What is tooth wear?

Decay is not the only cause of tooth destruction. Increasingly dentists are spending time restoring teeth that have lost their enamel due to erosion (damage from acid), attrition (tooth against tooth, nail biting, etc) and abrasion (e.g. vigorous tooth brushing). The increase in our average life span and the fact more teeth are being retained for longer means teeth are being exposed to these effects more than ever before.

Acid erosion has been largely linked to the high consumption of soft drinks, both fruit juices and carbonated drinks. However, erosion is also seen in patients with symptoms of gastric reflux (heartburn) and in patients with eating disorders such as anorexia and bulimia. This is due to the highly acidic stomach contents coming into contact with the enamel of the teeth.

Nocturnal tooth grinding is very common and might be exacerbated by stress and anxiety. It is the tooth to tooth contact that leads to the loss of tooth tissue. It can also lead to tooth mobility, tooth fracture and jaw joint pain.

Often it is a combination of factors which leads to severe tooth wear. When we discover tooth wear in a patient’s mouth we will always try to ascertain the exact cause of the loss of the enamel. It is very important to find the cause, so as to try to eliminate it or reduce its effect. This should be done before treatment is begun so that we can get the best long term result with the restorations that are placed. If the cause is acid erosion, we will look at your diet and advise the reduction, or sometimes the complete elimination of, carbonated drinks, fruit juices or other acid foods (pickles etc). We may question you about digestive problems and eating patterns (eating a heavy meal shortly before bedtime increases the likelihood of stomach contents being regurgitated into the mouth while asleep – you will not even be aware you have done this!) We will look for evidence in the pattern of your tooth wear that would suggest you are grinding your teeth. People are often unaware they are doing this, although sometimes partners have told them that they are kept awake with the noise of their gnashing teeth!!

Visit your dentist regularly – especially if you have been warned of early signs of tooth wear. And make sure that the dental clinic you go to has advanced dental equipment, such as dental binocular loupes, dental ultrasonic scaler, etc.

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