clenching or tooth cyst?

Nanazolie

Hi

I'm just back from my dentist for fitting a mouth guard. I've visited her more than I did my family in the last few months, with a vast array of issues from nagging feelings to pressure pains. She came to the conclusion that I am clenching my teeth at night, which seems very plausible given that I feel some thightness in my jaws, that I have chipped a small bit of a premolar without noticing and that I'm generally a nervous person.

However, she also mentioned that I could have a cyst in a tooth that had a root canal done 3 years ago, that never bothered me until recently when I woke up one day with a very acute pain and went to VHI clinic where they told me it was an abscess and gave me antibiotics. I gave the Xray to my dentist, she says it could either be caused by the clenching or it could be a cyst, we will only know if after 6 weeks of wearing the mouth guard I still feel some pressure

The tooth is not painful as such, but I can feel it, it's like a pressure that's not constant and the more I worry about it the more I feel it of course

So the question is: does anyone have experience of teeth clenching and did you find that the problems resolved after wearing a mouth guard? Also, does anyone have experience of dental cysts and what are the symptoms?

Thanks

Oral Surgeon

These are fairly different things...

Clenching results in generally sore teeth to bite on, sore muscles in your face, some limited opening, sometimes muscle development in your jaw (David Coulthard), some tooth wear, fractured teeth, sometimes pain localized to one tooth if it higher etc...

There are many types of dental cysts but the one in your case is likely to be a cyst related to a dead tooth or root canalled tooth (radicular cyst)
These are symptomless, slow growing lesions usually greater than 1cm diameter and form at the root tip of the tooth in question and are usually quite clear on x-ray...

A dead or root canal treated tooth can slowly form a cyst due to chronic inflammation etc. It is usually only when the area then becomes infected that it is symptomatic and noticed... An acute abscess should be obvious as there will be extreme tenderness in that area on the tooth and the gum beside the tooth, there will be some swelling in the adjacent gum etc... A chronic abscess may or may not be sore but there are ususally obvious signs on the x-ray and often a sinus in the gum draining pus...

If your root canal treated tooth is sore to bite on, slightly mobile and has radiographic changes characteristic of re-infection or inflammation then it either needs a re-do of the root treatment or extraction. A cyst is so big that it should be obvious to anyone... Slight widening of the apical space or periodontal ligament can be very difficult to diagnose as infection/inflammaton or reaction to grinding and clenching etc....

In short, it doesn't sound like much was seen on your x-ray. Get a bite splint to reduce grinding and monitor the tooth for resolution. If the tooth symptoms persist- investigate further re the root canal etc

OS

Nanazolie

Thanks a lot for your answer OS, it's very clear. The shadow on the Xray, which was taken only a month ago, 3 years after the root canal was done, was very small. So let's hope it's just the clenching.
In fact, I think I'm turning into a dental hypochondriac