Why Are My Teeth Wearing Down
There are three types of tooth wear that can affect patients of any age and can lead to tooth sensitivity, discoloration, and even crowding. Though tooth wear is a normal part of the aging process to some extent, pathological or physiological tooth wear can lead to more severe problems down the road. Types of tooth wear include attrition, abrasion, and erosion.
Attrition: Tooth wear as a result of tooth-to-tooth contact, such as bruxism, is called attrition. Bruxism is the unconscious and involuntary clinching and/or grinding of the teeth which many of us do in our sleep. Stress and anxiety or simply, malocclusion (a bad bite) are the main causes of bruxism. The effects of bruxism can be relieved by a simple custom-made night guard for the patient to sleep in.
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.
Abrasion: Tooth wear caused by friction such as brushing too hard or using a toothbrush with medium or hard bristles is called abrasion. Tooth wear from abrasion 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 when brushing with a soft-bristled toothbrush.
Erosion: Tooth wear caused by dietary and gastric acids is considered erosion. Erosion affects the enamel and dentin on the teeth by dissolving calcium in the tooth. It is usually preventable and is a common cause of tooth wear. 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.
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. Dentists are usually the first healthcare professional to identify a problem because the back surfaces of the front teeth are the first to be affected.
Treatment Options for Worn Down Teeth
The loss of enamel and resulting sensitivity of exposed dentin can be treated by your dentist. Small areas of wear can be desensitized and larger areas may be able to be repaired by composite bonding or a porcelain crown.
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. A porcelain crown is a restoration that is fitted over the entire tooth. Patients with severe tooth wear may need to have a crown lengthening (trimming and contouring the gum line) procedure to expose more tooth structure, giving a porcelain crown enough surface to affix to.
It is important to bring any tooth wear that you notice to the attention of your dentist. Left untreated, tooth wear will worser and can lead to more severe issues such as cracked or broken teeth.