An in-depth look at tooth wear

Tooth wear is a common dental condition encompassing various processes that lead to the wearing down of tooth enamel and underlying dentin, resulting in changes to the tooth's shape, size, and overall integrity.

Here, Dr Sahil Patel, leading cosmetic dentist, provides an expert insight into the different causes, types, and treatment options for tooth wear.

What is tooth wear?

Tooth wear refers to the accelerated loss of tooth structure.

What are the different types of tooth wear?

The four main types of tooth wear are:

• attrition – tooth-tooth contact
• abrasion – external damage
• abfraction – overloading
• erosion – internal or external acid damage

It is worth appreciating that the four types can be symptomatic of an underlying bite disease or a developed pattern of use caused by the temporomandibular system.

What are the causes of tooth wear?

• Occlusal (bite) disease

Occlusal (bite) disease is common. This can be deflective contacts in MIP (maximum intercuspation position) causing avoidance patterns that accelerate tooth wear. Occasionally, these can manifest as destructive patterns creating attrition or abfraction type appearances.

• Occlusal disease

Occlusal disease can be caused by tooth positions, genetics, neurologic patterns, dental procedures, and stress.

• Abrasion

Abrasion is typically caused by overzealous oral hygiene and piercings. Erosion can be from excessive intake of acidic drinks and/or acid reflux disease or bulimia.

What are the symptoms of tooth wear?

Common symptoms of tooth wear include:

• short teeth
• sharp square edges
• yellow or dark teeth
• chipping
• loss of function
• gaps

How is tooth wear diagnosed?

A dental examination by a cosmetic or restorative dentist would indicate if you have accelerated tooth wear. In addition, mounting of models of your teeth on a semi-adjustable articulator can also assist in diagnosing occlusal disease.

What are the treatments available for tooth wear?

The main treatments for tooth wear are:

• ceramics
• composite resin
• dental implants
• orthodontics

These options are often used in combination with each other to manage patient cases in a bespoke manner. Due to the varying presentations of tooth wear in the general population, there are no generic methods to manage it.

Ceramics is the most reliable and longest-lasting material to replace lost tooth structure. It is used to build the height of the teeth back to its anatomical form, which is performed by calculating how much tooth structure is lost and then trailing that onto the teeth themselves, before custom-making the final ceramics.

To schedule an appointment with Dr Sahil Patel, head on over to his Top Doctors profile today.