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Tooth Wear

Introduction

Nowadays lots of publicity are given by all types of media for health and fitness of individuals. Many magazines and TV programs concentrate on health and fitness. Everybody wants to look physically like the celebrities and they try their best to achieve the impossible standards for beauty and health by resorting to various means. People all over the world spend lots of time and money for their diets, beauty and fitness. In order to remain healthy they eat healthy foods such as yoghurt, fruits, sports drinks etc. They also resort to tooth whitening treatments to keep their teeth white. Unfortunately all these items could result in tooth wear. The pH levels of fruit, juice and sports are extremely low which means that they are highly acidic. Acidity is the main cause for tooth enamel wear. This FAQ gives the details on tooth wear.

Tooth Enamel and its characteristics

The outermost part of a tooth is the enamel and this covers the softer parts of the tooth like an egg shell thereby protecting the internal parts of the tooth from any damage. The similarity between tooth enamel and egg shell ends here because the thin layer of the enamel is the hardest substance in your body whereas the eggshell is not. The enamel is capable of withstanding the rough use of biting, chewing, crunching etc. provided you maintain a good oral hygiene.

The tooth enamel is very tough but this does not mean that it can be misused without causing any damage. Acids from foods and bacteria can erode the enamel thereby causing cavities. Enamel does not have the property of growing on its own like bone and any damage like chipping or cracking done to it is permanent.

What are the various types of tooth wear?

Many people exhibit different forms of wear to their dentition depending on the reason and these are classified as follows.

1.Abfraction

2.Abrasion

3.Attrition

4.Corrosion/ Erosion

The wear can occur either alone on their own or in combination with others. The lifestyle nowadays is hectic that leads to various habits which in turn are responsible for causing these problems.

What is Abfraction?

Abfraction can be defined as the loss of tooth structure from flexural forces. The teeth have a tendency to flex under pressure and this causes tension on one side of the tooth and compression on the other side of the tooth thereby causing V and C shaped impressions

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on the sides under tension and compression respectively. This theory is controversial and is yet to be fully proven in research.

What is Abrasion?

Abrasion is the loss of tooth structure that occurs because of mechanical contact with external objects frequently. This is a pathological process. Abrasion can be caused by any object that is placed against the teeth.

What is Attrition?

Attrition is defined as a loss of the structure of the tooth because of tooth-to-tooth contact. This is a physiological process that is primarily caused by tooth to tooth contact while chewing. The tooth wear occurs on – posterior teeth occlusal surfaces, anterior teeth incisal edges, maxillary anterior teeth palatal surfaces and mandibular anterior teeth labial surfaces. The surfaces affected by attrition will be hard, shiny and smooth. In some cases the teeth could become sharp and jagged. Once the wear goes through the enamel the areas of attrition might display a yellowish-brown discoloration.

What are Corrosion/ Erosion?

Corrosion/ Erosion – these terms are used synonymously although they are not the same. The term corrosion is normally used for the phenomenon of physical deterioration of any material – this includes teeth – because of any chemical or electro chemical action whereas erosion is the abrasive destruction of a material when liquid or gas passes over their surface and they may/ may not contain solid particles. However many people use the term erosion for the loss of tooth structure because of chemical dissolution.

The Saliva in your mouth has calcium that helps in strengthening and re-mineralizing the teeth. If the acid in your mouth is large this re-mineralization cannot take place. The acids in the foods dissolve the mineral structure of teeth that causes damage to tooth enamel thereby thinning the teeth. Repeated such exposures to acid will change the shape and color of your tooth. As the damage continues, the inner layer of the tooth – dentin

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– gets exposed causing the teeth to look yellow.

The children nowadays consume more acidic drinks and sodas thereby increasing the incidence of erosion of tooth enamel. The bottled water does not contain fluorides and people drink more of bottled water than tap water that contains protective fluoride.

What are the reasons for tooth wear?

The reasons for erosion of tooth are as follows:

1.Consumption of acidic foods and beverages – it has been found by researchers that consumption of highly acidic foods and beverages might cause tooth erosion as well as permanent damage to your teeth. Such items that contain high amount of acid are soft drinks, pure fruit juices and high energy drinks, yogurt etc. and could cause erosion of your tooth although they appear harmless. The acid in these items breaks down the tooth structure thereby resulting in tooth decay.

Some people eat or suck lemons as a habit and restoring the tooth surfaces of such persons require a number of dental restorative procedures.

Wine is another food item that could stain your teeth and also damage your tooth surface. This is the main reason why many wine tasters find that their tooth enamel erodes very fast. The probability of damaging your teeth is very high when you sip wine a number of times in a day and also swish the wine inside your mouth. Drinking acidic beverages with a meal reduces their effect largely.

2.Medical factors – can cause tooth erosion and these factors are – decrease in saliva, certain gastrointestinal conditions, acid reflux disease and the eating disorder bulimia.

3.Eating and digestive problems/ Stomach acids – also play a large role in tooth erosion. Conditions that cause vomiting or acid reflux can damage tooth enamel. Similarly when stomach acid gets into your mouth, it can cause erosion of your tooth. Bulimic persons or persons having reflux disease often have their tooth surfaces damaged.

4.Consuming foods with low pH – pickles, fruit juices, honey, fresh yogurt and raisins – also could cause tooth erosion

5.Dry Mouth – this could occur either because of your health condition or as a side effect due to medication; the acids last longer in your mouth because of dry mouth conditions thereby causing more damage to your tooth surface.

When the saliva flow in your mouth is normal it neutralizes the effects of the acid; it also supplies minerals required to strengthen tooth enamel.

6.Bruxism/ Teeth grinding – if you have the habit of grinding your teeth, the resultant clenching and friction due to teeth grinding will cause enamel wear-out. Sleep bruxism is more harmful to your teeth because you can not control it when you are asleep.

7.Abrasion – using your teeth for opening bottles, packages or any other item will cause cracking or chipping of your tooth enamel. In addition the following actions also could cause tooth wear.

•Chewing pens and pencils, Biting finger nails, Thread biting, Nut cracking, Chewing ice

•Digit sucking – meaning Thumb sucking/ Finger biting habits

•Using toothpicks as wedges to remove food particles.

•Pipe smokers clenching the pipe stem

•Seamstresses holding pins or needles in their mouth

•Tongue thrusting/ tongue pushing, Lip/ Cheek biting, Lip wetting/ Lip sucking

•Inserting finger nails in the inter-dental space

•Incorrect use of dental floss and tooth brush

•Holding eyeglasses or other objects between the teeth

What are the Signs and Symptoms of Tooth Wear?

The symptoms of tooth erosion are as follows

1.Discoloration – the natural color of the enamel is translucent whereas the color of dentin – inner layer of your tooth is white although many people think that the tooth outer layer is white. During the process of erosion of your tooth the dentin gets exposed which results in its discoloration or yellowing. Tooth becomes more yellow with increased exposing of dentin.

2.Tooth Sensitivity – since the worn out tooth enamel exposes the softer part – dentin – the tooth becomes very sensitive to extreme temperatures. Because of this you will find that eating ice cream or sipping hot coffee becomes painful and unpleasant.

3.Rounded Teeth – in the initial phase of tooth erosion you will find that the tooth will look round.

4.Transparent or Sand Blasted Appearance – occurs in the initial stages.

5.Cracking – the tooth edges start cracking as the erosion reaches an advanced stage.

6.Dents – small dents or cupping might occur in the biting areas of the teeth.

How do you prevent tooth wear?

Your teeth could get severely damaged because of tooth erosion; however you could prevent this by following the suggestions given below:

1.Neutralize the acid – this can be done by rinsing your mouth thoroughly with water after consuming foods that are acidic or drinking beverages.

2.Allow for re-mineralization – brush your teeth one hour after taking acidic foods or beverages thereby allowing for re-mineralization.

3.Reduce carbonated drinks consumption – and replace them with milk, water, or sugarless coffee and tea.

4.Use straw – for drinking carbonated beverages or any other sweet drinks like natural fruit juices that are acidic. When you drink the beverages using straw the liquid directly goes to the back of your mouth thereby avoiding washing your teeth.

5.Drink acidic liquids fast – by this method you can avoid holding or moving these liquids in your mouth.

6.Chew sugar-free chewing-gum – reduces dry mouth and increases the saliva flow hereby facilitating re-mineralization of your teeth.

7.Use soft toothbrush and fluoride toothpaste – fluoride reduces the sensitivity of your tooth.

8.Take some milk or cheese after meal – this will help in neutralizing the acids.

9.Improve your dental hygiene

10•Brush your teeth gently- using hard bristled tooth brush could damage the enamel.

11•Floss your teeth-do not use toothpicks.

•Be careful in using teeth whitening products because they could cause enamel damage if used improperly or more frequently.

How do you treat Tooth Wear?

Crowns and Dental Veneers can be used for treating enamel wear out.; in extreme cases you have to get your teeth replaced.