Tooth Wear: Abrasion, Attrition, Abfraction and Erosion
It is not uncommon for me to see excessive tooth wear on patients. It can happen with all ages but is more common in older patients. Tooth wear can be a serious dental problem but the good news is that for the most part it is preventable.
The most common cause of tooth wear is abrasion. This is typically caused by using too much force while brushing your teeth. It can be complicated by using abrasive toothpaste especially those that promote teeth whitening. These toothpastes work by an abrasive action to remove extrinsic stains. While they can help to remove tea and coffee stains, they can also remove your tooth enamel. So someone that has a history of abrasion should not use whitening toothpaste, and consider brushing with a fluoride or xylitol mouth rinse INSTEAD of toothpaste.
The next most common cause of tooth wear is attrition. Attrition is caused by grinding and clenching your teeth. Patients who grind their teeth at night typically cause the most damage. The affects of nightly grinding or bruxism can be greatly reduced by wearing a night guard while you sleep. A night guard is a generic term for an appliance placed on your upper or lower teeth to prevent tooth wear.
Chemical erosion is also common, especially in those patients that have a low ph in their saliva. Soft drinks probably being the most common factor but many other contributing factors can cause a low ph and erosion as well. Such as: sucking on lemons or too much lemon in their water, acid reflux, bulimia and sugar to name a few. After one drinks a soda pop for example it is a good idea to rinse out their mouth with water to raise the ph. Even better is to rinse out with a xylitol rinse or chew a piece of xylitol gum which increases the salivary ph.
Lastly there is the process of enamel wear called abfraction. This is caused by the flexing of the tooth during grinding. The thinnest area of enamel is at the root surface so this enamel progressively fractures off.
Often times tooth wear is cause by a combination of these factors. It is important for your dentist to educate you early as to the causes so that preventative measures can be taken. Sometimes restorative treatment is necessary but usually some lifestyle changes can make all the difference.