Tooth wear is a dental condition where the surface and structure of teeth are progressively reduced as a result of internal and/or external forces placed upon them.

When hard tooth material is worn away as a result of teeth grinding and/or clenching, it is called attrition. The extent of wear damage depends on the amount of grinding, and is typically more severe in individuals who exhibit this behavior in their sleep. The reduction of hard tooth material due to chemical forces is called erosion. It can be caused by drinking acidic beverages like soda, or by medical conditions like acid reflux or bulimia. Over time, this acid dissolves the outer enamel of the teeth and can expose the softer underlying dentin layer.

Wear caused an outside object is called abrasion. Abrasion can be caused by improper tooth brushing technique, excessive use of toothpicks, and the use of the teeth as a tool. Abrasion can also result in grooves and notches in the enamel that can also expose the dentin. Excessive tooth wear causes many oral health complications, including unattractive and irregular tooth levels, jagged and sharp tooth edges, tooth pain and eventual loss of the teeth all together. As the harder outer surface of the tooth is worn away, the softer dentin will be exposed speeding up the process.

There are preventative and corrective treatment options for patients experiencing tooth wear issues. Treatment will vary based on the cause of wear and when it is detected, making it critical to work closely with your Doctor to proactively treat the issue before more damage is sustained.

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For clients experiencing tooth wear due to nighttime grinding and jaw clenching, your dentist may recommend an occlusal appliance- commonly called a nightguard or bite splint- to help alleviate the complications associated with the condition. It is not uncommon for tooth wear to be associated with certain airway or breathing conditions, so your doctor may discuss this with you as well.

An occlusal appliance is a device that is worn in the mouth overnight and creates a barrier between your upper and lower teeth, eliminating the damage they cause by rubbing against each other. It also promotes improved jaw and bite alignment which can help address uneven tooth wear. Research has shown that a well-designed hard appliance will help to relax the musculature- reducing wear even when it is not being worn.

There are several designs and styles of appliances available to assist with treatment. Your doctor will expertly design your individualized appliance to ensure optimal bite alignment and maximum protection from additional tooth wear. Given the potential for costly dental treatments caused by untreated tooth wear, it is critical to work closely with your Doctor to proactively treat the issue before more damage is sustained.

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Non-carious Cervical Lesions describes a condition where tooth structure is lost below the gumline due to forces other than decay. Symptoms of Non-carious cervical lesions are often visual, with notches appearing on the teeth where the crown and root of the tooth meet. They can sometimes be accompanied by gum recession in the area as well. Depending on the depth of the lesions, sensitivity and/or pain may also be present.

Current research indicates two primary causes of these lesions- the first is abrasion, where the tooth material is reduced due to overly aggressive or improper tooth brushing technique. The other possible cause is abfraction – which creates the notches by placing stress on the teeth through grinding and clenching. Your dentist will be able to determine the likely cause after a comprehensive examination. Given that tooth structure is much softer below the gumline, once these lesions begin to form they very quickly penetrate the outer layer of tooth structure and expose the softer dentin layer beneath. Once the dentin is exposed the pace of the wear will accelerate dramatically. If allowed to progress, non carious cervical lesions can deepen and further expose the teeth to damage, making them weaker, more sensitive, and potentially prone to decay and fracture.

There are preventative and corrective treatment options for patients showing evidence of non-carious cervical lesions. Treatment will vary based on the underlying cause and the extent of tooth damage, making it critical to work closely with your doctor to proactively address the issue before more damage occurs.

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Dental erosion is a condition where tooth structure is lost due to corrosion, chemical reactions dissolving the hard protective coating of the teeth, known as enamel. Common signs and symptoms of dental erosion include tooth sensitivity, tooth discoloration, tooth breakdown, thinning and transparency of the edges of the front teeth, and pitting and cupping on the chewing surfaces of back teeth.

The most common cause of dental erosion is the overabundance of acid inside of the mouth. It can be introduced externally by drinking acidic beverages such as soda and fruit juice, and can be introduced internally by medical conditions that introduce stomach acids into the mouth such as acid reflux or bulimia. Over time, this acid dissolves enamel and exposes the softer inner layer called dentin, making the teeth weaker, more sensitive, and potentially prone to decay. In addition, once the softer dentin is exposed the pace of the wear can accelerate dramatically. This weakened structure can also increase the likelihood of severe cracks or fractures in your teeth.

Excessive tooth erosion causes many oral health complications, including discoloration, unattractive and irregular tooth levels, uncoordinated chewing movements, jagged and sharp tooth edges, tooth pain, and eventual loss of the teeth altogether. There are preventative and corrective treatment options for patients showing signs of erosion. Treatment will vary based on the underlying cause, the severity of the erosion, and the extent of tooth damage, making it critical to work closely with your Doctor to proactively treat the issue before more damage occurs.

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Bruxism is a condition where a patient grinds, gnashes, and/or clenches their teeth. It is typically an unconscious behavior, and can occur both while awake and sleeping. Common symptoms of bruxism include worn tooth structure and flattening of the teeth, increased tooth sensitivity, jaw soreness, tenderness of the facial muscles, and dull headaches. The grinding may be loud enough that it can be heard by others, especially if it occurs when you are asleep. Bruxism is commonly associated with airway disturbances, like sleep apnea, and gastric reflux.

The constant force of opposing teeth rubbing and grinding against each other causes the hard enamel outer layer of the teeth to wear away, exposing the softer inner dentin layer, making the teeth weaker, more sensitive, and could even become prone to decay. In addition, once the softer dentin is exposed the pace of the wear will accelerate dramatically. Bruxism can also potentially lead to cracks or fractures in your teeth.

Excessive tooth wear causes many oral health complications, including unattractive and irregular tooth levels, uncoordinated chewing movements, jagged and sharp tooth edges, tooth pain, and eventual loss of the teeth altogether. There are preventative and corrective treatment options for patients showing signs of bruxism. Treatment will vary based on the underlying cause, the severity of behavior, and the extent of tooth damage, making it critical to work closely with your dentist to proactively treat the issue before more damage occurs.

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To help minimize tooth wear due to grinding, reduce muscle pain and tension, and diagnose muscle and joint pain issues, a removable appliance called an Anterior Bite Plane may be recommended.

An anterior bite plane is a small appliance fabricated by your doctor that is placed on your upper front teeth creating a platform on which your lower teeth can sit and glide. It is typically worn while sleeping but can be worn during the day, typically not to exceed 8 hours. While creating a platform for the front teeth to touch, the appliance prevents back teeth from touching, protecting them from wear and minimizing stress on the jaw muscle. In addition, an expertly constructed appliance will help put the jaw joint into its most natural resting state, allowing you and your doctor to evaluate the extent of the disparity between that position and your current bite.

In the right circumstances, an Anterior Bite plane is an excellent choice to help decrease clenching and grinding, and virtually eliminate the tooth destruction caused by it. It can promote the longevity of your natural teeth and reduce the need for extensive restorative dentistry in the future.

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Even after a tooth has been restored, sometimes decay can reappear and compromise the structure of the tooth all over again.
Over time, bacteria works its way into the areas of the tooth surrounding and supporting the filling, and the tooth begins to deteriorate as a result.

As the decay worsens, the tooth continues to weaken, which can result in cracking, pain and potentially tooth breakage or loss.
If caught early enough, the decay can typically be removed and the tooth re-filled or crowned. However, if left untreated, more serious procedures might be needed such as a root canal, bridge or dental implant.

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