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Tooth Wear
All teeth wear throughout the life
of an individual. Usually tooth wear is very slow and, despite the fact nature
does not provide the means of repairing or applying new material to replace
parts worn or damaged, most teeth will survive the lifespan of that person.
Sometimes tooth wear becomes
excessive and the appearance of the teeth deteriorates or discomfort in eating
and sometimes pain can result.
Excessive tooth wear can be caused
by rubbing teeth together (attrition), by the softening and dissolving of the
surface of acids (erosion), by something hard or rough removing the surface
(abrasion), or a by a flexing of the tooth under excessive load (abfraction).
Usually combinations of all factors are present.
Attrition
The cause of teeth grinding
together and causing excessive tooth wear, might simply be a habit or as a means
of relieving stress or of wearing down something which prevents the teeth
fitting together properly when chewing (e.g. a filling which is too large or a
tooth which has grown into an odd position in the mouth).
Such wear occurs, for example, when
someone waits impatiently at a red traffic light, tensed up, with jaw set and
teeth grinding together. Others grind their teeth together when asleep and are
unaware of their habit. The first group can reduce such wear by altering their
habit and attempting to stop or reduce it. Those in the second group are
obviously unaware of their habit and are not able to stop. Sometimes a plastic
mouth guard which is worn at night can help reduce the wear.
Erosion
Tooth wear by erosion is caused by
acids, softening and dissolving the surface. The acids may be present in the
mouth either from the diet or from the stomach
Acid in the diet typically arises
from the excessive intake of cola-type drinks and carbonated, fizzy drinks with
high acid content. Many people who wish to adopt a healthy, natural diet, drink
daily, large amounts of fresh fruit juices most of which are very acidic. This
is harmful since in a truly natural diet, fruit and fruit juices were very
seasonal and the yearly intake by humans was quite modest. Nowadays, with modern
farming and industrial methods, vast quantities of pure juice from a wide
variety of fruits, worldwide, (pineapples, oranges, lemons, apples, kiwi fruit
etc) are available all year round from the local supermarket. Some people
consider that 1 litre per day can't do harm, but this would certainly harm not
only the teeth but could irritate the stomach. If you must consume fruit juice,
try to reduce the frequency and protect your teeth by using a drinking straw
(which will direct the acidic juice past the teeth) or gulp it down rather than
wash it around the mouth and teeth.
Other sources of acid in your diet
would be wine drinking (particularly white) and yoghurt. Again moderate amounts
are acceptable; excessive amounts are unacceptable. Odd habits such as
frequently sucking raw lemon slices are obviously harmful.
Acid from the stomach can arise
from:
A hiatus hernia or oesophageal
reflux
Anorexia nervosa and bulimia
Alcoholism and narcotic addiction.
Oesophageal reflux occurs when the
acid contents of the stomach are allowed to run back from the stomach into the
mouth typically when lying down or asleep. Pregnancy may also give rise to such
conditions. This can be reduced by avoiding eating a large meal or
consuming a large amount of drink just before bedtime. Those who suffer from a
hiatus hernia or heartburn may reduce their symptoms with antacid tablets
prescribed by their doctor.
Those who suffer from anorexia
nervosa or bulimia (the slimmer's diseases) vomit regularly, exposing their
teeth to acid each time.
Those who suffer from alcoholism
and narcotic addiction also have recurrent vomiting and reflux of acid from the
stomach to the mouth.
People who suffer from these
conditions will rarely admit that they are unwell and will certainly not accept
advice from a dentist. Tooth wear in such cases is difficult to control and will
only be possible once the individual accepts medical treatment and advice.
Extra damage is done to these
patients' teeth by immediately brushing their teeth after vomiting or taking
acidic foods. Always allow at least half an hour for your saliva to neutralise
the acid before brushing.
Abrasion
Tooth wear by abrasion is often
caused by an aggressive tooth brushing technique, or by using an abrasive
toothpaste or tooth powder (typically a "smoker's toothpaste"), or by brushing
too frequently or by using a hard brush.
To clean the teeth and gums
effectively it is only necessary to brush twice daily, using a gentle,
meticulous technique with a soft or medium nylon toothbrush. The well known
brands of toothpaste are acceptable but avoid any which are recommended for
removing stains from smoking since invariably these are too rough and gritty
Tooth wear will result if teeth are
used against hard unyielding objects - supporting pipe stems, stripping wire,
holding nails/hairgrips, opening beer bottles, cutting string –you name it, it's
been done.
Tooth wear is often only recognised
by the dentist and hence the importance of regular attendance for check-ups.
Since the changes are fairly small, impressions are taken on successive visits
to make stone models, which are then compared.
Abfraction
Usually occurs on pre-molar or
canine teeth and is characterised by a well defined notch at the gum level.
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