With proper care, your teeth can last a lifetime. Only very slight tooth wear as we age is normal – anything more is considered dental disease, same as cavities or gum disease. By “wear,” we mean loss of tooth structure. Wear starts with loss of the hard, translucent enamel, which is actually the human body’s hardest substance. Enamel is highly resistant to wear and chemical attack, as it would have to be given what your teeth do every day: bite, chew, and come in contact with acidic foods and drinks.
Still, it is possible for tooth enamel to wear down for various reasons. Your body has ways of compensating for minor wear. But when tooth wear becomes more significant, intervention will be necessary to keep your bite functioning properly and protect your teeth.
Types of Tooth Wear
Tooth wear can result from one or more of these processes:
Abrasion: This is caused by the interaction of teeth and other materials rubbing or scraping against them. The most common source of abrasion is traumatic tooth brushing, meaning that you are using a toothbrush that’s too hard or applying too much force when you brush. This can affect the root surfaces of your teeth just below the gum line or the enamel above the gum line. Other causes of abrasion can include improper use of toothpicks and dental floss. Some dental appliances such as partial dentures or retainers that are frequently taken in and out of the mouth can also abrade teeth. Abrasion can also result from a diet loaded with abrasive foods like sun flower seeds and nuts or habits such as nail-biting and pen-chewing.
Attrition: People with instability in their jaw joints (clicking, pain, limitation of movement) or instability in their bite (tooth grinding/clenching, bite discrepancies, tooth misalignment) will exhibit excessive wear on their teeth from daily chewing and swallowing. Biting and chewing normally generate forces between 13 – 23 pounds. Yet people who have clenching and grinding habits (of which they might not even be aware) can subject their teeth to forces up to 10 times that. This can damage teeth.
Erosion: When your teeth come in contact with acidic substances in your diet, the acid can actually erode (dissolve) the enamel on your teeth. Culprits of this kind of tooth wear often include sodas, sports drinks and so-called energy drinks. Certain fruit juices are also acidic. Confining these drinks to mealtimes and swishing water in your mouth after drinking them can help prevent this erosion.
Abfraction: This refers specifically to the loss of tooth enamel at the necks of the teeth (the thinner part right at the gum line). This is also caused by instability in the jaw joints and bite, where during chewing the teeth flex – as they do, notches develop along the necks of the teeth, often with gum recession. Eventually these areas can become sensitive and weaken the tooth.
By John M. Korolewski, D.D.S.