Worn Teeth

Teeth can wear in different ways.

Teeth can wear from exposure to acid. This is different from the acid made by bacteria that causes decay. This acid can come from your diet in the form of fizzy drinks and sports energy drinks. It’s important to mention here that diet fizzy drinks are just as acidic as sugary fizzy drinks. Even though they are diet, they will still cause significant damage to your teeth. Acid can come from your diet in loads of forms. It can also come from your stomach if you are sick a lot or get acid reflux (heart burn). These acids will uniformly wash away the enamel from your teeth.

Teeth can wear because of toothbrushing. This most commonly happens around the necks of the teeth, where the tooth and the gum meet. Naturally with time, your gums can shrink back. This can be made worse by brushing the gums too hard.

If your gums shrink back, they will expose the sensitive root surface. This root surface does not have a covering of enamel and will wear much more quickly. When this happens, little cup shaped areas can start to appear near the gum line. This is where the root surface is slowly being brushed away.

The final type of wear is caused by grinding. Simply, this is when someone is clenching and sliding their teeth over each other so much that they are wearing away the teeth. Most people will have some wear like this because of natural wear and tear when eating.

In fact, most people will show each of these three types of wear at least a bit in their mouths. That’s not the end of the world because a certain amount of wear and tear is going to happen unless you turn all of your food into mush and drink it through a straw.

When there is more wear than you would expect, treatment may be necessary

Treatment; Rebuilding

Worn teeth can often be rebuilt. The number of teeth that have been affected determines how complex the treatment is. Just a few teeth will usually be easier than every tooth in the mouth.

When rebuilding worn teeth, you can use porcelain or you can use tooth coloured filling material.

Porcelain has always been considered as the material that gives the best end cosmetic result. It is stronger than tooth coloured filling material and will usually last longer. It will be more expensive than rebuilding with filling material. Porcelain can come in the form of crowns or veneers. Veneers are a thin layer of porcelain that cover the front of a tooth to replace lost enamel or improve the shape, colour or appearance. The downside is that you often need to take away some enamel to place a veneer. There is more on veneers in our cosmetic section.

The second option is using a tooth coloured filling material. Now that filling materials are so amazing, dentists can now almost completely rebuild teeth with these filling materials, giving a great looking end result. There is so much that we can do with these materials that I consider it a really good alternative to using porcelain. It will generally be less costly than the porcelain alternative but they do need a bit more ongoing treatment. The material is not as strong as porcelain so will chip and stain more with time, requiring more ongoing repairs.

You can of course have a combination of both porcelain and tooth coloured material. Some times you can try something out in a tooth coloured material and if it successful, swap it to porcelain.

Treatment of wear will often need a lot of planning. If your teeth have been dramatically affected by acid damage, grinding or whatever it is, there often isn’t a quick fix. It should be considered and properly planned before starting any treatment. The point is that if you have had wear that you want fixing, please be patient. Please give your dentist time to work out your options and find the plan that best suits your needs and concerns.

Preventing more wear

The other aspect of wear is trying to prevent it getting worse or reoccurring once it has been treated. With acid wear for example, it may be that changes to your diet are required. If you are being sick a lot then your doctor will be more use than your dentist.

Preventing wear from over-brushing may require specific advice from your dentist about how you should be caring for your teeth. Electric toothbrushes can be really good at stopping you pushing too hard. Some models make a funny noise or a light may flash when you overdo it. For more information on brushing, please go to the article.

Wear from grinding may require you to wear an appliance at night; something that looks similar to a sports gum shield perhaps. For more on grinding, please go to the ‘Jaw joint’ article.

The point is that we don’t only want to rebuild the teeth; we also want to prevent more damage by wear in the future.