Tooth wear: causes, treatment, prevention

Enamel wears down over a lifetime. This is natural. But when teeth shorten quickly, the bite, the joint and aesthetics suffer. We explain how to tell normal wear from pathology and what the clinic does.

What tooth wear is

Wear is the loss of hard tooth tissue due to contact. The chewing cusps and incisal edges are most often affected.

The process is gradual. A person gets used to the changes and notices them late.

The doctor compares tooth height in different areas. Uneven tissue loss is a sign of pathology.

It matters whether the dentin is visible. It is softer than enamel and wears faster.

Wear on one side is often linked to missing teeth on the other. Chewing shifts to the healthy side.

So the doctor examines the whole dentition, not only the worn teeth. The cause may be far from the complaint.

Natural and pathological wear

Natural wear is slow. It does not disturb the bite and does not cause pain.

Pathological wear is fast. The teeth lose height, sensitivity appears and the joint is overloaded.

The doctor sets the boundary. To do so they assess crown height, the bite and the complaints.

Causes

• bruxism and night-time jaw clenching
• increased acidity in the mouth
• reflux or frequent consumption of acidic drinks
• bite problems
• a hard brush and abrasive toothpaste
• the habit of chewing hard objects

Acid softens enamel. After it, wear speeds up even from ordinary brushing.

Bruxism is the most common cause of rapid tissue loss. A person does not control clenching during sleep.

Professional cleaning with abrasive pastes also has an effect. Frequent polishing without need removes enamel.

The load on one tooth increases after a neighbour is lost. This speeds up wear in the area.

Daytime clenching is noticeable too. A person keeps the teeth together, although they should be apart at rest.

Symptoms

• the teeth have become shorter
• the chewing cusps are flattened
• increased sensitivity to cold
• a yellowish shade from the dentin
• chips of fillings and crowns
• pain in the joint and muscles
• a change in face shape in severe cases

One symptom does not confirm the diagnosis. The doctor assesses the whole set of signs.

Patients often come because of sensitivity, not shape. Pain appears when the enamel thins down to the dentin.

Consequences

When teeth lose height, the bite changes. The joint works in a different position.

Thinner enamel lets irritants through faster. Sensitivity appears, and then caries.

Restorations and crowns suffer too. They can chip or lose contact.

Over time a person starts avoiding hard food. This changes nutrition and the condition of the stomach.

Aesthetics suffer gradually. The teeth look shorter and darker.

Wear is rarely even. The teeth that contact first suffer most.

Diagnostics

The doctor examines the teeth, assesses crown height and the condition of the joint. They palpate the chewing muscles.

When indicated, X-rays or a CT scan are taken. They show the condition of the roots and the joint.

The doctor also asks about sleep, nutrition, medication and previous treatment. These data explain the cause.

Photo documentation helps compare the condition after a few months. Changes are visible even without complaints.

Comparison with previous images shows the speed of the process. This matters for the treatment plan.

The examination also includes the temporomandibular joint. Its condition affects the choice of treatment.

Children can also have increased wear. The cause is often acidic drinks and habits.

Treatment

• occlusion correction
• a protective splint for bruxism
• reflux treatment together with a doctor
• restorations to restore shape
• crowns for significant tissue loss
• orthodontic treatment for bite problems

The plan depends on the cause. If the cause is acid, restoring the shape alone will not stop the process.

First the doctor removes the load, then restores what was lost. This order reduces the risk of another chip.

If the cause is the bite, orthodontics is needed. Crowns only finish the work.

Temporary appliances let the doctor check the bite height. The patient wears them for several weeks.

Patients with reflux should be examined by a gastroenterologist. Without this the enamel keeps breaking down.

About protecting the teeth read in the article splint therapy for bruxism. About the cause itself - in the material bruxism: symptoms and treatment.

Prevention

• a soft brush and toothpaste without coarse abrasives
• do not brush your teeth right after acidic food
• do not chew ice, nuts in shells or pens
• wear a splint for bruxism
• treat reflux
• have a check-up every 6 months

After acidic food rinse your mouth with water and wait about 30 minutes before brushing. The enamel is softer during this time.

It is better to drink acidic drinks through a straw. This reduces contact with the enamel.

Saliva restores minerals. So drinking water throughout the day matters.

Sugar-free chewing gum stimulates saliva. It does not replace brushing.

For bruxism the splint is made from impressions. Pharmacy guards do not give even contact.

If the wear is already significant, the doctor may suggest an orthodontic stage. It restores space for the restorations.

The habit of resting the jaw on a hand creates uneven pressure. This gradually changes the load on the dentition.

Sleep and stress levels affect the chewing muscles. Working on the daily routine sometimes reduces symptoms.

Sweet drinks between meals do more harm than a dessert after lunch.

Do not use whitening pastes all the time. They often contain abrasives.

People get used to sleeping with a splint within a week. It does not disturb rest.

Regular hygiene reduces the risk of complications. Tartar and plaque speed up tissue loss.

Do not hesitate to ask about alternatives. Sometimes observation is enough.

Prices in Irpin

The full price list is on the prices page. The doctor gives the total after diagnostics.

Diagnostics are provided by gnathology, tooth protection by a bruxism splint, and shape restoration by dental crowns.