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What is tooth wear?
Tooth wear is the non-carious loss of tooth structure,1 which typically falls into three main categories: abrasion, attrition and erosion. While tooth abrasion and attrition are caused by mechanical reasons (bruxism, brushing, clenching and general age-related wear from mastication), tooth erosion is a non-bacterial chemical process which begins when the tooth structure coms in contact with the acids in foods and beverages. 1-4
Why is tooth wear a growing concern?
With advances in dentistry and healthcare, teeth are lasting longer now, than ever before. And today's modern lifestyle means that more patients are consuming the acidic fruits, juices and sodas related to one type of tooth wear, tooth erosion. In order to help teeth remain healthy for the long-term, early detection of tooth wear is important. 5
What types of patients are at risk for tooth wear?
Patients who consume diets that are high in acid from sources like fruit, sodas (including diet sodas), orange juice and wine may be at risk for tooth wear. These foods and drinks demineralize and soften the tooth surface, making it more susceptible to physical damage. 5 Other patients that commonly exhibit tooth wear include those suffering from acid reflux, or bulimia.1,3
Can brushing cause tooth wear?
Yes, as the enamel layer of a tooth demineralizes and becomes softened it becomes more susceptible to abrasion. That tooth can become visibly less white and older-looking.5
Are there visible signs of tooth wear for which I can screen?
Yes. Teeth with tooth wear may become visibly less white and older-looking. This can happen when the enamel layer of a tooth demineralizes, becomes softened and may be more susceptible to abrasion.5
What are the signs and symptoms of tooth wear?While teeth may look older and not appear as white, patients may also experience dentin hypersensitivity as the enamel begins to wear away.5,6
Should I screen patients for tooth wear?
Yes. You may wish to ask the patient whether they swish carbonated drinks around their mouth or retain food or drinks in their mouth for extended periods. You may also wish to inquire after tooth-brushing habits, symptoms of dentin hypersensitivity, and possible gastric conditions involving heartburn.5
Should I screen patients with tooth wear for dentin hypersensitivity?
It is recommended that dental professionals ask all patients about dentin hypersensitivity at each appointment, and open the discussion about possible triggers. Dentin hypersensitivity affects as many as one in five Americans,7 yet data indicates that up to 42% of patients with dentin sensitivity don't tell a dental professional about their symptoms.8
What may I recommend to patients with tooth wear?
For patients with tooth wear, you may wish to make the following recommendations:
- Reduce or eliminate intake of carbonated drinks6
- Cease retaining acidic foods and drinks inside the mouth6
- Chew sugar-free gum, suck a sugar-free lozenge or eat a piece of cheese after an acidic meal, to encourage saliva and protect enamel6
- Leave brushing of teeth for at least one hour after consuming acidic food or drink6
- Brush with a soft toothbrush, using a low-abrasion, low-acidity, high-fluoride, anti-hypersensitivity dentifrice6
Are there products I can recommend to my patients with tooth wear?
Patients with tooth wear may benefit from a de-sensitizing toothpaste with a low Relative Dentin Abrasivity (RDA), and fluoride. This can help relieve symptoms of dentin hypersensitivity, slow further enamel loss from excessive tooth abrasion, and help to harden tooth enamel.6 Toothpastes with 5% potassium nitrate as the desensitizing agent, when used twice-daily, have been proven to relieve dentin hypersensitivity within two weeks. This is the maximum amount of potassium nitrate allowed by the FDA to treat sensitivity.9-14
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