Tooth Wear

What is tooth wear? Most of us have it. Do we need to be concerned?

What is tooth wear?

“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.

What causes tooth wear?

Tooth wear can be caused by any of the following:

Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough. A removable dental appliance, such as a partial dentures or retainer, can also abrade teeth. Abrasion can also result from habits such as nail-biting and pen-chewing.

Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time. That’s because they can subject teeth to 10 times the normal forces of biting and chewing.

Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices. Eating sugary snacks also raises the acidity level in your mouth. If you can’t give up these snacks and drinks entirely, it’s best to confine them to mealtimes so your mouth doesn’t stay acidic throughout the day. Swishing water in your mouth after eating or drinking acidic or sugary substances can also help prevent erosion.

Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.

Concerns of Tooth wear:

Loss of enamel can weaken the structure of tooth and lead to fracture. Vertical fracture along the root can lead to patient losing their teeth. Also, loss of enamel can increase the risk of cavities. Once most teeth have been worn down, extensive and complicated treatment maybe necessary to restore the tooth back to proper form.

How is it treated?

The first step in treating any type of tooth wear is to determine the cause. Dr. Foroughi will exam for wear by doing a visual exam as wells utilizing x-ray to determine loss of tooth structure. Once the cause has been identified, Dr. Foroughi can come up with a treatment plan to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, Dr. Foroughi might recommend a nightguard that will protect your teeth during sleep or periods of high stress. Dr. Foroughi may also recommend orthodontic treatment such as Invisalign, if improper forces from a bad bite maybe causing the wear. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.