Pain isn’t normal

“Dear Doctor,

My teeth are constantly getting infected, and I have had root canals and crowns on most of my teeth. I come from a country where there is no fluoridation in the tap water, and my mother had terrible teeth, too, so I am not surprised. When I went to the dentist, he told me that the cause of my problems is that I have bruxism. I have never heard of this before in my life, and when he explained to me what it was, I thought it a little bit strange. He also asked me if I get headaches and neck aches, and I told him yes, I am an adult. This is a natural part of life, everyone has back and neck pain above forty! I would like a second opinion, could you please help me out with this?

Best wishes,



Dear Olga,

In order to assess what is the matter with your teeth, I would first have to see them. Without seeing them, only a hypothetical diagnosis can be established. But judging from the symptoms you described in your letter (head and neck pain coupled with systematic appearance of caries far and wide in the mouth without chronic periodontitis or other signs of a general infection in the mouth), it seems extremely likely that your dentist was correct. Bruxism affects many adults, and most of them will have absolutely no idea that they have a disease at all. This is because the problems themselves do not become apparent for a while, and as the damage is done while the patient is unconscious, a certain degree and pattern of damage needs to occur before dentists can identify the problem as bruxism. If the dentist has identified it, it is very likely that his/her diagnosis was correct, seeing as the signs are very obvious and hard to confuse with other dental problems.

Genetics do play a role in teeth, but much less so than believed by most people. Even if you inherited poor quality teeth with certain chronic problems, these can be rectified and dealt with, and with proper at home oral care, you will not see the dentist any more frequently than anyone else. Fluoridation of tap water is important and can help, but it does not explain the state of your teeth, while bruxism does. The head and neck pains just reaffirm this suspicion.

The third thing I will leave you with is a little advice as someone who has worked in the medical profession for many years: pain is never normal, it is a sign that something has gone wrong. The reason our parents thought that pain is a part of getting older is that they did not have access to the kind of medical facilities and treatments that we have today. But pain is a way that the body signals that something that is not supposed to be happening is happening, and it is a sign of something being wrong. If your neck and head hurt, you do not have to deal with it,you need to seek treatment, find out what is wrong and get it taken care of,like a responsible adult.

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