The Truth About Tooth Wear

Do you know what the one of the most common dental problems is in the United Kingdom? It's not cavities or gum disease. It's tooth wear! Tooth wear can be caused by a number of factors including acid erosion, bruxism (teeth grinding at night ), and poor oral hygiene. In this blog post, we will discuss the causes, treatment, cost, and prevention of tooth wear. We will also answer some common questions about this condition. If you have tooth wear, you must simply read this article.

There are a number of factors that can contribute to tooth wear, including:

This is one of the most common causes of tooth wear. Acid erosion occurs when acidic substances come into contact with your teeth. The greater the contact time and frequency, the greater the level of acidic wear. These acids can come from food and drinks (such as citrus fruits, vinegar, and fizzy drinks), stomach acid (from gastric reflux or other digestive disorders) and even some medications. Did you know that a hot lemon drink can have the same acidity level as that of battery acid!

Bruxism is another common cause of tooth wear. This condition occurs when you grind or clench your teeth. This can happen during the day or at night (while you're sleeping). Studies have shown that if you grind at night, teeth make almost 300 times more contact that they would normally do during the day. No wonder the enamel eventually wears down.

Poor oral hygiene is another factor that can contribute to tooth wear. If you overbrush and/ or do not maintain good levels of oral health, this can lead to enamel erosion and attrition leading to tooth wear and other dental problems. We generally do not advise using a hard bristle tooth brush ; although this may feel like it is cleaning well, they are often too hard leading to wear at the gum level called cervical wear.

The most common symptom of tooth wear is a change in the shape of your teeth. You may notice that your teeth are shorter than they used to be, or that they have become more pointy. The enamel often becomes more translucent and chips at the edges. Teeth become uneven in height creating aesthetic issues.

Other symptoms include:

1. Sensitivity to hot and cold temperatures - this is due to the exposure of the underlying dentine which contains many ' nerve endings'.

2. Pain when chewing or biting - this is often due to cracks within the teeth from bruxism and weakening of the underlying tooth structure.

3. Worsening of existing dental problems (such as cavities or gum disease).

The treatment for tooth wear will depend on the underlying cause. If the cause is acid erosion, we will recommend that you avoid acidic foods and drinks. We can arrange a special diet analysis and provide healthier alternatives. We may also suggest that you use a special toothpaste or mouthwash which can act to counter an acidic oral environment.

If the cause is bruxism, the minimum recommendation is that you wear a mouthguard at night. This is sometimes called an occlusal splint or bite guard. These guards can be hard or soft.

These are ways of preventing further tooth wear but often we want to restore the tooth wear for aesthetic and functional reasons. In the past this may have involved very extensive reconstruction work using multiple dental crowns and veneers. However, we much prefer minimally invasive method of treatment and one of those is called the Dahl technique.

The Dahl technique was originally suggested by a dentist called Dahl in 1975 to treat severe localised tooth wear at the front. Originally, the technique involved using a removable chrome cobalt appliance with an anterior (front of mouth) bite plan that caused the back teeth to remain open (disclude). Rather than using this space to restore the back teeth, the teeth were allowed to re-establish contact over a period of 4-6 months. Dahl suggested that this was due to both intrusion of the front teeth and extrusion of the back teeth.

Over time, this technique has been adapted so that we can now directly bond the front teeth using modern composite materials without having to cut any healthy tooth away. Using the Dahl principles, the back teeth will be open usually by 2-3mm as the front teeth have been restored back to their original size. This is where the magic happens and we simply wait. Over nearly 20 years of experience of this technique, we have never seen failure of the back teeth to make contact once again. So no drilling, no need for needles, no pain and far more affordable than crowns and porcelain veneers!

Typically, a soft night guard will be £225 and a hard one £450. Fully adjusted occlusal splints for those with severe grinding problems and jaw/ muscle pain are approximately £2000.

Treatment for the Dahl technique is typically around £2000-£2500 for both upper and lower front teeth using a direct composite bonding procedure. If a diagnostic wax up is needed, the additional laboratory fees are in the region of £500.

If you suffer from tooth wear and would like to prevent it in the future or restore the worn down teeth, please contact us. We can arrange a free video consultation first and Dr Nissit Patel will discuss the entire treatment in great detail. With nearly twenty years experience using the Dahl technique, he can show you many successfully treated cases. Don't wait, teeth do not grow back themselves!