Tooth Wear

With proper care, your teeth can last a lifetime. But a small amount of wear as we age is considered normal. By “wear,” we mean loss of tooth structure. Wear starts with loss of the hard, translucent enamel that forms the outer covering of teeth, and might, in more serious cases, progress to the softer inner tooth structure known as dentin.

Enamel is actually the human body's hardest substance. It is highly mineralized and non-living, in contrast to bone and dentin which are living tissues. Enamel is highly resistant to wear and chemical attack, as it should be to be given what your teeth do every day: bite, chew, and come in contact with acidic foods and drinks.

Still, it is common for enamel to wear down for various reasons. But when tooth wear becomes noticeable or significant, intervention may be necessary to keep your bite functioning properly and protect your teeth.

Types of Tooth Wear

Tooth wear can result from one or more of these processes:

Abrasion: This is caused by the interaction of teeth and other materials rubbing or scraping against them. The most common source of abrasion is traumatic tooth brushing, meaning that you are using a toothbrush that's too hard or applying too much force when you brush. This can affect the root surfaces of your teeth just below the gum line or the enamel above the gum line. Some dental appliances such as partial dentures or retainers that are frequently taken in and out of the mouth can also abrade teeth. Abrasion can also result from a diet loaded with abrasive foods like sun flower seeds and nuts or habits such as nail-biting and pen-chewing.

Attrition: This is an effect of tooth-to-tooth contact, which happens many times throughout the day as your teeth bite and chew food. Biting and chewing normally generate forces between 13 - 23 pounds. Yet if you have clenching and/or grinding habits (of which you might not be aware) can subject your teeth to forces up to 10 times that. This can damage teeth. Many clenching/grinding habits take place at night and are associated with stress, obstructive sleep apnea, acid reflux, side effects of medications and more.

Erosion: When your teeth come in contact with acidic substances in your diet, the acid can erode (dissolve) your enamel. Culprits of this kind of tooth wear often include sodas, sports drinks and energy drinks. Most fruit juices and lemon/lime flavored waters are also acidic. Confining these drinks to mealtimes and swishing water in your mouth after drinking them can help prevent this erosion.

Abfraction: This refers specifically to the loss of tooth enamel at the necks of the teeth (the thinner part right at the gum line). It typically looks like a V-shaped notch at the neck of the tooth.  This is caused by tooth flexion from side-to-side (also called lateral) biting forces. Abrasion and erosion can contribute to this problem.

Treating Worn Teeth

When examining worn teeth, Dr. Susan will always seek out the cause of the wear before proposing treatment or a method of protection. For example, if you have a clenching or grinding habit, a centric-relation bite splint can be custom-made for you that will reduce (or even eliminate) grinding forces and protect your teeth during sleep or periods of high stress. If you have Obstructive Sleep Apnea, a different oral appliance can be custom-made to help you stop snoring, sleep without interruption and protect your teeth at the same time. If you suffer from abfraction, Dr. Susan may recommend “equilibration” or bite balancing adjustments to your teeth, or she may recommend tooth-brush abrasion, changing toothbrush techniques and/or paste.

Lost tooth structure sometimes needs to be replaced so your bite functions properly and your teeth look great once again. Depending on the situation, this can be done with bonding, veneers, or crowns. Fortunately, modern dentistry can restore the normal shape, appearance and function of worn teeth — beautifully and successfully!