Tooth wear is the term used to describe the progressive loss of a tooth’s surface due to actions other than those which cause tooth decay or dental trauma. Tooth wear increases with age.The amount of tooth wear seen currently is considerably greater than in the past due to the fact that more people are now retaining their natural teeth into old age. Tooth wear is caused by three phenomena: erosion, attrition and abrasion.
Erosion is also a problem in individuals who suffer from gastro-esophageal reflux disease (GORD) or from certain eating disorders (e.g., anorexia, bulimia). In addition, risk of erosion is high in individuals with a low “unstimulated” salivary flow rate.
For example, it will increase in people who habitually clench or grind their teeth (a condition known as bruxism), e.g., during sleep. It will also tend to be more pronounced in people who eat a particularly fibrous diet.
It will also be seen in individuals who use their teeth as a tool (e.g., to remove bottle tops, to hold pins, clips or nails).
Erosion of teeth
Its the progressive loss of tooth substance by chemical or acid dissolution, and no bacteria are involved. Erosion of tooth surfaces is mostly the results of too frequent or inappropriate use of carbonated drinks (including sparkling water) and fruit juices with high levels of acidity. This habit would appear to be particularly common amongst teenagers and young adults.
Attrition of teeth
Is the progressive loss of hard tooth substances caused by mastication or grinding between opposing teeth.
For example, it will increase in people who habitually clench or grind their teeth (a condition known as bruxism), e.g., during sleep. It will also tend to be more pronounced in people who eat a particularly fibrous diet.
Abrasion of teeth
Is the progressive loss of hard tooth substances caused by mechanical actions other than mastication or tooth-to tooth contacts. Abrasion is commonly associated with incorrect toothbrushing technique, giving rise to notching at the junction of the crown and root of teeth.
It will also be seen in individuals who use their teeth as a tool (e.g., to remove bottle tops, to hold pins, clips or nails).
The long-term use of tongue jewellery also causes tooth abrasion, when the jewellery is hitting against the teeth against it.
Prevention
Reducing the frequency of drinking carbonated drinks and fruit juices with high levels of acidity is the key to preventing erosion of the teeth. Brushing of teeth should be avoided immediately after consuming acidic drinks and foods for a period of time (at least 20 minutes), as the acid softens the enamel making it susceptible to damage from brushing. Attrition is a slow-progressing condition and many people will only be made aware of the damage to their teeth on visiting the dentist. In the case of bruxism, treatment may require the wearing of a bite guard during sleep.
Abrasion can be reduced by adopting a correct toothbrushing technique.
In particular, the toothbrush should be held using a pen-grip and vigorous horizontal scrubbing actions with a hard toothbrush should be avoided. Teeth should not be used as a tool to grip or hold items. Long-term use of tongue jewellery should be avoided. Toothpastes vary in their level of abrasiveness; whilst abrasives help to remove tooth stain they may also contribute to tooth wear. Those concerned about tooth wear could seek a less abrasive fluoride toothpaste. Fluoride toothpastes also help to combat tooth wear, specifically erosive tooth wear, as the availability of fluoride promotes the formation of a calcium flouride layer.
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