My teeth are wearing down!

A 29-year old man goes to his dentist and is informed his teeth are “wearing down “severely. The dentist prescribed and made a nighttime “grinding guard” to protect his teeth. Did he do right?

History

Mr. W. a fit and well 29 year old regular dental attender was aware that his teeth were worn badly when his dentist recommended a “night guard” (or “bite guard”) to protect his teeth from further wear at night when it was taking place.

Alas some time afterwards he started to experience jaw joint pain and headaches, the dentist advised him to not wear the appliance but Mr. W couldn’t understand why it hadn’t worked, nor why his dentist apparently didn’t understand either.

He was now faced with his teeth continuing to wear and faced expensive second opinions from specialist s that didn’t all had their own ideas.

Investigation

An independent examination, appraisal, interpretation and report highlighted that the appliance made had the effect of pushing the lower jaw back against the jaw joints.

Mr. W’s bite (the way in which his teeth meshed) and general facial structure, had not been discussed previously but appeared to predispose Mr. W for such headaches. The inappropriate design of appliance made the situation worse and likely precipitated the symptoms.

Recommendations were offered including a sleep disordered breathing assessment and therapy in order to protect Mr. W’s teeth – he was found to be suffering from obstructive sleep apnea and likely should have been tested before a “grinding appliance” was made initially.

Studies support the findings that a single arch grinding guard may worsen sleep disordered breathing (i.e. obstructive sleep apnea).

Review

Despite the clear benefits of an independent assessment prior to treatment, reporting after the fact did provide answers. An adequate report would include the assessment (and management if present of a sleep disorder.) Mr. W. was returned all fees and costs.

This article illustrates the value of a review before leaping headlong into a legal case. A good lawyer will consult a dental Expert Witness such as myself, for advice.

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