Why Are My Teeth Wearing Down?
Tooth wear is a normal, although unfortunate, part of the aging process but if it is left untreated it can lead to more severe problems including tooth sensitivity, discoloration, and even crowding. There are three types of tooth wear that can have an impact on a patient’s smile which are abrasion, attrition, and erosion. Below, we will review each type of tooth wear in more detail.
Attrition
Attrition is tooth wear resulting from tooth-to-tooth contact. 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.
Bruxism is the unconscious and involuntary clinching and/or grinding of the teeth which many of us do in our sleep. Stress or a bad bite (malocclusion) are the main causes of bruxism. The effects of bruxism can be relieved by a simple, custom-made night guard that the patient can sleep in.
Abrasion
Tooth wear caused by friction such as brushing too hard or using a toothbrush with medium or hard bristles is called abrasion. This type of wear 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. Patients should use gentle, circular motions (not back and forth!) with a soft-bristled toothbrush.
Erosion
Erosion affects the enamel and dentin on the outer surface of the teeth by dissolving calcium in the tooth and is caused by dietary and gastric acids continually washing over the surfaces of the teeth. Foods and beverages with a high acid content can cause tooth erosion. Erosion can also be caused by an internal source as with stomach acid.
Erosion is common and usually preventable. Acid produced in the stomach is powerful enough to damage bone and teeth. Patients suffering from gastric reflux or chronic regurgitation, such as bulimia, can have extensive damage as a result of stomach acids repeatedly coming into contact with teeth.
Treating Worn Down Teeth
Loss of enamel and the resulting sensitivity from exposed dentin can be treated by your dentist. Small areas of tooth wear can be desensitized and larger areas may be able to be repaired by composite bonding or with the placement of a porcelain crown or veneer. Composite bonding is a tooth-colored, resin material that is applied over the affected area and cured with an ultraviolet light. This is the same material that is used for dental fillings and is minimally invasive and does not require any anesthetic!
A porcelain restoration is appropriate for patients with severe tooth wear. A crown fits over the entire surface of the tooth above the gum line and a veneer covers on the front surface and is therefore reserved for the front teeth only. Patients may need to have a crown lengthening procedure to expose more tooth structure, giving a porcelain restoration enough surface to hold onto.
Any tooth wear that you notice should be addressed by your dentist as soon as possible. Left untreated, minor tooth wear can progress and lead to bigger problems like cracked or broken teeth which can be very painful and much more costly to fix!