About 15% of our population here in the United States suffer from worn down teeth due to bruxing and grinding habits. This is a genetic habit that is caused by very strong cheek muscles that exert an enormous amount of force when we are sleeping at night. Many of us are unaware of our grinding habits, and over time, our teeth begin to slowly wear down and chip away. By the time many of these patients reach their 30s and 40s, its as if half their normal teeth structures have been removed. For people in this situation, we have to ask if this problem is fixable, and if so, how can we fix it?
What are the main causes of tooth wear?
- Attrition: Attrition is loss of tooth structure due to physical tooth-to-tooth contact. The word attrition is derived from the Latin verb attritium, which infers to action of rubbing against something. Attrition mostly causes wear to the top portions of your teeth (known as the occlusal and incisal portions). Attrition has been associated with strong grinding or bruxing forces that happen at night. A degree of attrition is normal, especially in older individuals.
- Abfraction: Abfraction is loss of tooth substance at the front margins near the gum line, purportedly caused by minute flexure of teeth under extreme biting forces. The term is derived from the Latin words ab and functio meaning ‘away’ and ‘breaking’ respectively. Abfraction presents as triangular lesions along the cervical margins of the front surfaces of the teeth where your enamel is thinner and therefore, in the presence of occluding forces, is prone to fracture. Abfractions can lead to sensitive teeth and overall recession of your gum tissue.
- Erosion: Erosion is chemical breakdown of tooth substance caused by acids, unrelated to the acids caused by intraoral bacteria. Erosion may occur with high consumption of acidic foods and soft-drinks, or medical conditions involving repeated regurgitation and reflux of gastric acid (GERD). Erosion usually occurs on the inside surfaces of upper front teeth and the top surfaces of the molar teeth. Dental erosion is rarely seen in historical records, but certain cases have been described suggesting acidic fruits and/or plants where regularly consumed. The following are all causes of Erosion:
- Gastroesophageal reflux disease (GERD)
- Dietary – liquids of low pH (acidic drinks like Coke and Pepsi).
Steps to take in fixing worn down teeth:
- Consider a full mouth reconstruction with a certified cosmetic dentist: What is a full mouth reconstruction? It is the use of dental crowns to help rebuild your teeth to their natural appearance. Also known as a full mouth rehabilitation, this is a complex procedure requiring a skilled cosmetic dentist to properly treatment plan and perform the necessary treatment. A full mouth reconstruction involves adding height to your teeth that has been lost over the years. Also known as restoring your vertical dimension of occlusion, adding height to your teeth may feel strange at first as the entire way that you bite down changes.
- Prevent your teeth from wearing down more by purchasing a nightguard from your dentist: A nightguard is an appliance that you place in your mouth at night that helps prevent your teeth from engaging each other while your sleeping. Your grinding patterns will still be present, but the guard will act as a shield to prevent any more harm from coming to your actual teeth structures.
- Consider gum surgery: If your dentist sees that you have an overgrowth of gum tissue along with your worn down teeth, he may begin treatment by recommending a gingivectomy, or a small gum surgery. This will help lengthen your teeth, but it is usually followed up with a full mouth reconstruction to help rebuild your teeth’s natural beauty.
With modern advances in dental technology, it is becoming more predictable in correcting teeth that have been worn down through time. Remember to make sure that a certified cosmetic dentist is handling your case. He or she can customize a treatment plan just for you to get you smiling once again!