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Question
Hi Dr. Amin,
  Last week I had my 6 month cleaning and exam and my dentist found a cavity in the top left back tooth. He asked me if I have been eating anything sticky and at the time I replied no. But after thinking about it I chew sugarless gum at night to help me stop clenching and grinding. I have discovered that as long as I have something chewy in my mouth at night when I start to clench or grind I simply chew. I have tried a store bought mouth guard which I find irritating. When I try to go without the gum or guard I either grind my teeth so bad that it awakens my and I fear that I have broken my tooth. I get out of bed and immediately check my teeth carefully to see if any damage has been done. Or I clench my mouth together so hard that pain shots through my teeth and jaw awakening me. Needless to say without the gum I don't sleep well at all. I have never mentioned this to my dentist . So here are my questions.
1. Could the sugarless gum be causing my tooth decay?
2. Should I mention this to my dentist?
3. Is the gum causing more harm than good?
4. Is there anything I can do to stop the clenching ang grinding?  

Answer
Hi Christina,
The sugarless gum doesn't increase your rate of decay, because the sugar substitute can't be used as food by the bacteria in your mouth.
I would absolutely mention this to your dentist.  He/She may be able to create a better fitting nightguard, that will be less irritating and more protective for your teeth.
I would recommend this over the gum:  even though you feel like you sleep better with it--chewing gum is an active process and you won't get the true rest sleep your body needs while engaging in it; and if you do enter a deeper sleep:  it's dangerous since you may choke.

Clenching and grinding habits are overwhelmingly associated with more stressful periods as well as generally stressful lives.  While it interferes with your sleep, this can induce more stress, and eventually produce a cycle of stress, grinding/clenching, poor sleep, more stress b/c of the poor sleep, etc.

I recommend anything you can do to minimize the stress in your life.  This may involve many things including a daily exercise routine, new hobbies, keeping a journal, etc.  So, I first recommend lifestyle modifications.  If this doesn't work, consult your dentist and/or physician to see if they have any other alternatives/suggestions.

Best of Luck,
Ketan Amin, DMD
Austin Center for Endodontics (Root Canal Specialists)
Austin Center for Endodontics

Dentistry

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Ketan Amin, DMD

Expertise

Graduating from Harvard School of Dental Medicine, I received a broad understanding of both medicine and dentistry. I continued my training at New York University, as a dental specialist in endodontics, which concerns root canal therapy, related surgeries, as well as diagnosing and managing various forms of pain occurring in the head and neck

Experience

Dentistry; Specialist in Endodontics (Root Canal Therapy).

Organizations
American Association of Endodontics American Dental Association American Academy of OroFacial Pain

Education/Credentials
Harvard School of Dental Medicine-Doctorate in Dental Medicine (DMD) New York University College of Dentistry-Certificate, Endodontics

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