Tooth Wear and Tear: Causes and Solutions Worth Smiling About

By Dr. Joe D’Angelo

Maintaining a healthy smile starts with the basics: brushing, flossing and routine checkups. When we maintain our smiles, it can lead to a natural, beautiful smile for an entire lifetime. But when it comes to wear-and-tear, nature will, at times, take its course – but that doesn’t mean we can’t stay proactive about our pearly whites.

Causes of tooth wear

Tooth wear is the result of friction, stress and erosion of the enamel – the white, outer layer of the tooth. Tooth wear can be caused by acidic diets, acid reflux, bruxism (grinding at night) or clenching, Other causes include brushing teeth too hard and using our teeth for inappropriate things -- prying open packages or biting off clothing tags, for example. Often there is a combination of factors, such as acidity and bruxism, occurring simultaneously. Surprisingly, very little wear occurs from normal day-to-day chewing. Therefore, excessive wear is not normally due to normal activity but rather the unwanted events that we need to be aware of.

Signs and Symptoms

Some of the most common symptoms of tooth wear include sensitivity to cold, acidic foods, heat or sweets. However, tremendous damage can occur with absolutely no symptoms except for the gradual deterioration in their appearance.

Irregularities in shape:

If you notice indentations in your teeth (referred to as “cupping”), you may have eroding enamel due to excessive acid or clenching. Flattening of the edges of the teeth is caused by tooth grinding at night. Eventually, this leads to shortening of the teeth and a loss of proper tooth function. When the enamel has worn through to the dentin, the process accelerates, as the dentin is much softer than enamel. It is quite amazing that many people who grind or clench their teeth don’t even know it.

Hairline fractures or chips.

Small hairline fractures in your teeth are not normally a cause for concern. Fractures of cusps on the back teeth can result form the enormous strain on the teeth that typically occurs when someone clenches their teeth. This usually occurs during REM sleep in some people and patients affected are rarely aware.

Prevention

To maintain a lifetime of beautiful teeth while minimizing tooth wear, it’s important to:

Watch the acidic foods.

Lemons, oranges, carbonated sodas and even tomatoes can contribute to tooth wear and eroded enamel. At the very least, rinse your mouth with water after consuming acidic foods

Be aware of acid reflux or heartburn

: Acidity from the stomach can cause tremendous damage to teeth as well as other tissues. I recommend discussing these symptoms with your doctor if you have experienced them. The presence of acid in the mouth in addition to bruxism tends to accelerate the problem of wear significantly.

Wear a night guard.

People who grind or clench their teeth at night are rarely aware of it. The damage after years of bruxism is often the first sign. When we see this, a night-guard is recommended to wear during sleep. A properly made guard allows the teeth and jaws to function normally in the event of bruxism while protecting the tooth surfaces from wear. Designed to be worn on the upper teeth, the night-guard also serves as an excellent retainer for keeping those beautiful teeth straight.

Your teeth can be beautiful again

If you’re like many individuals, your teeth may already show signs of erosion. In some cases, you may even need intervening treatments such as bonding,

veneers

or

porcelain crowns

1. In more severe cases, we have seen damage that has progressed to the point where the teeth have shortened significantly. In these cases there has been a loss of vertical dimension and the teeth may appear short or not even show when smiling. The normal functional design of the teeth may be entirely lost. It is actually possible, with a well orchestrated restorative plan, to regain the vertical dimension of the bite and restore the teeth and smile to their natural beauty and proper function. It is incredibly rewarding to watch these patients relearn how to smile and observe how smiling changes their entire perspective on life.

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