Dentistry has had a lot of success stories in the past few decades. But, also a few failures.
One of the biggest areas of concern is the steady increase in the effects of acids. Acids can lead to the wearing away of tooth enamel and loss of gum attachment.
A truly complete discussion of acids and oral health is way beyond the scope of this blog article. I’ll include some references at the end of Part II if you wish to do more reading on the subject (but no, you won’t get extra credit nor have your grade adjusted).
There are several types of damage to teeth and gums that we often see:
Erosion - the non-bacterial dissolving away of tooth structure by chemical acids. The acids may come from the stomach or from your diet.
Abrasion - the wearing away of the hard tooth structure by items other than tooth-to-tooth contact. Most often this involves the improper type or use of a toothbrush. Overly abrasive toothpaste can also cause wear (see my previous blog article Just Toothpaste).
A more recent causal factor is the use of dental jewelry in the tongue or cheek. These hunks of metal continually rub on the teeth and gums and so wear down and chip the teeth and cause recession of the gums.
Abrasion coupled with erosion is especially damaging. In these cases, delaying tooth brushing for at least 30 minutes after consuming highly acidic foods and beverages or vomiting/purging can minimize wear.
Attrition - wear from tooth-to-tooth contact. Some attrition is inevitable over our lifetimes. But, several factors increase the rate of wear.
Biting and chewing forces vary considerably from person to person - from 100 pounds per square inch (psi) of biting force to over 400 psi. That is quite a range - you can tell the 400 psi people by their huge masseter muscles (which close the jaw), badly worn teeth, and frequent visits to the dentist to have broken dental work repaired.
Clenching and grinding, especially during sleep, are also factors in some patients. Stress and poor sleep quality or sleep habits can increase this. Irregular sleep times, caffeine or alcohol consumption, sleep apnea, obesity, and certain medications all can play a role in affecting sleep and increasing tooth wear. If we add extra acid to this mix, then the wear caused by clenching, chewing, and grinding are increased.
The net result of all of the above is loss of tooth structure on the chewing surfaces and also the sides of teeth. As the chewing surfaces wear, they become flatter and are less efficient at chewing. They also become more sensitive, and cause the bite to change and slowly collapse as the years go by.
Wear on the sides of the teeth, especially at the gum-line areas, can lead to receding gums and loss of tooth support. This also increases sensitivity and the risk of tooth decay. Both types of tooth loss also negatively affect the appearance of the smile, and create shorter, misshapen, and darker teeth.
In my next When Acid Attacks - Part II, I will discuss where this acid comes from and what can be done to reduce it - stay tuned!
Happy Holidays from all of us at Greene & Miller Dentistry!