Tooth wear described as the progressive loss of a tooth’s surface due to actions other than those which cause tooth decay or dental trauma.
Teeth wear increases with age. It is the irreversible loss of tooth surface. The resulting structural loss can harm appearance, impair function and cause sensitivity.
Tooth wear is caused by
Attrition is the loss of tooth structure by mechanical forces from opposing teeth initially affects the enamel and if unnoticed may proceed to the underlying dentin.
- constant chewing tobacco.
- Polished facets on enamel surfaces.
- Flattening of incisal edges.
- Dentin is exposed
- Sensitivity of dentin
- Decreased clinical crown height.
Abrasion is the progressive loss of hard tooth substances caused by mechanical actions other than mastication or tooth to tooth contact.
- Incorrect tooth brushing techniques
- Seen in individuals who use their teeth as a tool (to hold pins, nails, to remove bottle caps)
Lesions are typically rounded or “v” shaped ditches seen on the bucal/labial surfaces in the region of cej
Most commonly affected teeth are canines and premolars.
Notching of the incisal edges on upper central incisor teeth is often seen as aresult of habit such as biting nails,thread,hairpins.
Progressive loss of tooth substance by chemical or acid dissolution, and no bacteria are involved.
- Too frequent consumption of carbonated drinks.
- excessive consumption of acidic fruit juices
- people who suffer from gastro esophageal disease.
- people who suffer from eating disorders.
- chewing tobacco and chewing gums
- drymouth ,which increases the risk of damage from acid attack.
- medcation such as vitamin c,aspirin,iron preparations.
- chlorinated swimmingpools
- Teeth appears yellow in color due to darker dentin showing through thin outer enamel.
- Teeth appearing smooth and glazed
- Front teeth edge becomes squarish,transparent,eventually becoming shorter.
- T6eeht becoming sensitive to hot,cold or sweet foods and drinks.
- Occlusal surfaces of back teeth showing smooth,concave surfaces
Abfraction is the microstructural loss of tooth substance in areas of stress concentration.
This occurs most commonly in the cervical region of teeth, where flexure may lead to a breaking away of the thin layer of enamel as well as microfracture of cementum and dentin.
Occlusal forces which cause the tooth to flex, cause small enamel flecks to break off, inducing the abrasive lesions.
Abfraction is associated with
- Anterior open bite
- Occlusal restorations that changes the cusp movements.
- Abnormal tongue movements.
Classical wedge shaped lesion with sharp rims at the cervicoenameljunction.
The extent of the lesion is dependent on the size,duration,direction,frequency and location of forces concerned.
Recurrently failing cervical restorations.
Combined mechanism of tooth wear:
Treatment of Tooth Wear:
Reconstruct the affected teeth by giving restorations, crowns.
Use desensitizing toothpastes.
Splint therapy to treat bruxism.
Prevention Methods for Tooth Wear:
- Avoid brushing shortly after acid exposure
- Use the remineralising toothpastes which increase surface hardness of teeth.
- Reduce the frequency of consumption of acidic fruits and juices.
- Use less abrasive toothpaste
- Avoid overzealous brushing
- Change the habits such as pencil biting, holding needles, nails with teeth
- Low pH mouth rinses should be avoided