3 Reasons to Be Concerned about PTSD and Teeth Clenching and Grinding

I suffer from PTSD, and for the past 4 years, I clench my teeth during the day and grind them at night. I have some neck pain and headaches that I think are related to my habit. I’ve had the same dentist since 2011, and he says my teeth look okay. But I’m starting to feel short spurts of dull pain in my lower molar teeth. My last exam and cleaning appointment was in mid-February. I’m afraid of the dentist anyway and need sedation for all my appointments. Now with the COVID-19 restrictions, I’m not going to any dentist. Besides, the office is only open for emergencies. I’m wondering if the dull pain and pressure on my lower teeth might be due to cavities or from teeth grinding. Is there anything I can do about this at home? – Thanks. Quinn from San Antonio

Quinn – We’re not sure why your dentist though your checkup appointment was good if you’ve been clenching and grinding your teeth for about four years. And you’re feeling pain and pressure in your teeth. That’s a problem.

Photo of female patient sitting and relaxing in a dental chair, for information on sedation dentistry from Plano female dentist, Dr. Miranda Lacy.
Sedation will help you relax throughout dental procedures

Dr. Lacy would need to review your x-rays and check your teeth and mouth. We’re concerned that your dentist didn’t thoroughly examine your teeth.

When you clench and grind your teeth, more than cavities and fillings are involved. Other oral health issues can arise, including

  • TMJ disorder
  • Gum disease
  • Poor occlusion

We recommend that you seek a second opinion from a dentist who will be more thorough. The pain you’ve described could be from gum disease or the trauma of grinding your teeth. In either case, you need an examination. Without an exam, gum disease can progress and lead to jawbone loss. Grinding your teeth will wear them away.

Your new dentist may be able to resolve your pain and discomfort with a custom night guard. It’s worth it to contact a new dentist and at least have a video conference to describe your symptoms. You’ll receive recommendations on what you can now and how to handle the situation before you see a dentist.

Plano, TX female dentist Dr. Miranda Lacy sponsors this post.

Three Causes of Tooth Pulp Sensitivity and Irritation

In early February, one of my bottom molar teeth cracked. The tooth had an old filling in it, and I felt it crack while I was at dinner with friends. At the time, I had only been in AZ for about two months. I relocated and still don’t have a job yet, so I found a dentist with reasonable fees. She said I needed a crown. She prepared the tooth and put on a temporary crown. The crown made my gums sore, and it hurt to chew on that side of my mouth. I also told my dentist that I felt some sensitivity in the tooth whenever I drink anything cold.

That issue wasn’t resolved before she placed my permanent crown later in January. The pain got worse, so I returned to the dentist she took x-rays and poked around the crown to see if I felt any pain or pressure. Of course, my tooth didn’t respond to any of her tricks, so she told me to wait two or three months for it to settle down. My tooth hurts daily. It’s not constant pain, but it hurts and is now sensitive to hot food. I’ve entered my symptoms in Google, and everything I read sounds like I need root canal treatment. Is my tooth dying? Thank you. Eun-ae M. from Flagstaff

Eun-ae,

Thank you for describing your symptoms and the history of your tooth pain. We recommend that you call an endodontist, or root canal specialist.

Side-by-side diagram of an infected tooth being cleaned out with root canal treatment (left) and a healthy tooth to the right.
Root canal treatment can save your cracked tooth

But without criticizing your dentist, we want to clarify a few facts.

Causes of Tooth Pulp Irritation and Sensitivity

  • Cracked tooth – A crack can easily affect the tooth pulp (living tissue, nerves, and blood vessels) inside your tooth. An infection can cause inflammation that chokes the pulp and makes it die.
  • Aggressive preparation for a crown – Significant sensitivity after your dentist prepares a tooth for a crown can result from improperly sealing the temporary crown or aggressive tooth preparation. But a tooth can be coated with a desensitizing product to limit the discomfort.
  • Cementing the crown – A temporary crown on a molar tooth should be made of durable material and bonded with soothing cement to help the tooth nerves calm down. Permanently cementing an already irritated tooth can cause further complications and the need for root canal treatment. The increased sensitivity you’re feeling might be due to changes in the tooth ligament near the root. An endodontist can see that, but most general dentists won’t recognize it as an issue.

Instead of allowing your general dentist to do any more work on your teeth, we recommend that you see a specialist.

This post is sponsored by Plano, TX female dentist Dr. Miranda Lacy.