What is Tooth wear?

Tooth wear:

Apart from bacterial causes of tooth loss, tooth substance loss can be caused by attrition, erosion and abrasion. Attrition is loss of tooth substance by contact of teeth against each other. The patient presents with reduction in size of teeth and sensitivity.

Teeth grinding is also an example of attrition. Erosion is loss of tooth substance by acidic diet. Again, the patient will have symptoms of sensitivity. Drinking cold drinks and fruit juices can cause erosion. Abrasion is loss of tooth substance by any foreign body in contact with teeth. Using hard toothbrush and improper technique for brushing is an example of abrasion.

Signs & symptoms, prevention & treatment of tooth wear.

Signs & Symptoms

Tooth sensitivity. Reduction in height of teeth. Gum recession (in tooth brush abrasion). Yellowish coloration of teeth. Absence of plaque around teeth (in erosion). Pinkish spot visible in the centre of tooth (in severe erosion). Increased transparency of teeth. Dull headache, pain in temple area on both sides upon awaking, damaged sides of tongue (in teeth grinding).

Prevention

Do not use hard toothbrush. Use Fluoride toothpastes. Avoid biting pen, pencils, pipe, needles etc. Avoid acidic diet and avoid tooth brushing till 2 hours after acidic intake, after acidic intake, immediately rinse mouth with water. Avoid alcohol. Avoid stress. Drink soft drinks only by straw to avoid more contact with tooth substance.

Treatment

Eliminate the cause. Dentist may give you mouth/night guard if teeth grinding has worn your teeth to a more advanced level. Occlusal adjustment may be required. Fillings may be required to compensate for the loss of tooth substance. Desensitizers such as Fluoride, Potassium Nitrate or Potassium Citrate, Strontium Chloride may be prescribed.

Patient showing severe erosive lesions on upper teeth. Note the dissolution of tooth substance exposing the inner layer of teeth (yellow in color) thereby in- creasing the chances of sensitivity. The patient reported drinking fruit juices and soft drinks more than ten times a week.

Dental Problems Associated with Tooth Wear

People with worn teeth may experience the following problems:

• Cracked or chipped teeth
• Jaw, neck, and back pain
• Frequent headaches
• Tooth sensitivity
• Receding gums
• Tooth decay
• Yellow teeth
• Difficulty chewing and biting