TMJ and Root Canal Issues: Can Night Grinding Cause Tooth Damage?

Temporomandibular joint and root canal issues?

Hello, Doctor.
I have had root canal treatment on my upper left second molar, but I have not had a crown placed.
I have a problem with grinding my teeth at night.
Could this molar be at risk of fracture due to nighttime grinding? If so, would wearing a night guard help prevent this? Additionally, if I make a night guard first and then later get a crown, will the night guard still be usable? Due to financial constraints, I am hesitating whether to make the night guard first or wait and get the crown before making it.
Thank you for your guidance.

J, 20~29 year old female. Ask Date: 2020/08/22

Dr. Huang Tingfang reply Dentistry

Hello! After completing root canal treatment on a molar, it is recommended to place a crown for protection.
If a bite splint is made before the crown, it may lead to issues where the bite splint does not fit properly, requiring adjustments or remakes.
Additionally, wearing a bite splint does not guarantee that the tooth treated with root canal therapy will not fracture.
Thank you, take care! Wishing you all the best! Sincerely, Dr.
Huang Ting-Fang, Dentistry.

Reply Date: 2020/08/22

More Info

Night grinding, also known as bruxism, can indeed pose significant risks to teeth, particularly those that have undergone root canal treatment. When you grind your teeth at night, the excessive force can lead to various complications, including the potential for tooth fracture or damage, especially in teeth that are already compromised due to previous dental procedures like root canals.

In your case, the left upper second molar that has undergone root canal treatment is particularly vulnerable. Without a crown (or dental cap) to protect it, the tooth structure is weakened, making it more susceptible to the forces generated during grinding. This can lead to what is known as "tooth collapse" or fracture, where the tooth may crack or break under pressure.
Wearing a night guard, or occlusal splint, can be an effective solution to mitigate the risks associated with bruxism. The night guard acts as a protective barrier, absorbing some of the forces generated during grinding and preventing direct contact between the upper and lower teeth. This can help reduce the likelihood of damage to your root canal-treated tooth, as well as other teeth.

However, it is important to note that while a night guard can provide some level of protection, it does not guarantee that the tooth will remain intact. If the tooth is already significantly weakened, there is still a risk of fracture, even with the use of a night guard. Therefore, it is advisable to consider getting a crown for the tooth as soon as your financial situation allows.
Regarding your question about the compatibility of the night guard with a future crown, it is possible that adjustments may be needed after the crown is placed. The fit of the night guard may change slightly due to the new crown, and it may require modifications to ensure comfort and effectiveness. However, this does not mean that the night guard will be rendered useless; it may just need to be adjusted or remade to accommodate the new dental work.

In summary, while a night guard can help protect your tooth from the effects of grinding, it is still crucial to prioritize getting a crown for your root canal-treated tooth. This will provide the necessary structural support and protection against further damage. If finances are a concern, consider discussing payment plans or alternative options with your dentist. Your oral health is important, and addressing these issues promptly can help prevent more serious complications in the future.

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