Tooth wear is a common problem in the society. Different reasons play a role in its formation. For example, fractures at the ends of the teeth due to impacts such as falling, tissue loss due to physiological aging of the teeth, dental caries due to the effect of microorganisms, as well as brushing, acid exposure, high chewing forces may cause tooth wear. The type and severity of the abrasive factor affects the appearance of the abrasion and the way it is treated.
Why do teeth wear down?
Some definitions emerge according to the type of factor that causes tooth wear. These are as follows;
- Tooth decay
- Tooth fracture
- Atrision
- Abfraction
- Brush abrasion
- Acid erosion
- Tooth decay
Caries is the dissolution of the tooth tissue by the acid produced by microorganisms as a result of consuming the food taken. Caries in the area where the tooth and gum meet (cervical area) is an example of tooth wear. It should be distinguished from cervical abrasions caused by other reasons.
Tooth fracture
It is the loss of hard tissue that occurs indirectly in the tooth as a result of excessive force directly on the tooth or in the mouth area. Generally, both enamel and dentin under the enamel are lost. There are different treatment options according to the size of the fracture.
What is attrition?
It is a type of abrasion caused by tooth to tooth contact. With aging, such abrasions increase in people’s teeth and are physiological. In addition, the rate of wear increases even more due to reasons such as tooth clenching. If the extra abrasions caused by tooth clenching are not treated, they may damage the tooth structure later. It can cause serious tooth tissue loss and aesthetic losses that will make a holistic change in the whole face.
What is abfraction?
It is usually caused by the accumulation of excessive chewing force due to tooth clenching. Unlike harmful atrision that requires treatment, it is the accumulation of high chewing force in the part of the tooth close to the gingiva (cervical) and unnatural loss of tooth tissue at the gingival level.
What are abrasion and brush abrasion?
Abrasion is the loss of tooth hard tissue caused by a foreign, mechanical factor coming into contact with the teeth. It usually occurs with a toothbrush. It is the V-shaped tooth tissue loss that occurs at the gingival line, especially in the small molar teeth of people who brush with horizontal, back and forth movements and high force. Another example of abrasion is notches on the cutting edges of the front teeth. These notches are usually caused by intensive core fencing, prolonged and frequent holding of objects such as needles and nails between the teeth, or due to the position of the pipe in pipe users, and due to the instrument in artists playing wind instruments. It appears as a notch at the ends of the front teeth.
What is acid erosion?
Dental erosion is the unnatural loss of tooth tissue caused by the effect of acid (e.g. excessive consumption of acidic foods, stomach problems such as reflux or the effect of stomach acid with frequent vomiting) without the effect of microorganisms. In addition to the acid that causes tooth destruction, factors such as tooth brushing and teeth grinding are also involved in the formation of erosion. This is very important for detection.
How do we know if our teeth are worn?
When our teeth are worn, colour differences are seen in certain parts of our teeth and sensitivity begins. Tooth wear due to clenching and atrision is seen as flattening and yellowing in the middle points of the mounds on the chewing surface of our teeth. The reason for this yellowing is the colour of the dentin tissue under the enamel. Because while enamel has a whiter structure, the original colour of dentin is yellow. For this reason, the places where the enamel is eroded and the dentin is exposed appear yellow. Abrasions caused by factors other than attrition are usually seen in the tooth tissue at the gingival level.
Does tooth sensitivity indicate tooth wear?
Not every sensitivity and discolouration of the teeth means tooth wear.
Cracks in the teeth cause tooth sensitivity when acidic or cold foods are consumed.
The root surface is exposed as a result of gum recession due to calculus. The root surface is very open to external factors. Therefore, gum recession is another cause of tooth sensitivity.
Dental caries can be confused with abrasion sensitivity because it causes sensitivity.
Discolouration such as smoking, tea, coffee should be distinguished by the colour difference in tooth abrasion.
How is tooth wear detected?
While examining tooth wear, your dentist tries to decide on the necessity of treatment by checking which surface it is on, the shape of the wear, the width and depth of the wear, and which teeth it is on. In this examination, intraoral cameras, photographs, dental films can be used if deemed necessary in addition to the classical visual intraoral examination. At the end of the examination, your dentist will determine the cause of the abrasion and plan treatment accordingly. If you have the above factors that cause tooth wear or if you have a suspicion that there is wear, contacting your dentist without delay will prevent the problem from progressing. Thus, your problem will be solved with easier treatments without progressing. Because these abrasions must be treated in order to keep our teeth in our mouths for a lifetime. It is necessary to go to the dentist every 6 months for the control of these abrasions.
Dt. İrem Sena Divanlıoğlu
