How to Prevent Tooth Loss Due to Abrasion or Erosion
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With all the modern advances of dental science, many new things are now understood about tooth loss. As a dental patient, you are probably familiar with certain well-known topics like dental caries (cavities) or even periodontitis (gum inflammation), but you may not be as familiar with a serious dental problem known as Non-Carious Loss of Tooth Structure (NCLTS). While NCLTS may be a condition you have never heard of, it is actually more prevalent than all the documented cases of dental caries and periodontal disease put together.
So, what is NCLTS and how does it affect your dental health?
Quick Facts About Non-Carious Loss of Tooth Structure (i.e. Tooth Wear)
NCLTS is the terminology used to explain a loss of tooth structure that is not caused by decay. Dental caries, also known as a cavity, is a bacterial infection that eats away at the hard tissues of your teeth. Dental caries create tooth loss eventually by causing a soft spot, leading to demineralization of the enamel, dentin and cementum of your tooth.
NCLTS is different from dental caries in that the tooth loss is not caused by a bacterial infection. While dentists are easily able to recognize the signs of NCLTS, the cause of this condition is unfortunately not as obvious. If the term NCLTS sounds unfamiliar to you, perhaps you know Non-Carious Loss of Tooth Structure by a different name … tooth wear.
Tooth wear is one of the most common changes seen in teeth and is often considered to be a natural part of life. Wearing of teeth is seen especially on opposing tooth surfaces. While it is seen as physiological under normal life conditions, it is pathologic under a different set of circumstances when the wearing of tooth structure is excessive. Once there is an abnormal amount of tooth wear, it is then considered NCLTS. Two known causes of NCLTS are abrasion and erosion.
Effects of Tooth Surface Loss
The effect of surface loss varies, depending on the severity of the tooth tissue that is lost. Things to be considered are the loss of enamel thickness, occlusal surfaces of teeth and any underlying exposure of the dentin. Once tooth surface loss continues, the exposure of underlying dentin can lead to extreme sensitivity. Loss of the tooth height can lead to a decrease in vertical height and an uneven occlusion. The painful effects are often felt in the temporomandibular joint (TMJ), causing difficulty eating and chewing. Rapid loss of tooth structure may threaten the pulp and viability of the tooth itself. Loss of tooth structure can affect overall health and quality of life.
What Causes Dental Erosion? (Including a Major Cause in Health-Conscious People ...)
Erosion is a word that literally means "to gnaw" or "to corrode." It describes a process that gradually destroys the surface of something. When erosion occurs to a tooth structure, it is the pathologic, chronic, local and painless loss of hard dental tissue that is chemically etched away from the surface by a type of acid with no bacterial involvement. The acids that are responsible for tooth surface erosion occur due to intrinsic or extrinsic acids that exceed any kind of buffering capability or neutralization function of normal saliva in your mouth.
Dental erosion begins when the amount of demineralization exceeds the amount of mineralization in calcified dental tissue. In the fight against dental erosion, saliva is the weapon of choice. When the acids are increased in your mouth, they stimulate salivary production. This process dilutes and clears acid from all dental surfaces and keeps your mouth in a balanced state. Your saliva also plays a role in the formation of acquired pellicle, which is a type of barrier that keeps acid from contacting tooth structures. Erosion can have varying effects on teeth, causing damage in some teeth that may be minor, while others may have damage that is major to their teeth. So what are some examples of dental erosion?
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Erosion from regurgitation. One of the most prevalent causes of NCLTS occurs when you vomit. When you regurgitate, the stomach acids that are present in vomit are exposed to your teeth. It is at this point that the acid begins to dissolve tooth structure, causing damage to enamel and underlying structures of your teeth. NCLTS is often present in people who suffer from an eating disorder called bulimia.
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Erosion from fruit mulling. This is the third major cause of erosion and is seen frequently in people who are health driven. With this kind of erosion, people consume fruit during the day while delaying the act of swallowing the fruit pulp so it can be mulled between the teeth. These people are oftentimes vegetarians or grind their teeth due to high stress.
Common Causes of Tooth Abrasion
The loss of tooth surface due to friction is called abrasion. The friction is generally caused by using abrasive toothpaste, brushing your teeth with too much force or even habitually biting your nails. Naturally, the rate of tooth loss depends upon the amount, force, contact time and frequency of friction. Some of the abrasive ingredients in toothpaste include silicates, calcium phosphate and calcium carbonate.
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Abrasion from bruxism. Bruxism is a term used to describe grinding your teeth together when you are not eating. This condition occurs most often in your sleep, when you are unaware of what you are doing. It is very rare that people suffer from bruxism during the daytime. Bruxism is the major cause of NCLTS from abrasion.
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Abrasion from tooth brushing. Abrasion can occur at any time when you are brushing your teeth. Brushing your teeth horizontally can also create more cervical wear than vertical brushing can. In addition, the type of toothbrush bristles that you use can create abrasion. People who are unhappy with the color of their teeth often believe that excessive brushing is needed in order to whiten their teeth. Unfortunately, excess brushing only abrades the tooth structure and allows the dentin to be seen through each tooth.
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Abrasion from toothpaste. This is the second major cause of abrasion. Anytime you brush with too much force, you can create abrasion. The abrasives found in toothpaste are used as the means to remove plaque and tartar from teeth. Teeth without many anatomical details or a sandblasted appearance serve as evidence for toothpaste abrasion.
How to Prevent NCLTS Caused by Erosion or Abrasion
So with NCLTS being such a prevalent dental problem, what can you do ahead of time to prevent the loss of tooth structure? Following the tips listed below will lower your risk of developing problems.
In addition to the tips above, one of the most important things you can do for preventative maintenance is to get regular dental check-ups. Your dental team can easily identify (and even prevent) future problems associated with NCLS. Your dentist is able to examine your teeth thoroughly and take the x-rays needed to discover any problems below the gingival margin. It will also be much easier for your dental team to notice changes in enamel thickness, any wearing away of molar cusps or changes in color that may indicate the dentin can be seen.
Another preventative dental practice method is to make dental casts of your upper and lower dentition. If you experience problems with bruxism, having a dental examine of your dental casts can easily identify any telltale signs of NCLTS.
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Sources
Inside Dentistry, Volume 7, Issue 9
How to Avoid Tooth Abrasion and Tooth Erosion
