People who are stressed by daily problems or trouble at work seem to be more likely to grind their teeth at night. Researchers writing in BioMed Central’s open access journal Head & Face Medicine studied the causes of ‘sleep bruxism’, gnashing teeth during the night, finding that it was especially common in those who try to cope with stress by escaping from difficult situations.

Maria Giraki, from Heinrich-Heine-University, Düsseldorf, Germany, worked with a team of researchers to study the condition in 69 people, of whom 48 were ‘bruxers’. She said, “Bruxing can lead to abrasive tooth wear, looseness and sensitivity of teeth, and growth and pain in the muscles responsible for chewing. Its causes are still relatively unknown, but stress has been implicated. We aimed to investigate whether different stress-factors, and different coping strategies, were more or less associated with these bruxism symptoms”.

Tooth grinding was measured by thin plates that were placed in trial participants mouths’ overnight, while stress and coping techniques were assessed by three questionnaires. Bruxing was not associated with age, sex or education level, but was more common in people who claimed to experience daily stress and trouble at work. Giraki adds, “Our data support the assumption that people with the most problematic grinding do not seem to be able to deal with stress in an adequate way. They seem to prefer negative coping strategies like ‘escape’. This, in general, increases the feeling of stress, instead of looking at the stressor in a positive way”.

Dental implants, rather than a fixed bridge or removable dentures, are an increasingly popular method of replacing teeth lost to an accident, gum diseases or tooth decay.

In an interview in the January issue of Mayo Clinic Women’s HealthSource, Sreenivas Koka, D.D.S., Ph.D., chair of Mayo Clinic Department of Dental Specialties, discusses the advantages of dental implants and what’s involved.

To place an implant, an oral surgeon or periodontist cuts open the gum to expose the jawbone and then drills a small hole in the bone for the metal cylinder that serves as the implant. “It’s almost like drilling a screw into the wall,” says Dr. Koka. The patient is under anesthesia.

Over the next three months, the area heals and the implant fuses with the jawbone. Patients may undergo a second procedure in which a post, called an abutment, is attached or screwed down into the implant. This can be done at the same time the implant cylinder is put in or after the area has healed.

In the final step, the dentist attaches a realistic-looking artificial tooth to the implant or to the post. The entire process takes about four months.

A big advantage, says Dr. Koka, is that an implant acts as a substitute for the roots of a natural tooth. “If you are missing a single tooth, this allows you to leave the other teeth around it alone,” says Dr. Koka. “With a bridge, you have to cut down the teeth on each side of the empty space so that a false tooth can be held in place by two crowns.”

Almost any adult in reasonably good health is a candidate for dental implants.

Dr. Koka says that patients often ask if osteoporosis would prevent them from getting dental implants. It doesn’t. Mayo Clinic research has shown that patients with osteoporosis or those taking oral bisphosphonates used to treat osteoporosis have about the same success rate as other patients. And the success rates for dental implants are high — 90 to 96 percent.

Tooth enamel is tough, harder even than skeletal bone. But even with good dental hygiene, the enamel protecting teeth may show signs of decay in older adults. The January issue of Mayo Clinic Health Letter covers what to look out for and what to do to promote an enamel-friendly setting in the mouth. According to the newsletter, two significant contributors to tooth decay are too little saliva and inadequate fluoride.

Too little saliva: Saliva helps repair the earliest stages of tooth decay. It supplies high levels of calcium and phosphate particles that enhance protection of the tooth’s enamel surface. In addition, saliva protects the mouth by washing away food and the sticky film of acid-producing plaque that can cling to teeth.

Because of saliva’s importance, dry mouth symptoms should be evaluated by a care provider. Dry mouth can be caused by medical conditions or their treatments. Examples include Sjogren’s syndrome, an autoimmune disorder, diabetes and HIV or AIDS. Dry mouth is a common side effect of many prescription and nonprescription medications, including some antidepressants and anti-anxiety medications, antihistamines, medications for high blood pressure, anti-diarrheals, muscle relaxants and medications for urinary incontinence and Parkinson’s disease.

For some people, medications or doses can be changed to minimize this side effect. When that’s not possible, chewing sugar-free gum sweetened by a naturally occurring sugar substitute called xylitol can help. Studies have shown that the frequent use of gum with high levels of xylitol can prevent cavities and even harden a tooth’s surface where a cavity has begun. Chewing gums that contain Recaldent also can help. This ingredient is a form of calcium phosphate that penetrates and binds to the tooth enamel. It’s found in Trident Xtra Care gum.

Inadequate fluoride: This mineral is an important enamel ally that can make teeth stronger and can enhance saliva’s remineralizing, anti-decay properties. Most people get adequate fluoride exposure through drinking fluoridated water and brushing twice daily with fluoride toothpastes.

But people who drink primarily bottled or filtered water may not be getting adequate fluoride. Even with adequate fluoride, dry mouth can throw off the normal balance teeth need to stay healthy.

A dentist may recommend fluoride treatment to protect and strengthen tooth enamel. Fluoride can be applied two to four times a year. Another option is nonprescription fluoride rinses available in drugstores.

Also helpful is limiting tooth enamel contact with acids that come from many foods and beverages. Examples include citrus fruits, tart candies, diet and regular sodas or sports drinks, fruit juices and wine.

Elevated dental plaque acid is a risk factor that contributes to cavities in children. But eating bran flakes with raisins containing no added sugar does not promote more acid in dental plaque than bran flakes alone, according to new research at the University of Illinois at Chicago.

Some dentists believe sweet, sticky foods such as raisins cause cavities because they are difficult to clear off the tooth surfaces, said Christine Wu, professor and director of cariology research at UIC and lead investigator of the study.

But studies have shown that raisins are rapidly cleared from the surface of the teeth just like apples, bananas and chocolate, she said.

In the study, published in the journal Pediatric Dentistry, children ages 7 to 11 compared four food groups — raisins, bran flakes, commercially marketed raisin bran cereal, and a mix of bran flakes with raisins lacking any added sugar.

Sucrose, or table sugar, and sorbitol, a sugar substitute often used in diet foods, were also tested as controls.

Children chewed and swallowed the test foods within two minutes. The acid produced by the plaque bacteria on the surface of their teeth was measured at intervals.

All test foods except the sorbitol solution promoted acid production in dental plaque over 30 minutes, with the largest production between 10 to 15 minutes.

Wu says there is a “well-documented” danger zone of dental plaque acidity that puts a tooth’s enamel at risk for mineral loss that may lead to cavities. Achint Utreja, a research scientist and dentist formerly on Wu’s team, said plaque acidity did not reach that point after children consumed 10 grams of raisins. Adding unsweetened raisins to bran flakes did not increase plaque acid compared to bran flakes alone.

However, eating commercially marketed raisin bran led to significantly more acid in the plaque, he said, reaching into what Wu identified as the danger zone.

Plaque bacteria on tooth surfaces can ferment various sugars such as glucose, fructose or sucrose and produce acids that may promote decay. But sucrose is also used by bacteria to produce sticky sugar polymers that help the bacteria remain on tooth surfaces, Wu said. Raisins themselves do not contain sucrose.