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Dentistry/Jaw /palate adjustments and bruxing.

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Expert: - 11/12/2008


Question
Hi Dr Myerson,
I have recently been told I have been grinding or clenching for some time and have worn smooth a couple of molars.  I have now got a upper jaw guard to wear at night.  I've only had this a few days but it is very painful to wear and feels very tight on my front teeth and side.  Should it feel this way?

Also I have recently started enquiring about orthodontics as I have very uneven teeth and apparently narrow upper jaw (I used to suck my thumb profusely).

I have been recommended a plate device which widens my palate and then a retainer brace.  Is this normal practice and is there any issues with this procedure I should be aware about?  I am 38 yrs old (no longer thumb sucker, happy to say) so is this normal for adult treatment?

One dentist has mentioned possible jaw realignment (I have a recessive chin??).  What does this procedure entail, and is it safe?

Many thanks, sorry for the multiple questions!

Emma

Answer
I can't comment on the recommended treatment without having the benefit of an examination of you and your x-rays.  I can, however, make some general comments.  The night guard should not be uncomfortable to wear after a few days of getting adjusted to it.  Beyond that there should be some adjustments made for improved comfort.
Any maxillary expansion that is done for an adult should not be done with a "plate" device.  This treatment usually requires a cemented appliance and is done in conjunction with a surgical procedure on the palate.  This usually is followed by full braces on upper and lower teeth and is often accompanied by surgical realignment of the jaws.  It is a complex treatment plan that requires close coordination between dentist, orthodontist and oral surgeon.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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