Erosion and Tooth Wear

We often think of decay as the reason for holes and while that is a common cause, we can also lose tooth structure without decay.Tooth loss where decay (caries) is not the cause, is called non-carious tooth loss, and can be just as damaging despite great oral hygiene.  Non-carious tooth loss generally falls into 3 categories:

1. Erosion is where there is a chemical component to the tooth loss, most commonly due to acid.  The protective enamel on our teeth is a hard mineral.  When acid is placed on a mineral, it starts to remove components of that mineral, essentially dissolving and weakening the structure.  One of our saliva’s main roles is to make our mouths less acidic, and to replace the mineral in our teeth.  If our mouth are too acidic for too long, due to a high and regular dose of acid from soft drinks, sports drinks, wine, juice etc, then the weakened structure can start to break down, causing irreversible loss.  Given the microscopic nature of these minerals, it won’t be evident immediately, but over time, little by little, we can wear through this enamel and into the dentine below.  The enamel is there to protect our teeth, so the less we have, the less protection we have from decay, sensitivity, and chipping and breaking.

A few ways to avoid and minimise the damage cause from erosion are:

• Drink lots of water to maintain good saliva
• Try to not sip acidic drinks over a long period of time as it keep the environment acidic for a longer duration.
• Never brush straight after having acidic drinks. Have a drink or rinse with water and give it 30 minutes to give the saliva a bit of time to get some mineral back into the teeth to strengthen them up again.  If you brush over the soft and weakened structure it will remove some of it, never allowing it to repair.
• Use of products that will help drive mineral back into your teeth, such as Tooth Mousse Plus, especially if you have compromised saliva.

1. Attrition
   Attrition is where the teeth are being physically worn down by the opposing teeth, most typically with grinding (bruxism).This is a process that usually takes a bit of time, but can have consequences that are difficult and expensive to fix if not addressed early.Attrition often happens subconsciously when we’re sleeping as is not always easy to stop.  If there are signs that you grind, a splint to wear at night can be helpful.  Stress is often a big contributor to grinding, and it would also be worth looking at and addressing your stress levels where possible.  Pain and airway/breathing problems have also been suggested to play a role a well.Unnatural tooth positions, or teeth that don’t line up properly, can also play a role in attrition and can accelerate the damage caused by grinding.  Straightening your teeth can help address these issues.

2. Abrasion
   Where attrition is physical wear caused by opposing teeth, abrasion is physical wear caused by a foreign objects, most commonly a toothbrush. If we scrub our teeth too hard, we can actually wear away parts of our teeth.  Most commonly this occurs around the gumline, leading to sensitivity.  To avoid abrasionmake sure you always:
   • Use a soft or extra soft toothbrush
   • Avoid scrubbing backwards and forwards, and try to use an up and down or circular motion. If you struggle not to scrub, an electric toothbrush might help.
   • Wait at least 30 minutes to brush your teeth after having acidic foods and drinks. The acid will essentially soften the enamel make it more susceptible to wear.  Giving your saliva a bit of time (helped along with some water is great) to overcome the affects of the acid before starting to brush can go a long way.

We often feel like if we don’t scrub hard, then we won’t clean our teeth properly, however when we are cleaning our teeth the goal is to remove plaque which is very soft, and no match for even a soft toothbrush and gentle circles.

If you suspect you might have some tooth wear, or would like more information, please don’t hesitate to give us a call on (07) 3379 1328