Erosion

A second major cause of tooth wear is acid erosion. Erosion of the tooth structures by acid occurs when the acid demineralizes the enamel and dentin and then the demineralized and weakened tooth surfaces are rubbed away by the toothbrush, the tongue, the cheek, the opposing teeth, and food.

Erosion of tooth structure is preventable and the dental team can advise patients on how to slow down and stop the erosion process. (For more dental info, visit my website at www.lajolldental.com)

The two sources of acid that causes erosion of the teeth are ingested acids in food and drinks and internal digestive acids that are regurgitated into the mouth. The position on the teeth of the erosion will tell us if it is ingested acid or internal acid. Ingested acid, coming into the mouth from the front, will erode away the fronts of the teeth and the biting surfaces of the teeth. Internal acids by comparison, enter the mouth from the esophagus and cause erosion on the back side of the front teeth and the biting surfaces of the teeth.

Bruxism

One of the three major causes of tooth wear is attrition. Attrition is caused by tooth to tooth contact. The back teeth become flatter while the front teeth become shorter. In a healthy well-balanced bite the rate of attrition is minimal throughout life. When that rate is dramatically increased, wear will appear on some or all of the teeth. (See my website at www.lajolladental.com)
One of the conditions that accelerate the attrition or wear is bruxism. Bruxism is an involuntary clenching-grinding of the teeth. It is believed to be caused by stress, anxiety, and an imbalance in the biting position of the upper and lower jaws – malocclusion. Bruxism can occur subconsciously during the day or while sleeping.
Moderate to severe attrition of the front teeth can leave a patient with short and unpleasant looking teeth and an aged smile. It is possible to have attrition accompanied by acid erosion and/or abrasion.

Tooth Wear – Attrition, Erosion, and Abrasion

We are saving more teeth these days through gum treatments, root canals, and better patient awareness. As such, with more teeth in patient’s mouths than we saw 20 years ago, we are finding more wear on the teeth. The wear is not simply a sign of age, it is an indication of other conditions.
Wear has three causes, and it is important for the dental team to identify which of the three causes has affected your teeth, because the treatments will differ. (See my website for more dental information)
The three causes are:
1. Attrition – which is true tooth-to-tooth grinding.
2. Erosion – which causes tooth wear by demineralizing the tooth structure with acid and demineralized tooth areas getting rubbed away.
3. Abrasion – which is when a person aggressively brushes his or her teeth over a period of time and that abrades portions of the teeth. Another abrasion cause is when older over-contoured porcelain crowns abrade the opposing teeth, wearing them away.