only help the treatment, but help with the cause as well

;)

Saffythecat · 20 June 2018 at 7:23PM

Yes, fair dos, Toothsmith. Until last year I was a dream patient, attended every six months, had a check and scale and polish, goodbye, and thank you. Now I am falling to bits!

Dental mouthguard that doesn’t cover front teeth?

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