Why Are My Teeth Wearing Down?
Tooth wear is a common problem that many patients experience at some point in their life. Categorized as either pathological or physiological, tooth wear is a loss of tooth structure that is not caused by decay or injury. Types of tooth wear include attrition, abrasion, and erosion.
Attrition is when the teeth wear down as a result of tooth to tooth contact, such as bruxism. Bruxism is unconscious and involuntary clinching and/or grinding of the teeth, which many of us do in our sleep. Causes of bruxism are often stress and anxiety or simply, malocclusion (a bad bite). The effects of bruxism can be relieved by a simple custom-made night guard that the patient will sleep in.
This mechanical wearing down of the occlusal surface (the biting and chewing surface) causes teeth to become flat and short. Severe attrition of the anterior teeth can have a disfiguring effect on the appearance of facial structures. It may also cause sensitivity to sugar, or hot and cold foods and beverages.
Abrasion is tooth wear caused by friction such as brushing too hard or using a toothbrush with medium or hard bristles. Tooth wear from abrasion is typically evident on the outer surfaces of the back teeth where a wedge or V-shaped indentation of the tooth can be seen at the gum line.
Erosion is tooth wear caused by dietary and gastric acids, which affect the enamel and dentin on the teeth by dissolving calcium in the tooth. Erosion is usually preventable and is a common cause of tooth wear. Foods and beverages with a high acid content such as citruses, soft drinks, sparkling mineral water, sports drinks and any other beverages that contain carbonation can cause tooth erosion.
Acid produced in the stomach is powerful enough to dissolve any food, unfortunately, it can damage bone and teeth as well. For a patient suffering from gastric reflux or chronic regurgitation such as bulimia can have extensive damage as a result of stomach acids coming into contact with and eroding the teeth. Dentists are usually the first healthcare professional to identify a problem because the back surfaces of the front teeth are the first to be affected. Patients suffering from bulimia or gastric reflux may be at risk of a condition called Barrett’s esophageal cancer.
Can tooth wear be treated?
The loss of enamel and resulting sensitivity of exposed dentin can be treated by your dentist. Small areas of wear can be desensitized and larger areas may be able to be repaired by composite bonding or a porcelain crown.
Composite bonding is a tooth colored material that is applied and shaped over the affected area and cured with an ultraviolet light. A porcelain crown is a dental restoration that is fitted over the entire structure of the tooth above the gum line. Patients with severe tooth wear may need to have a crown lengthening procedure performed in order for a porcelain crown to have enough tooth structure to hang onto. Crown lengthening is essentially contouring the gum tissue to expose more tooth structure.
If you notice tooth wear, speak with your dentist to assess the severity and discuss treatment options before more damage is done.