What happens to the tooth and what kind of abrasion happens?
Enamel is the hardest tissue in the body, but it cannot be restored. When the enamel layer becomes thinner, dentin is exposed, which wears off several times faster. Therefore, the process is accelerating. Dentists distinguish physiological loss, which slowly accumulates over decades and does not bother anyone, and pathological - when over several years the teeth shorten and change shape. According to the direction of loss, horizontal, vertical and mixed forms are distinguished, and according to prevalence - local, when a group of teeth suffers, and generalized.
- Physiological - uniform, with age
- Pathological - rapid, with a change in the shape of the teeth
- Local - a group of teeth in the overload zone
- Generalized - the entire dentition
- Abfraction - wedge-shaped defects at the neck due to load
- Erosion - acid dissolution of enamel
Causes and risk factors
The main mechanism is excessive mechanical load. It occurs during bruxism, when, during sleep or stress, a person clenches and moves his jaws with a force many times greater than normal chewing. The second mechanism is chemical: the acid softens the enamel, and it wears off even with normal chewing. The third is improper distribution of the load due to malocclusions, oversized fillings and crowns, or missing chewing teeth. In people with dry mouth, the protective effect of saliva is weakened, and the enamel is damaged more quickly.
- Bruxism and constant jaw clenching
- Gastroesophageal reflux, frequent vomiting
- Sour juices, carbonated drinks, citrus fruits, vinegar
- Malocclusions and missing lateral teeth
- Too hard brush and abrasive pastes
- Dry mouth, taking certain medications
- Working in acidic spray conditions
Symptoms
At an early stage, a person notices only increased sensitivity: a short sharp pain from cold water, sour or sweet. Later it becomes clear that the cutting edges of the front teeth have become transparent and uneven, and shiny areas and craters have appeared on the chewing teeth. With severe abrasion, the appearance changes: the face visually shortens, the folds around the lips deepen, and jams appear in the corners of the mouth. Many people come to us for the first time when a piece of a tooth breaks off or an old filling begins to break down.
- Sensitivity to cold and sour
- Transparent and uneven cutting edges
- Areas and pits on the chewing surface
- Chips of enamel, loss of fillings
- The teeth became shorter, the oval of the face changed
- Pain and fatigue of the masticatory muscles in the morning
Diagnostics
The dentist examines the dentition, evaluates the shape and height of the crowns, the condition of fillings and restorations, and checks how the teeth fit together. Be sure to look for the cause: they ask about heartburn, teeth grinding at night, diet and occupational hazards. Photo protocols and diagnostic models of the jaws are useful - they allow you to measure tissue loss and plan restoration. Sight shots show how close the loss has come to the pulp. If reflux is suspected, the patient is referred to a gastroenterologist; if bruxism is severe, the patient is referred to a neurologist.
- Examination and assessment of teeth closure
- Photo protocol and diagnostic models
- Spot X-rays
- Lower face height assessment
- Examination of the temporomandibular joints
- Consultations with a gastroenterologist and neurologist according to indications
Treatment and prevention
The treatment takes place in two stages: first the cause is removed, then the shape of the teeth is restored. For bruxism, a protective sleep guard is made, for reflux, the stomach is treated, and for malocclusion, an orthodontist is involved. For restoration, composite restorations, ceramic onlays, veneers and crowns are used, and if the bite is significantly reduced, treatment is planned comprehensively, with gradual restructuring. There is no point in putting fillings without eliminating the cause - they chip. Prevention is simple: a soft brush, a toothpaste without high abrasiveness, limiting acidic drinks and timely restoration of extracted teeth.
- Night guard for bruxism
- Treatment of reflux and nutritional correction
- Orthodontic bite correction
- Restorations, onlays, veneers and crowns
- Restoration of missing chewing teeth
- Fluoridation and products for sensitive teeth
- Check-up with a dentist twice a year