What Should the Prosthetic Material Be for Patients Who Grind Their Teeth?

With the development of technology and artificial intelligence, we live in a period where time is passing quickly, we are trying to fulfill our responsibilities at this pace and keep up with life. During this process, people have started to turn to yoga, meditation, psychological counseling, and healthy nutrition to keep their motivation high, protect their energy and health. This picture shows us that people today have a lot of stress and are trying to develop their own methods to cope.

Teeth are the organs that we get spiritual support from. In fact, this is the reason why it is often expressed as “clenching your teeth” among the public. We can clench our teeth when we are dealing with a stressful, delicate task. When our stress level increases, it starts to affect our sleep. Just as we have bad dreams during these periods, we start to clench our teeth. And bruxism, which is a habit, usually starts to be seen in people in this way.

What are the effects/consequences of teeth grinding?

Although our teeth wear out under these forces, our dentures do not. If there is a tooth against our dentures (coatings), they will wear that tooth out even more or the porcelain may break.

Our standard prosthesis materials consist of 2 parts. In order to provide aesthetics, the entire surface visible from the outside is porcelain. However, since porcelain is not strong enough, there is a metal or zirconia material in its substructure and this substructure gives the porcelain its strength.

What are the developments in prosthetic (crown, bridge, veneer) materials?

While metal-supported porcelains were often used in the past, zirconia, which is a healthier and more aesthetic material for the gums, has begun to be used in many cases with its development. Many studies have been conducted to improve both the durable and aesthetic structure of zirconia. With the development of computer-aided technology, CAD/CAM systems have emerged.

Today, zirconia is produced with completely digital systems in scraper devices without touching them, in a way that has high aesthetics and durability. In this way, the need for porcelain structure has decreased considerably.

In addition, porcelain materials have been developed and strengthened separately and can be used alone. The material we call E-max is produced by the almost perfect production of reinforced porcelain by digital systems and machines.

Which material should individuals who grind their teeth prefer in dental treatments?

In the porcelain-made dentures that are manufactured with a substructure and the porcelain that fits over it, fractures called chipping occur in the porcelain during teeth clenching. This is of course not a situation we want. Especially in patients who clench their teeth, we prefer to use single-piece materials thanks to digital CAD/CAM systems. Because in patients who clench their teeth, fractures occur due to this combination as a result of the dentures being exposed to a force higher than the bonding force of the two materials.

While the use of specially produced single-piece (monolithic) zirconia in the back regions provides sufficient strength, emax crowns (coatings) that provide maximum effectiveness in terms of aesthetics in the front region can be preferred. Depending on the preference, single-piece (monolithic) zirconia or emax crowns can also be used in the entire mouth.

Although monolithic material is the most ideal for patients who grind their teeth, the decision of whether to choose zirconia or full ceramic emax crowns should be made according to the person's grinding force. For this reason, the knowledge and experience of the physician who examines patients who grind their teeth is very valuable.

What should individuals who grind their teeth pay attention to after dental treatment?

In all treatments performed on patients who grind their teeth, the use of a night guard plate (night plate, splint) is the gold standard. Because especially at night, the amount of force is very, very high. Thanks to the plate, the forces coming to the teeth will be distributed and some of the force will be absorbed by the plate. In this way, excessive force transfer to the teeth is prevented. Again, thanks to the night plate, the clenching efficiency will decrease as the muscles will lengthen a little.

Teeth grinding botox is a good option that can be applied to suitable patients in the treatment of bruxism. It aims to erase the habit of teeth grinding from the muscle memory by returning the contraction power of the muscles to normal. Even if this does not happen, it is a good supportive treatment that relieves the person's pain and prevents the muscles from overdeveloping and appearing swollen.

Again, to reduce the effect of teeth grinding, face yoga, facial massage is recommended to relax the chewing muscles, and to strengthen the back and neck muscles with yoga and pilates to provide muscle strength balance. It helps to reduce the pain caused by muscle fatigue as a result of teeth grinding.

Smile at life…

Dr. İrem Sena Divanlıoğlu