Many people are unaware that our bodies (and all the living tissues that make up our bodies) are in a constant state of break downing and rejuvenating. The process of growth actually occurs when rejuvenation exceeds breakdown. So, from adolescence to adulthood or the point where we reach our maximum maturity, our muscles, tissues and bones are all growing at a rate faster than they are being broken down and this causes us to grow. When we reach our maximum maturity, the ledger balances out and we begin to age, which is a process where breakdown exceeds the rejuvenation.
Teeth are an unusual anomaly, in that they are a combination of living and non-living material. The enamel, which is the first layer of our teeth is actually a non-living material and it is the hardest substance in the animal kingdom. The layer behind the enamel, the dentine, is a living material as it lives off the pulp, which is contained in the root canal. That means that teeth don’t wear down in exactly the same way as other parts of our body, because they are protected by a non-living material that isn’t subject to the normal process of break down and rejuvenation. This can be a good thing, but it also has its negatives—once you have worn away your tooth enamel it can never grow back.
What is Tooth Wear?
Tooth wear is often defined as the loss of tooth substance, due to two major reasons:
- Erosion: this is caused by some form of acid attack. What happens is that the acid softens the outer tooth structure, making it more suspect able to further dissolution. This acid can be from an extrinsic source (so outside the body). Things like coca cola, red bull and those sorts of drinks all contribute to acid attack. Or it can be intrinsic, from causes inside the body. This is usually due to gastric reflux, also known as Gerd, during which you experience a regurgitation of stomach acids. If you suffer from Gerd, then it’s a good idea to consult your GP first, who can prescribe medication to keep this issue under control.
- Teeth grinding: research has shown about 20% of the population grind their teeth. This can be during the day or at night. Those that experience this at night often have what is called Bruxism.
It has been estimated that during normal wear and tear we will loose about 1mm of tooth substance every 100 years.
Progression of Tooth Wear
The outer layer of the tooth, the white layer, is one of the hardest substances in the body and provides a protective layer around the other parts of the tooth. The next layer, is called dentine, followed by what is called pulp tissue (which includes nerves and blood tissue).
With tooth wear, the enamel wears down and exposes the softer layer of dentine. Once the dentine is exposed, tooth wear can progress rapidly to expose the nerve layer. If this occurs, you may end up with bacteria entering your tooth, and even travelling as far your nerves and bone in your jaw. If this occurs, it can cause abscesses, pain and swelling.
Symptoms of Tooth Wear
There are a number of different symptoms that you may experience, should you suffer from tooth wear, including:
- Your teeth can start to get shorter, which can effect your smile
- You can develop sensitivities to both hot and cold food and drinks
- Your bite can start to change, which can cause pain or stress on joints and bones, particularly the TMJ bone. With this, you can end up with headaches and pains, particularly when waking up in the morning
- Eating can become difficult because teeth can start to move as they become loose
- Spaces can open up between the teeth, with food becoming stuck and then pushing into the gums, with the gums then becoming sore
- If bacteria gets into the nerve of the tooth, then pain and swelling can occur. This will normally require extraction or root canal treatment
Treating Worn Down Teeth
The first step in the treatment of any dental issue is always diagnosis — that’s where Dr Olstein will begin when it comes to treating worn down teeth.
Depending on the severity of the issue, your treatment can be relatively simple to begin with. We may start with the use of a customised splint, which can help to relieve the pressure on your teeth and gums at night if you are grinding at night.
If your dentine is already exposed, then treatment will be a bit more involved. It may require some smile restoration including procedures such as a porcelain veneer or a crown. This will restore your smile. If we restore your bite, and engineer it properly, then you’ll end up with a more stable chewing position.
Some people can be nervous about what a new smile might look like, which we completely understand. That’s why Dr Olstein provides a complimentary digital smile design service to begin with. This involves taking some photos of your smile, and sending them to a laboratory, which then provides a digital design of how your smile will look once its finished. If you like it, we form a plan.