Expert: Mark Bornfeld DDS - 1/9/2008

Question
I visited a new dentist for the first time yesterday (my former one closed practice).  He showed me cracks in my canines and other front teeth that he said were due to "bruxism" (which he advised me to research).  While I am aware that I clench my teeth at night sometimes due to stress, the examples of damage that he showed me look just like the pictures of "craze lines" that I've found and nothing like anything to do with bruxism.  I'm 34, and it seems likely to me that my teeth are aging.  No other dentist has ever mentioned damage from bruxism before.  Should I purchase the expensive night guard he's recommending or see another dentist?  I hate to question his educated diagnosis, and I appreciate your advice.  Thank you!

Answer
Dear Monique,

It is difficult if not impossible to distinguish cracks due to bruxism from the type of craze lines that are in evidence in nearly every adult tooth. Sometimes there are more cracks in a "bruxer", but there is seldom any visual qualitative difference that could allow a dentist to identify them as due to bruxism. However, bruxism is often very much in evidence in other ways-- characteristic wear patterns in the teeth that are of a magnitude inconsistent with a patients age; stiffness or pain in the temporomandibular joint (TMJ) area, especially on awakening; and complaints of noise from one's bed partner.

It is always best to treat a diagnosed disorder rather than just a symptom, and when considered alone, cracks in teeth do not rise above the level of a symptom. If in doubt, get a second opinion.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY