Tooth Wear refers to the loss of tooth surface, owing to physiologic or pathologic reasons rather than decay or injury. As we age, our teeth are subject to wear and tear with daily use, just like the rest of our body parts. This is quite normal. However, pathologic tooth wear is something that occurs beyond the scope of what dentists would consider normal. This is because it can impact the function of the teeth, such as chewing and biting, and also cause pain and aesthetic problems.
Tooth wear is categorized into three types:
- Attrition: When other teeth cause mechanical wears to a tooth’s biting and chewing surface, it is termed as attrition. This could include damage to the tooth structure due to tooth grinding and clenching. The contact with other teeth during grinding causes the front teeth to become shorter and the back teeth to become flatter. Severe attrition could also lead to distortion in the shape of the face and cause tooth sensitivity.
- Abrasion: this type of tooth wear is caused by friction and happens when the teeth are brushed too hard with sweeping horizontal strokes. The use of a hard toothbrush also causes abrasion. Abrasion can be seen on the outer surface of the back teeth in the form of a V-shaped or wedge indentation at the gum margin.
- Erosion: When an acid causes the dentin and enamel to wear away, the wear is termed as erosion. Our mouth receives acids either via food or through the stomach. Highly acidic foods can erode the enamel and dentin. The acid released from the stomach is powerful enough to dissolve bone and teeth apart from food. Gastric acid comes in contact with the teeth when the stomach contents are regurgitated due to conditions such as bulimia or any other problems that cause repeated vomiting.
The enamel lost and the sensitivity of exposed dentin due to tooth wear can be treated in the following ways:
- Small areas of erosion can be desensitized
- In areas where the dentin is largely exposed, bonding can be used for repair.
- Crowns can be used in cases a large breakdown of the tooth structure has resulted due to erosion.
- Crown lengthening procedures may be necessary in addition to crowns. This is because a worn tooth continues to erupt and as a result, it pulls the bones and gums with it.
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