What is tooth wear?

Tooth wear also called 'Occlusal Disease' is one of the most prevalent dental problems of the modern age. This is defined as the loss of dental hard tissue(mainly enamel) caused by factors other than tooth decay or trauma.
As we age the amount of wear increases on our teeth and thus reflecting our true biological age. The problem becomes rapidly bigger if this wear increases due to factors other than the ageing process resulting in the person looking old before their time!
Many people today suffer from some form of tooth wear and only become aware of it when it becomes a cosmetic problem(front teeth) or create some form of tooth sensitivity. The most common factors in causing this type of wear are mainly teeth grinding/clenching and diet.

How much Tooth Wear is normal?
When your dentist tells you that you are showing signs of excessive tooth wear most people think of teeth grinding or clenching. The truth is that every time your teeth occlude against the opposing teeth wear takes place.

Tooth wear from normal function should not be more than 0,021mm per year. This means +- 1mm of tooth loss over a 60 year period or 1,5mm at age 75 years. Today we are seeing an alarming amount of young patients in their 20's with enamel loss ranging from 1,5mm - 3mm. This is very serious as it really means that our teenagers or young adults have teeth that are ageing at an accelerated rate!

Causes of Tooth Wear
Tooth wear mainly happens due to the following reasons:

1) Tooth attrision
This is the typical wear on teeth due to excessive grinding or clenching  usually at night times. The enamel wears away or chipping appears due to the excessive touching of teeth other than during normal eating or swallowing. A poor bite(the way the teeth fit together) will lead to an increase in attrision wear and correcting the bite is thus essential.

2) Tooth erosion
Erosion is the removal of tooth structure due to eroding of enamel from a low pH. Dietary causes include drinking soft drinks(Cola), orange juice, coffee and acidic energy drinks on a regular basis. Erosion can also happen due to stomach acid from conditions like bulemia.
     
3) Tooth abfraction
This is the typical chipping lesions that often appears in the neck areas of teeth(canine and back teeth) due to lateral bending forces from grinding or clenching.

4) Tooth Abrasion
These are chipped or worned areas in the necks of teeth due to excessive brushing with the wrong technique. Years of incorrect brushing can cause abnormal wear in the necks of teeth where only a thin layer of enamel is present.

5) Combination
Most cases are really a combination of the above causes and thus make the prevention much more difficult and complex.

Location of Tooth Wear
The loss of tooth structure mainly occurs either on the front teeth only, back teeth only or the whole mouth. It is important to evaluate the areas in order to make a proper diagnosis on the causes and treatment of tooth wear.