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By Dr. Aastha Chandra


Wear And Tear Of Teeth: Types, Causes and Preventive Measures

Tooth wear and tear is the gradual loss of the tooth surface as a result of decay or trauma. Some patients experience tooth wear and tear as early as their teen years. It gradually worsens with age, so it is essential to be proactive early on and practice good dental regimes.

Below are some of the different types of tooth wear and tear:

1. Abrasion:

Abrasion is particularly a common type of tooth wear. This form of wear occurs as foreign and abrasive objects contact and move against the teeth. Abrasions cause a gradual loss of tooth enamel. This form of tooth wear is usually attributable to brushing with too much force.

Those who use their teeth as tools also suffer from abrasion. As an example, using the teeth to open bags or bottle caps, and nail biting will likely cause considerable abrasions. Even using an abrasive toothpaste or a wrong brushing technique has the potential to cause wear in the course of time. It is best to use a soft-bristled brush and move it in circular motions across the entirety of a person’s teeth. Unfortunately, plenty of people rely on a horizontal brushing technique that is overly intense and abrasive.

These abrasions can also be caused by a poorly fitting removable prosthesis that causes progressive wear of the tooth.

To treat a dental abrasion it is necessary to restore the original anatomy and structure of the tooth, for which veneers, fillings, crowns and inlays are usually used depending on the severity of the wear. It is equally important to eliminate the causes of these abrasions such as wrong brushing techniques, using a medium-hard brush and/or incorrect prostheses.

2. Attrition:

Attrition is the gradual and physiologic loss of tooth enamel as a result of an excessive or abnormal tooth to tooth contact. This form of tooth wear typically occurs from clenching and grinding of the lower teeth with the upper teeth. The extent of attrition hinges on the pressure applied when grinding or clenching the teeth.

Bruxism, commonly called teeth grinding, can cause serious damage to a person’s teeth as it puts excessive amounts of stress on them. This leads to increased wear on the teeth.

Bruxism being the main cause of this problem, the solution will be focused on solving this habit, either through orthodontic treatment and/ or the use of splints.

3. Erosion:

Erosion is the destruction of the tooth surface caused by external elements, usually chemicals and/or acids. Erosion often results from elevated levels of intrinsic or extrinsic acid in the mouth. It is the result of tooth structures being broken down by the acids in the person’s mouth. Bacteria in a person’s mouth can convert food particles into acids, and specific food items like sugar and citrus fruits are highly acidic. Alterations in saliva flow, gastroesophageal diseases, health issues like acid reflux disease, bulimia, or anorexia, and consumption of carbonated beverages are some of the causes of dental erosion.

Erosion is slow to progress and can go unnoticed before the patient notices any symptoms (sensitivity to changes in temperature, sweets, acids, etc.). Unlike dental caries, erosion occurs even in places where there is no dental plaque.

To treat dental erosions, we need to eliminate the causativestimulus. This can be achieved by reducing the consumption of carbonated or acidic beverages in patients who consume many. If the problem comes from eating disorders or oesophageal reflux you should put yourself in the hands of a specialist in the field.

4. Abfraction:

This form of tooth wear is a wedge-shaped flaw that impacts and is limited to the neck of the teeth. It is caused by continued trauma due to excessive forces on the teeth or a bad bite. When tension zones are generated, microfractures are produced that can cause the loss of tooth structure in the long term.

Abfraction often looks similar to cervical abrasions or tooth erosion. Once abfraction occurs, the damaged portion has the potential to become more significant with abrasion, erosion and/or attrition.

It is advisable to carry out a study to assess the ability to perform an orthodontic treatment and thus be able to place the teeth in their correct position and ensure that they mesh correctly with each other.

Signs Of Dental Wear

As dental wear tends to be very gradual, it is not always easy to detect this problem. However, there are some indicators that can help us in this process:

a) Colour Change In The Teeth – As the enamel deteriorates, the dentin becomes transparent through it, showing a more yellowish colour. That is why people with dental wear tend to have more yellowish teeth.

b) Dental Fracture And Cracks – A friction and excessive contact between the teeth can also produce small cracks in the surface of the tooth or even fractures.

c) Dental Sensitivity – As the outermost and protective layer of the tooth, which is the enamel, is lost, stimuli such as cold, sweet or acid can be transmitted more easily to the dentin and to the interior of the tooth, that is, to the nerve or pulp.

d) Tooth Pain – When tooth wear is already advanced, it can cause pulpitis, that is, a painful inflammation of the dental pulp.

e) Reduction In Vertical Height – The vertical dimension is the height of the teeth when biting. A decreased vertical dimension due to tooth wear can give a more aged appearance and cause problems in the temporomandibular joints and cause problems of angular cheilitis at the corners of the lips.

How Can Dental Wear Be Prevented?

Like almost any other oral problem, dental wear is preventable by following certain guidelines. Some general ones:

  • Use a medium or soft bristled toothbrushe.
  • Use toothpastes with a low abrasiveness index.
  • Do not brush your teeth immediately after consuming acidic foods or drinks.
  • Periodically visit the dentist.

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