Tooth Decay, Grinding, and Cracked Teeth Issues

Q: Tooth Decay, Grinding, and Cracked Teeth Issues

Hello： It is recommended to find a trusted physician and undergo long-term treatment at that location. <br>Many of the questions you raised require prior and subsequent X-rays or objective data from follow-up observations to determine whether filling is necessary, whether to proc

Cavities, bruxism, and tooth fractures?

Hello, doctor.
I was breastfed until I was two and a half years old.
At three, I discovered cavities in my primary teeth that required root canal treatment, but I did not address those teeth because they were going to fall out.
As I grew older, I became prone to cavities, and my oral hygiene habits were poor, brushing only in the morning and at night.
Later, I had traditional braces due to occlusion issues, and by the time they were removed, it had been about four years, during which multiple teeth developed cavities.
For the past two years, I avoided regular dental visits due to fear of the dentist.
In 2017, I had one root canal treatment.
At the end of 2022, after a filling fell out, I resumed dental visits and started using dental floss sticks after every meal, and now I use dental floss and brush my teeth four times a day (after each meal and before bed), use a plaque disclosing agent twice a week, and use alcohol mouthwash every other day.
I would like to ask if my teeth will ever improve in the future.
I often check my teeth with a small mirror for dark cavities, and I observe some, but when I recently went for a cleaning, the dentist did not mention any need for fillings.
I would like to know why the dentist did not bring this up.
I also have had fillings done twice, but there still appears to be some dark areas near the fillings; does this mean that the cavities were not completely removed? Recently, I discovered that I grind my teeth, as I noticed that I unconsciously clench my jaw while sleeping.
Currently, the occlusal surfaces of my lower second molars (the horizontal wisdom teeth have been extracted) have cracks, but they are not deep.
When I bite into hard foods, I feel something, but it is not a sharp pain, and I do not have sensitivity issues.
I would like to know if these two teeth might require root canal treatment.
Additionally, I came across information online about vital pulp therapy as a partial alternative to root canal treatment; can I bring this up with my dentist? I really hope to avoid losing many teeth before I turn 30.

Nuan Nuan, 20~29 year old female. Ask Date: 2023/11/30

Dr. Lin Jiayong reply Dentistry

Hello: It is recommended to find a trusted physician and undergo long-term treatment at that location.
Many of the questions you raised require prior and subsequent X-rays or objective data from follow-up observations to determine whether filling is necessary, whether to proceed with root canal treatment, or if neither is needed.
Treatment must be based on the underlying cause, and the confirmation of the cause cannot solely rely on the patient's subjective statements.
For vital pulp therapy, it is advisable to consult with a specialist in restorative dentistry or endodontics at a medical center for a detailed evaluation, as it involves out-of-pocket expenses and long-term efficacy, and a complete examination must be conducted beforehand!

Reply Date: 2023/11/30

More Info

Tooth decay, grinding, and cracked teeth are common dental issues that can significantly impact oral health. Your history of dental problems, including early childhood cavities, root canal treatments, and recent concerns about tooth decay and grinding, highlights the importance of maintaining good oral hygiene and regular dental visits.

1. Tooth Decay and Oral Hygiene: It’s commendable that you’ve improved your oral hygiene routine by brushing after every meal and using dental floss. However, tooth decay can still occur, especially if there are existing cavities or if plaque buildup is not adequately managed. The presence of dark spots on your teeth may indicate areas of decay or residual decay around existing fillings. If your dentist did not recommend treatment during your last visit, it could be due to several reasons: the decay may not have progressed enough to warrant immediate intervention, or it may have been deemed manageable with your current hygiene practices. It’s essential to communicate your concerns with your dentist, as they can provide clarity on the condition of your teeth and whether any treatment is necessary.

2. Cracked Teeth and Grinding: The grinding of teeth, known as bruxism, can lead to significant wear and tear on your teeth, resulting in cracks or fractures. The cracks you mentioned on your second molars, especially if they are not deep and do not cause sharp pain, may not require root canal treatment immediately. However, it’s crucial to monitor these teeth for any changes in sensitivity or pain, as these could indicate that the cracks are worsening or that the pulp of the tooth is affected. If you notice increased discomfort or if the cracks deepen, it would be advisable to seek further evaluation from your dentist.

3. Root Canal vs. Vital Pulp Therapy: Vital pulp therapy is a treatment option that aims to preserve the vitality of the tooth's pulp while addressing decay or damage. This method can sometimes be used as an alternative to traditional root canal therapy, especially in cases where the pulp is still healthy or only mildly affected. Discussing this option with your dentist is a good idea, as they can assess whether your specific situation qualifies for this treatment. It’s essential to have an open dialogue with your dentist about your concerns regarding tooth loss and the desire to preserve your natural teeth.

4. Future Dental Health: While it may feel discouraging to have a history of dental issues, it’s important to remember that with consistent care and regular dental visits, you can significantly improve your oral health. Continuing your current hygiene practices, along with professional cleanings and check-ups, can help prevent further decay and manage any existing issues.
5. Communication with Your Dentist: If you feel uncertain about the treatment recommendations or the state of your teeth, don’t hesitate to seek a second opinion. A different dentist may provide new insights or treatment options that could be beneficial. It’s crucial to feel confident and informed about your dental care.

In summary, while your past dental issues may seem daunting, proactive measures and open communication with your dental care provider can lead to better outcomes. Regular check-ups, maintaining good oral hygiene, and addressing any concerns promptly will help you preserve your natural teeth and maintain a healthy smile.

Similar Q&A

Understanding Sleep Disorders: Teeth Grinding and Mental Health Connections

Dear Doctor, Hello! I was referred to you by my sister's website, and I have a question to ask. Recently, I have been unconsciously grinding my teeth while sleeping, and I wake up with a sore feeling in my face, sometimes accompanied by mild pain. Three years ago, I disloca...

Dr. Li Zhengfeng reply Psychiatry
Hello: First of all, thank you for your letter. Severe teeth grinding can indeed be quite bothersome. There are many factors that can contribute to bruxism, including individual constitution, oral structure, and psychological stress. To address the issue of teeth grinding, I reco...

Addressing Tooth Grinding and Dental Issues: Seeking Solutions

Hello, due to my upper front teeth being misaligned and having a slight overbite, a poorly qualified dentist extracted my upper front teeth. Since then, I have had a specific tooth that grinds against others, and my dentist recommended orthodontic treatment for my lower teeth, bu...

Dr. Wu Jinjun reply Dentistry
Hello: There are many reasons for teeth grinding, including issues related to occlusion in the mouth and facial muscle tension caused by emotional stress. Your situation is quite unique, and I recommend that you visit a dental department at a teaching hospital to check for any oc...

Understanding Teeth Grinding and Occlusal Splints: Your Questions Answered

I've lived for so long and only recently discovered that I have a teeth grinding problem. I've worn down some enamel, and my canine teeth are no longer sharp. This has also caused a clicking sound in the joint on the right side of my jaw, and sometimes I have difficulty...

Dr. Zhuang Suhui reply Dentistry
Hello: 1. Most people experience improvement after wearing an occlusal splint. 2. Worn enamel cannot regenerate; if there are no symptoms, no treatment is necessary. 3. For joint issues, please visit a dental clinic specializing in temporomandibular joint disorders (usually found...

Experiencing Dental Trauma: A Patient's Struggle with Poor Care

On July 21, I went to dentist A for a scheduled teeth cleaning, but was told it couldn't be done. I still made an appointment for a filling. The third molar on the lower right side had a small piece of filling that had fallen out (at this time, my tooth was fine and not pain...

Dr. Lin Jiayong reply Dentistry
Hello: If you have already consulted with three different physicians at two clinics, and they have all explained that there are no significant issues, it is recommended to relax and not worry too much. If you are experiencing emotional distress, it is advisable to seek counseling...