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Preventing Tooth Erosion or Tooth Attrition

July 1, 2017

Filed under: Tooth Erosion,Tooth Reshaping/Bite Adjustment — Tags: — Dr Gillis @ 8:00 am

Is tooth erosion or attrition part of the normal aging process?  Yes and NO!

Severe wear into the softer dentin of both upper and lower teeth.

Severe tooth erosion into the softer dentin of both upper and lower teeth.

Tooth erosion is not from normal aging, tooth attrition is.  See below for definitions.

Is it natural for our teeth to wear down and become shorter as we age?  Yes, your teeth will wear from chewing food, but not very much!  Normal chewing  should only cause you to lose about 1 mm of tooth length over a lifetime of 100 years!  The type of food eaten will make a difference in the amount of wear as well.  Ages ago when people ground grains between stones to make their breads and other foods, some bits of stone would be in the resulting flour or meal and eating foods prepared with this would, over years of time, cause excessive wear of tooth structure.

Severe erosion into the softer dentin of the lower teeth. Note the 'cupped' shape of the top or chewing surface of the tooth.

Severe erosion into the softer dentin of the lower teeth. Note the ‘cupped’ shape of the top or chewing surface of the tooth.

The more severe wear we are talking about in this blog is preventable tooth wear from tooth erosion.  Think of the ways that people use their teeth as tools (trimming nails, breaking string, cracking nuts, holding tools) and you can imagine that this causes way more wear than any type of natural chewing.    Sometimes, even your occupation will make your teeth more likely to undergo heavy wear.  If you work in an area of heavy dust and grit this gritty film will often be present on your teeth and if this is combined with any type of clenching and grinding, the wear can be severe over a short time.

Why do some people’s teeth look old and worn while they are still young?  This is most likely due to tooth or dental erosion or attrition.

Tooth Erosion  results in the loss of tooth structure due to softening of the tooth surface from an acidic diet. the softened tooth wears away more easily during chewing and is especially prone to more severe wear if you clench or grind your teeth.   Tooth attrition  is a type of irreversible wear caused by the contact of the upper and lower teeth resulting in loss of tooth structure.  This type of wear starts in the areas where the teeth contact during normal chewing.  Tooth wear is a physiological process and is commonly seen as a normal part of aging.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Note that the upper teeth are almost see-thorough at the edge. Severe erosion into the inner layer of the teeth (the dentin) on both upper and lower teeth.

Our friends at Wikipedia note that, “Advanced and excessive wear and tooth surface loss can be defined as pathological in nature, requiring intervention by a dental practitioner. The pathological wear of the tooth surface can be caused by bruxism, which is clenching and grinding of the teeth. If the attrition is severe, the enamel can be completely worn away leaving underlying dentin exposed, resulting in an increased risk of dental caries and dentin hypersensitivity. It is best to identify pathological attrition at an early stage to prevent unnecessary loss of tooth structure as enamel does not regenerate.”

Our office would be happy to answer your questions about tooth erosion. We will let you know your options!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

 

 

Are Athletes More Prone to Oral Health Problems ?

October 31, 2016

Filed under: Customer Service,Dental Health,Occlusion or Bite — Tags: , — Dr Gillis @ 6:13 pm

Are athletes more likely to have oral health problems?

Playing sports may affect an athletes oral health.  Here are some reasons why.

An athletes oral health may be more prone to problems than the general population. I think most people would assume that the answer to the above questions is a resounding No. Actually, the answer is Yes!  Athletes in general, are concerned with their physical health.  For peak performance they need to maintain muscle fitness, eat properly, and they want to look and feel good.

A recent article in “Decisions in Dentistry,” “Managing Oral Health Challenges in Athletes”, October 2016 noted that “The training required of both professional and recreational athletes is physically demanding.  While sore muscles and overuse injuries are common among athletes, oral health can also be adversely affected.”  The most prevalent athletes oral health problems are the following:

  • Tooth clenching that results in excessive and irreversible wear of teeth
  • Tooth grinding or bruxism which also results in excessive wear
  • Tooth erosion which is the loss of tooth structure due to acidic attack as seen in people who drink excessive amounts of soda.
  • Xerostomia or mouth dryness

How are athletes oral health  more affected you might wonder?  One of the major muscles that closes the mouth is called the masseter muscle.  Studies have shown that when large muscles in the legs, arms and back are activated, the masseter is also activated.  We have all seem the ‘grimace face’ of weightlifters and sprinters.  The masseters are contracting and the teeth are touching forcibly which, over time, causes wear of the hardest structure in the body, the tooth enamel.

Severe tooth abrasion has created cupped lesions in the teeth.

Severe tooth abrasion has created cupped lesions in the teeth.

The the same article noted a study linking clenching your teeth with improved body stability.  This may affect participants in several sports.  Our office tries to let our patients know that your teeth could only contact if you are chewing or swallowing. Can athletes maintain the desired stability without clenching?  I would hope so for the sake of their teeth! Chronic bruxism or clenching can also lead to problems with the TMJ or jaw joint, the muscles of the jaw that make all the things we like to do with our teeth and our mouthed possible or the bone supporting the teeth may be affected.  Teeth could become loose or bone may be irreversibly lost.  Teeth, crowns and fillings could fracture.

Tooth erosion depends on the erosive agent and the amount of time that the teeth are exposed.  Competitive swimmers may expose their teeth to slightly acidic water for hours at a time.  Many endurance sports encourage mouth breathing which, of course, leads to a dry mouth (xerostomia) which can lead to increased decay and gum disease.  Plaque forms easier and is more sticky and damaging on dry teeth and tissue leading to problems with an athletes oral health.

What can be done for athletes oral health?

  • Mouth guards may protect the teeth from some of the effects of clenching and grinding.
  • Teeth that have been eroded can be aesthetically and conservatively restored (Ask Dr. Gillis! She would be happy to discuss options with you!)
  • Topical Fluoride treatments help form a protective barrier on the surface of teeth.
  • Over-the-counter fluoride rinses i.e., Listerine with Fluoride can help
  • Chewing gum during exercise especially sugar-free boosts protective saliva production – but use lozenges and gum during sports with caution to avoid choking!

Keep on exercising but take care of your teeth, your mouth and yourself!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

 

Tooth Erosion and Abrasion are Different -Why?

January 7, 2016

Filed under: Tooth Erosion — Tags: , — Dr Gillis @ 10:42 pm

What is Tooth Erosion or Abrasion?

This is erosion. Note the lack of tooth enamel - the white part - on the molar.

This is erosion. Note the lack of tooth enamel – the white part – on the molar.

Tooth erosion and abrasion are very different but both are very destructive!  Tooth erosion or acid erosion, also known as dental erosion, is a type of tooth wear. It is defined as the irreversible loss of tooth structure due to chemical dissolution by acids.  This is very different from tooth loss due to dental decay or trauma and is not of bacterial origin.  The acid comes from beverages or even from your stomach in the form of ‘heart burn’. (more…)

What is Tooth Erosion?

August 25, 2014

Filed under: Dental Health,Diet for Health,Tooth Erosion — Tags: — Dr Gillis @ 6:29 pm

What is tooth erosion?

In the photo to the right you can see the yellow dentin showing on a first molar with severe tooth erosion.   All of the white enamel has been eroded away exposing the underlying yellow dentin.  These particular molars (first molars) typically erupt when a patient is about six years old and they are meant to last a lifetime.  So, keeping them healthy is very important!  Do you have tooth erosion?  You may not even be aware of this but the effects are permanent and should be diagnosed as soon as possible to prevent this irreversible trauma!

Severe erosion of first molar.

Severe erosion of first molar.

A quick search of the internet (I elected to copy some of the information that I found) will tell us that Tooth erosion or enamel erosion can be caused by the following:

  • Excessive soft drink consumption (high levels of phosphoric and citric acids)
  • Fruit drinks (some acids in fruit drinks are more erosive than battery acid)
  • Dry mouth or low salivary flow (xerostomia)
  • Diet (high in sugar and starches)
  • Acid reflux disease (GERD)
    • Gastrointestinal problems
    • Medications (aspirinantihistamines)
    • Genetics (inherited conditions)
    • Environmental factors (friction, wear and tear, stress, and corrosion)

    What are some of the environmental causes of tooth surface erosion?

    Friction, wear and tear, stress, and corrosion (or any combination of these actions) can cause erosion of the tooth surface. More clinical terms used to describe these mechanisms include:

    • Attrition. This is natural tooth-to-tooth friction that happens when you clench or grind your teeth such as with bruxism, which often occurs involuntary during sleep.
    • Abrasion. This is physical wear and tear of the tooth surface that happens with brushing teeth too hard, improper flossing, biting on hard objects (such as fingernails, bottle caps, or pens), or chewing tobacco.
    • Abfraction. This occurs from stress fractures in the tooth such as cracks from flexing or bending of the tooth.
    • Corrosion. This occurs chemically when acidic content hits the tooth surface such as with certain medications like aspirin or vitamin C tablets, highly acidic foods, GERD, and frequent vomiting from bulimia or alcoholism.

     

The contralateral molar in this patient also shows severe erosion.

The contralateral molar in this patient also shows severe erosion.

Enamel is the thin outer covering of the tooth. This tough shell is the hardest tissue in the human body. Enamel covers the crown which is the part of the tooth that’s visible outside of the gums.  Because the loss of enamel during tooth erosion usually occurs over a long period of time, there is often very little sensitivity in teeth with erosion.  The tooth actually has the ability to lay down more tooth structure from the inside protecting the nerve inside the tooth from painful stimuli.

Looking at the photo to the left, you can also see staining or decay within the enamel of the molar behind the molar with tooth erosion.  Sometimes tooth erosion will look like small pits in the enamel before the near total destruction of the enamel on the chewing surface of the tooth as seen here.

Enamel is translucent meaning that it allows some of the underlying color of the tooth to show through as light passes through it. The underlying portion of the tooth, the dentin, is the part that’s responsible for your tooth color — whether white, off white, yellow, or grey.  So when enamel is lost with tooth erosion, the darker dentin color of the tooth becomes more evident.

See bilateral erosion of the lower first molars.

See bilateral erosion of the lower first molars.

If you are concerned about whether you have tooth erosion, or if treatment is needed here, our office can help! Call our Grand Junction, Colorado office at (970) 242-3635 and we will do our best to answer your questions about this or any dental health concern!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

1190 Bookcliff Ave. Suite 201, Grand Junction, CO 81501 USA
Julie M Gillis DDS Grand Junction, CO cosmetic, general, & restorative dentist. (970) 242-3635 (970) 242-8479 jgillis@juliegillisdds.com