Patient: D.H.
Chief Concern: Continuous wear down of teeth
Diagnosis: Loss of tooth enamel and underlying dentin because of severe clenching and grinding habit. The wear down is also exacerbated by acid erosion (from stomach) due to under-treatment of GERD (Gastro-Esophageal Reflux Disorder).
Treatment: Fabrication of Night Guard appliance to protect teeth against the destructive effects of night time clenching and grinding to be worn at night during sleep. Fabrication of Fluoride trays to immerse teeth in Fluoride gel during the day to strengthen tooth enamel and combat acid erosion. Prescription for MI Paste (additional measure to strengthen tooth structure). Referral to GI specialist to possibly start patient of a proton pump inhibitor medication.
The ideal follow up treatment for this case would be restoration of the lost teeth structures with either porcelain veneers or full coverage crowns. However patient was happy about finding out the reason for his condition and preventing further erosion of his teeth and did not want to pursue any reconstructive dental work.
Case Report by
Syamack Ganjavian, DDS
