Interesting Tooth Grinding Case

I recently treated a senior citizen with discomfort in her lower anterior teeth.  She just couldn’t get used to the feel of the cosmetic veneers recently placed on her upper teeth. I spent an hour adjusting her bite which did help some, but she was still uncomfortable with the feel of it. In fact she was taking a file to her teeth to adjust the high points or at least what she perceived as uncomfortable. So to help her wit this I had a bite guard fabricated for her lower teeth.

Bite Guard Fit

On the date of the delivery, we discovered that the lower bite guard was much too big for her even though this was a traditional type bite guard. So my solution was to have the laboratory fabricate a smaller bite guard that would fit over her front teeth and premolars. I also had my assistant fabricate a lower bleaching tray that was trimmed back to cover the front teeth and premolars. Bleaching trays are much thinner and will not provide much protection for grinding. In any case, when I delivered both of them, it was the bleaching tray that was very thin that felt comfortable to her and she will wear.

The interesting point on this was that I was trying to prevent her grinding. What was really needed was something to help her break her habit of grinding her teeth plus using a file to carve them down. It took a bit of listening to come up with this solution. She received this appliance only a few weeks ago and I will find out how she does with this at her next appointment.