What is tooth wear?
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
What causes tooth wear?
Tooth wear can be caused by any of the following:
- Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough. A removable dental appliance, such as a partial dentures or retainer, can also abrade teeth. Abrasion can also result from habits such as nail-biting and pen-chewing.
- Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time. That’s because they can subject teeth to 10 times the normal forces of biting and chewing.
- Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices. Eating sugary snacks also raises the acidity level in your mouth. If you can’t give up these snacks and drinks entirely, it’s best to confine them to mealtimes so your mouth doesn’t stay acidic throughout the day. Swishing water in your mouth after eating or drinking acidic or sugary substances can also help prevent erosion.
- Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.
How is it treated?
The first step in treating any type of tooth wear is to determine the cause during a simple oral examination right here at the dental office. Once the cause has been identified, we can work together to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, we can make you a nightguard that will protect your teeth during sleep or periods of high stress. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.
Fans of the classic bumbling-buddies comic film “Dumb and Dumber” will surely remember the chipped front tooth that Jim Carrey sported as simpleminded former limo driver Lloyd Christmas. Carrey reportedly came up with the idea for this look when considering ways to make his character appear more “deranged.” He didn't need help from the make-up department, however… He simply had his dentist remove the dental bonding material on his left front tooth to reveal the chip he sustained in grade school!
Creating a Bond
A dental cosmetic bonding involves application of a composite filling material that our office can color and shape to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. This is the quickest and lowest-cost option to repair a chip.
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.
A veneer can be used to hide smaller areas of missing tooth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface also may be necessary to fit a veneer.
A chipped tooth makes an impression, but generally not a flattering one. Nearly 20 years after “Dumb and Dumber” hit the theaters, the only thing Jim Carrey had to do recently to hint at a sequel for his nitwitted character was tweet a photo of that goofy grin!
If you would like more information about repairing a chipped tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”
- Bonding – tooth-colored composite resin can fix small chips or cracks
- CEREC crown – with CEREC technology, it only takes one dental visit to cover a crack, chip or loosened tooth
- Porcelain veneers – these custom, thin shells are a great cosmetic choice to fix tooth discoloration, chips and cracks
Does anyone truly enjoy flossing their teeth? We can’t rule it out — but for most of us, flossing is something we do because we understand how very important it is to our oral hygiene. Yet there are some for whom flossing is a much greater challenge — for example, people with limited mobility, or those who are wearing braces. Is there any alternative to flossing that offers these people the same health benefits?
Perhaps — but before we discuss the options, let’s remember why flossing is so important. The number one enemy of your oral health is plaque: a sticky, bacteria-rich film that builds up on the surface of your teeth every day. Flossing is an effective means of removing plaque from the tiny spaces in between the teeth — the places a regular brush can’t reach. Left alone, plaque builds up into a hardened layer called tartar or calculus, which generally requires a professional cleaning with special dental tools to remove. Both plaque and tartar are the major causes of tooth decay and gum disease.
If you are unable to remove plaque via regular flossing, a tool called an oral irrigator may help. Sometimes called a “water flosser” or “pick,” this device is designed to squirt a pulsing jet of high-pressure water through a hand-held wand. Special tips may be also available for use with braces or dental implants.
Since these devices first became widely available in the 1960s, they have been the subject of many studies. The general conclusion from the research has been that water irrigators can be helpful in controlling plaque — particularly in people who would otherwise have trouble doing so. For example, a 2008 study showed that orthodontic patients who used an irrigator with a special tip after brushing normally were able to remove five times as much plaque as those who used brushing alone.
Oral irrigators aren’t just for use in the home. Many dental offices use similar devices for special treatments that can help control gum disease. Of course, in that case, the professional-grade tool is handled by a specially trained dental hygienist, dentist, or periodontist — and it’s part of a procedure that may also involve other manual or power instruments, plus special cleaning solutions.
So does it make sense to use an oral irrigator instead of flossing? For most people, flossing is probably the best way to ensure that you remove as much plaque as possible. But if for some reason you aren’t able to floss effectively, using an oral irrigator offers some well-documented benefits. Why not ask us the next time you come in? We can help you decide which method is right for you, and even demonstrate the most effective techniques for plaque removal.
If you would like more information about oral irrigators, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Cleaning Between Your Teeth: How Water Flossing Can Help.”
This is the story of a well-known man, fearless in most respects, who was afraid of the dentist. Even though his fears had resulted in neglect and serious damage to his teeth, modern dentistry and a talented dental team were able to restore his smile to health. If you share this fear, his story may inspire you to take action.
We're talking about William Perry, former defensive lineman and fullback for the Chicago Bears. Here is a man who could fearlessly face a football squad — but not a visit to the dentist. Nicknamed “The Refrigerator” for his 380-pound massive frame, Perry played for ten years in the NFL before retiring in 1994. Since retiring he founded and operated a construction company in South Carolina in addition to making celebrity appearances.
With his celebrity in mind, a team composed of a talented restorative dentist, implant surgeon, and lab technician agreed to give “The Fridge” a makeover. After discussing modern technology and virtually pain-free dentistry with him, they managed to overcome Perry's fears. “I had been in constant pain for many years and I neglected myself, not having had any dental care for over 20 years, not even emergency care. Unfortunately, as I grew older my teeth started to get loose,” Perry told an interviewer. He had lost many teeth and became known for his gap-toothed smile.
Perry had severe gum disease and many of his remaining teeth were loose. In the past his only option would have been a full set of dentures. But his new dental team was able to place dental implants (permanent tooth replacements) supporting fixed bridges. In most cases dental bridges are attached to healthy teeth, but in Perry's case the implants served as anchors for the bridges. They also stabilized his jawbone, which would otherwise “resorb” or melt away after his teeth were lost. This is important because it helps preserve the contours of his face.
After careful planning “The Fridge” had eight dental implants placed in his upper jaw and seven in his lower. The final bridgework was completed four months later. It turned out that even though the gap between his teeth had become his trademark, “the Fridge” never really liked it. He was thrilled with his new smile.
Even if you have some fears, don't hesitate to follow Perry's example and make an appointment with us for a consultation about dental implants, smile makeovers, or bridgework. For more information about William “The Refrigerator” Perry, see the Dear Doctor magazine article “How Immediate Implants Saved 'Refrigerator' Perry's Smile.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.