Teeth are designed to withstand daily use, yet they naturally wear down over time. The extent and nature of this wear vary significantly among individuals. Understanding tooth wear mechanisms and accelerating factors is important for oral health.
The Natural Process of Tooth Wear
Teeth undergo gradual wear from mechanical and chemical actions. This involves three primary mechanisms: attrition, abrasion, and erosion. These processes often occur simultaneously, contributing to tooth loss.
Attrition
Attrition is physical wear from direct tooth-on-tooth contact during chewing, speaking, or grinding. Continuous friction flattens cusps and shortens biting edges.
Abrasion
Abrasion is wear caused by external objects interacting with the tooth surface. Common sources include aggressive toothbrushing with hard bristles or abrasive toothpaste. Chewing on hard items like pens, ice, or fingernails can scrape away enamel.
Erosion
Erosion is chemical dissolution of tooth structure, primarily enamel, due to acid exposure not caused by bacteria. Acids come from dietary sources (acidic foods/beverages) or internal sources (stomach acid). Once enamel wears away, the softer underlying dentin becomes exposed, accelerating further wear.
Factors Influencing Accelerated Wear
While some tooth wear is natural, various behaviors, conditions, and environmental factors can significantly accelerate this process. Recognizing these influences helps identify potential risks.
Bruxism
Bruxism, involuntary teeth clenching or grinding (especially during sleep), significantly contributes to accelerated tooth wear. Intense, repetitive forces stress teeth, leading to rapid loss of structure. Stress or sleep disorders can exacerbate this habit.
Dietary Habits
Dietary habits play a substantial role, especially frequent consumption of acidic foods and beverages. Drinks like sodas, sports drinks, fruit juices, citrus fruits, and vinegar can soften tooth enamel. This softened enamel becomes more vulnerable to mechanical wear from chewing and brushing.
Medical Conditions
Certain medical conditions can accelerate tooth wear. Gastroesophageal reflux disease (GERD) causes stomach acid to repeatedly flow into the mouth, leading to widespread erosion on inner tooth surfaces. Bulimia, involving self-induced vomiting, exposes teeth to highly corrosive stomach acids, resulting in significant enamel loss. Dry mouth (xerostomia) reduces saliva’s protective effects, leaving teeth more susceptible to acid attacks and wear.
Occupational Exposures and Oral Habits
Occupational exposures can contribute to accelerated wear. Workers in environments with acidic fumes or abrasive dust, such as factory workers or wine tasters, may experience increased tooth erosion or abrasion. Oral habits like nail biting, pen chewing, or using teeth as tools can mechanically damage teeth, leading to localized or generalized wear patterns.
Consequences of Significant Tooth Wear
Significant tooth wear leads to noticeable effects on oral health, function, and appearance. These consequences often prompt dental attention.
Sensitivity
Increased tooth sensitivity is a common complaint. As enamel wears away, the underlying dentin, containing microscopic tubules leading to the tooth’s nerve, becomes exposed. This causes sharp pain or discomfort when teeth are exposed to hot, cold, sweet, or acidic stimuli.
Appearance
Changes in appearance are a frequent outcome of considerable tooth wear. Teeth may appear shorter or smaller, with chipped or fractured edges. Exposure of yellower dentin beneath the enamel can also lead to noticeable discoloration, affecting smile aesthetics.
Functional Issues
Functional issues can arise, making everyday activities challenging. Significant wear can alter a person’s bite, leading to difficulty chewing. This may contribute to jaw pain or issues with the temporomandibular joint (TMJ).
Other Dental Problems
Severe tooth wear increases the risk of other dental problems. Exposed dentin is softer and more susceptible to decay, making teeth prone to cavities even with good oral hygiene. In advanced cases, wear can lead to gum recession or tooth loss if structure is compromised.
Managing and Preventing Tooth Wear
Addressing tooth wear involves proactive preventative strategies and various treatment options. Preventative measures focus on minimizing factors that contribute to accelerated wear.
Preventative Measures
Modifying dietary habits by reducing frequency and duration of exposure to acidic foods and drinks is beneficial. Rinsing the mouth with water after acidic items can help neutralize acids and protect enamel.
Proper Oral Hygiene
Proper oral hygiene practices are important. Using a soft-bristled toothbrush and non-abrasive toothpaste with gentle brushing prevents mechanical wear. Avoiding brushing immediately after acidic substances allows saliva time to re-harden enamel.
For bruxism, a custom-fitted night guard protects teeth from grinding forces. Regular dental check-ups are important for early detection and intervention, as dentists identify wear patterns and offer personalized advice. Managing underlying medical conditions like GERD or bulimia significantly reduces acid exposure to teeth.
Treatment Options
When tooth wear has occurred, several treatment options restore tooth structure and function. Dental bonding or composite fillings can rebuild less extensive worn areas with tooth-colored resin. For significant damage, crowns or veneers may cover and protect the entire tooth surface, restoring shape and strength. Orthodontic treatment can correct bite issues contributing to uneven wear patterns. Fluoride treatments or desensitizing agents can be professionally applied or used at home to strengthen enamel and alleviate sensitivity.