Tooth wear – what is it and how can it be prevented?

Tooth wear refers to loss of tooth substance by anything other than tooth decay. All of us can show signs of tooth wear as we get older, but in some people the amount of tooth wear is more advanced, which can lead to the sensitivity of the teeth and even tooth loss.

Different types of tooth wear

Tooth wear is categorised in 3 main groups:

1. Attrition: is loss of tooth surface caused by physical tooth-to-tooth contact.
2. Abrasion: is loss of tooth surface caused by physical means other than teeth.
3. Erosion: is chemical dissolution of tooth surface caused by acidic foods and drinks.

Why do some people show more tooth wear compared to the others and how can we prevent the tooth surface loss?

People with a history of grinding and clenching teeth can show more tooth wear (attrition). This can be prevented by wearing mouth guards or splints. Studies have shown that grinding is largely stress related so it’s important to try and treat the route cause.

Those with the habit of hard brushing or pencil biting etc. can show more tooth wear (Abrasion). This can be prevented by changing to an electric toothbrush, improving brushing techniques and cessation of some harmful habits.

Patients who have the habit of consuming lots of fizzy/carbonated drinks, acidic food and juices or even with medical conditions such as regurgitation or reflux, can show more erosive tooth wear. This can be prevented by improving the diet and also a consultation with the GP. It’s not just the quantity of fizzy drinks you consume that’s important, but also the frequency. Every time you consume something fizzy, the pH of your mouth drops to around pH4 or below. It then takes around 30 minutes for the saliva to neutralise the acidic environment and in this time your teeth will be eroding away. So, if you consume one can of cola, at one time, the mouth will be eroding for 30 mins. However, if you consume the same one can of cola, but instead of drinking it at once you take one sip every 30 minutes, your mouth will be in that erosive state for pretty much the whole day (i.e. until you finish the can). Therefore, the ways you can mitigate this risk is:

• cutting down the frequency of acidic drink consumption,
• drinking through a straw,
• consuming fizzy drinks with a meal. This works because the foods neutralize the acids.

Sometimes more than one factor of tooth wear is present which can lead to extensive tooth surface loss.

Treatment options for tooth wear

The treatment depends on the severity of the tooth surface loss, these treatments can include:

1. Prevention and monitoring – this is ideal if caught early on.
2. Simple fillings and restorations – to cover exposed bit to tooth and to improve aesthetics.
3. More complicated treatments such as nerve treatments (root canal treatments) and crowns.
4. Extraction of the teeth and replacement with dentures or implants.

If you are suffering from tooth wear please contact us and we would be happy to discuss treatment options.