The average life expectancy in British Columbia has increased to over 78 years. With the advances of modern dentistry it is now quite possible to keep your teeth for your lifetime. It is important, therefore, at my patient’s exams to look for signs of early wear and/or erosion. Once identified we can then plan to eliminate or reduce whatever is causing it and help maintain the teeth. In this article I’ll discuss several of these processes which can cause wear and erosion.
Bruxing: We all brux (grind our teeth) in our sleep to varying degrees. Sometimes we go through periods of intense grinding and clenching and then periods of much less depending on the level of stress present in our lives. Children are not immune to this. Many kids grind their teeth in their sleep too. The usual sign of this bruxing is wear of the front teeth which gives the edges a ragged appearance. During the day a protective reflex stops us from clenching very hard; if you’ve ever encountered a small stone as you’re chewing you’ve noticed this protective reflex. In our sleep this reflex ceases. In sleep we can clench with much more muscle force than when we’re conscious. This can cause wear of the teeth but can also cause soreness of the facial, head and neck muscles and damage to the Temporo-Mandibular Joint (TMJ). Headaches can also be a sign of bruxing and can often be treated by reducing this nighttime activity. There are new dental appliances that have had great success even with migraine headaches. These appliances function to reduce bruxing activity and to protect the teeth.
Notching of the teeth: Notching occurs on the outer (cheek side) of the teeth at the gumline. While we used to think that bruxism caused these notches, new research has shown that it’s our own brushing habits that cause them. In studies where extracted teeth were brushed by a machine it was shown that the hardness of the brush was not important. When toothpaste was added to brushing, however, this notching started to occur from the abrasiveness of the toothpaste. It is important, therefore, to follow your dental hygienist’s recommendations about brushing technique and the type of toothpaste that you use.
Erosion: Acid erosion of the teeth can appear in many forms. People with eating disorders, especially bulimics who vomit frequently, can experience severe erosion of the inside front teeth. Many foods and beverages are acidic as well. One young patient of mine in his early 20’s had severe erosion of a number of teeth. Through discussion we finally realized it was from the three to four soft drinks he was consuming per day and the way he was drinking them. He always swished the liquid around in his mouth before swallowing. This was causing the erosion.
Soft drinks, fruit juices, many fruits, wine and some foods are acidic. Some recommendations are:
-decrease the amount and frequency of acidic foods or drinks and never swish these around in your mouth.
-drink acidic drinks quickly rather than sipping. Using a straw may help.
-eating disorder patients should seek out a trained therapist/psychologist as well as visit a dentist to learn how to protect their teeth.
-although contentious, topical fluoride rinses can help counteract the acid.
-cheese can actually help neutralize acid in the mouth (wine and cheese anyone?)
-do not brush immediately after an acid challenge as the surface of the teeth are softer then and can be easily abraded. Rinse with water or chew an antacid tablet. Brush 30 minutes later.
Of course the best prevention of tooth wear or erosion is to visit your dentist every 6 months. Dentists are trained to recognize the signs on your teeth and will set up a personalized plan to treat the problem so your smile will last a lifetime.