Bruxism and Pain after Dental Treatment

When you grind and clench your teeth, you're essentially eating away on your own teeth. Along with that, the dental materials in your mouth just won't last as long. They can break, loosen up, or the seal will break without you knowing and get another cavity easier. Your old fillings and crowns you got when you were young are now disintegrating on you is pretty much expected.

Now, you started working and you're under a lot of stress. It's tough being an adult. Your dental evaluation reveals cracks and cavities in your teeth and bleeding inflamed gums during perio probing. So you get some treatment done.

What should you expect?

  1. no discomfort
  2. some initial discomfort, but subsides in a few days or a couple weeks at most
  3. no discomfort, but after a few days, gets cold sensitive, not better or getting worse.
  4. uncomfortable to start, never got better, now cold/hot sensitive, getting worse.

If No.1, awesome.
If No. 2, it's also awesome.
If No. 3, it's mostly related to your bruxism. 
If No. 4, it can be related to your bruxism, but can be more than that. 

Let's look at scenario No. 3

Whenever you get dental work done, there is irritation caused by the treatment itself to the teeth and gums. So afterwards, there is a recovery phase. But research reveals that your clenching and grinding habit can put 1200lbs - 1ton of weight on your own teeth and supporting structures. That's pretty enormous. So normally, your body is very intelligent and it adapts to this chronic trauma and pressure, allowing this problem to go unnoticed. But with dental treatment, everything is irritated, fresh, and raw. So even if ok at first, it gets more irritate by the day. 

Bruxism also can increase in intensity directly after dental treatment. A stiff jaw from days, months and years of clenching/grinding is now propped open for treatment. The strain from it causes more tension and clenching.

So you are giving your teeth and gums no time or space to heal and recover after treatment. But what can you do? You're not clenching on purpose. 

Some solutions include:

properly equillibrated night guard 
prescription dose Ibuprofen therapy for 7-10 days
antibiotic therapy for 7-10 days
hydrotherapy with a hot and cold compress around the jaw and treatment area
adjustment of the bite to relieve some pressure off the treated teeth
good home care - cleanliness from bacteria
laser perio therapy of the gums to reduce inflammation
life-style change to help reduce stress - aerobic exercises, regular stretching exercises

In the case of Scenario No. 4

If your symptoms still persist after you and your dentist have done it all as described in scenario No.3, your dentist will suspect other causes or issues which could be treated with root canal therapy or even extraction as an alternative. 

In some rare cases, patients can have unique nerve and muscle anatomy which causes the teeth to hurt for a prolonged period of time due to special wiring of the nerves(again jaw issues but slightly different). This usually does not require a root canal but requires jaw therapy - the above mentioned peroperly equillibrated night guard. 

If the problem is complex, your dentist may refer you to a specialist to work in collaboration for a solution. 

Dr. Hyun S. Bang, D.D.S. Doctor of Dental Surgery Loma Linda University 2008

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