What is tooth wear ?
Tooth wear is loss of tooth structure for reasons different to dental caries. It is a normal physiological process and is very common. It could have an impact on normal function,aesthetic and therefore requires good understanding and adequate management.
What types of tooth wear exist?
There are four main variants:
1/ Erosion
This happens when acids weaken the enamel of the teeth and make it susceptible to wear. The acid could be originating from outside (drinks,foods,medicines) or inside the body(stomach acid). The frequency of acid attacks is the most important factor that determines the speed and scale of tooth damage.
2/Abrasion
This is mechanical wear of the teeth that is related to forces not arising from teeth. This could be coming from tooth brush bristles when excessive force is applied. On other occasions foreign objects such as pens,piercing or tooth picks could be responsible for this type of damage
3/Attrition
This is caused by tooth against tooth contact. It could occur as the age increases or because of of habits like clenching/grinding teeth over night or during the day.
4/ Abfraction
Clinical and laboratory studies suggest that this fourth form of tooth wear exists. It occurs at neck area of the tooth because of stress arising from chewing and biting forces.
What are the signs and symptoms of the tooth wear?
The most significant sign that the teeth are wearing is the change in their look.
Initially there is a glassy appearance on the outer side of the upper front teeth which widespreads as time goes by.
As the condition progresses change in teeth color becomes visible. This is because of the exposure of the darker dentine underneath.
In the back teeth many small cavities may form at first which, as the time progresses, join in one big lesion. This could result in bite problems as the teeth don’t meet when biting together.
Sensitivity is another feature of the tooth wear. There might be a brief,sharp pain when cold stimulus makes contact with the tooth. It most commonly occurs at the area of the tooth just above the gum line.
What can I do about tooth wear ?
The most important steps when dealing with tooth wear are prevention and identifying the risk factors.
The most important aspect of prevention is monitoring the rate of the tooth wear.The most common way of doing this is by regularly taking impressions ,making study casts and obesrving them for changes. Nowadays digital dentistry allows the clinicians to follow the progress of the tooth wear by using data from intra oral scanners.
Giving the right dietary advice is equally important. Frequency of consumption of acid foods and drinks should be decreased and alternatives found.Avoiding swishing beverage around the mouth and using straw is also very beneficial.
Fluoride has an important role in the prevention of tooth wear occurrence. It hardens the enamel and increases its resistance to destruction from acids.
Do the teeth need restorations because of wear?
This usually becomes necessary when there is significant sensitivity and change of appearance. Restoring such teeth though represents long term commitment and restorations require regular maintenance. It could also involve costly and lengthy procedures.
This is something that everyone should be aware of before they make a decision to engage in treatment of their worn teeth.