Patty, a 45-Year-Old Attorney, Presents in Your Dental Office for a Comprehensive

Patty, a 45-year-old attorney, presents in your dental office for a comprehensive oral examination. Her medical history reveals a history of stomach problems or ulcers that she associates with her high stress job and pain in her jaw upon waking. Her intraoral/extraoral examination reveals bilateral crepitus and significant bilateral linea alba. Her dental examination reveals a Class II occlusion, wear facets on the occlusal surfaces of many teeth, several Class II composite restorations on posterior teeth, missing first premolars, and anterior crowding. The patient reports having orthodontic treatment for 2 years when she was in her early teens. She is disappointed with the orthodontic relapse and would like straighter teeth. Her periodontal conditions include moderate bleeding on probing (BOP) and generalized 4 to 5 mm pocketing with 2 to 3 mm of recession on Nos. 13, 20, and 29. Patty states that she brushes 2 to 3 times per day and flosses about once per week. She also states that she has not been keeping up with her recommended re-care appointments
-The dental hygienist suggested a preliminary diagnosis of night-time clenching/grinding. This diagnosis was based on all of the following factors except one. Which is the one exception?

A) Pain in her jaw upon waking
B) Significant bilateral linea alba
C) Wear facets
D) Anterior crowding