Enamel Wear

Front teeth are often the first to wear down because one of their purposes is to guide the lower jaw in its movements. When the lower jaw slides forward and sideways during chewing or grinding, the front teeth limit its movements and guide it. When this occurs, the upper teeth contact and rub against the lower teeth. Some people have a grinding habit called bruxism and do this when they sleep or even when they are awake. The bottom line is that after enough years of these teeth rubbing together, the enamel often wears away and the biting edge of the teeth now has no enamel on them and dentin is now exposed.

Dentin is much softer than enamel and very porous. When you see it under a microscope, it looks like a sponge with tiny tubules that run from the surface of the tooth all the way to the nerve chamber. The dentin wears much faster than enamel and the net effect is that the teeth now begin to become very thin at the edges and start chipping and looking uneven. Over time, the teeth actually get shorter and shorter. Eventually, these teeth will be worn down to the gums and it will appear as though there are no teeth present when the person smiles.

If allowed to progress long enough, I have seen the teeth wear down so far that the nerve is exposed and the tooth needs root canal or extraction. This seems like a tragic situation since it could have been prevented at the beginning stages instead, with simple filling material to protect the vulnerable biting edge of the tooth many years earlier.

Since tooth wear begins with loss of enamel on the biting edges of the teeth, it is easily treated by protecting that edge with tooth colored filling material called composite. The filling material is more similar in hardness to the enamel that used to be there. It will, therefore, slow down the wear process and help to prevent the need for more involved and expensive crownsroot canals and extractions.

A little wear of enamel on the front teeth may not seem like a big deal now, but it has a way of sneaking up on you over the years until it is much more difficult to address and can even involve the need to open the bite and complete full mouth restoration with over 30 crowns.

It may be tempting to say, “If it ain’t broke, don’t fix it”, but I have news for you…It is broke. We are not born with enamel worn off of our teeth. When this happens, it’s like a shoe wearing through the sole to almost expose the foot inside. That enamel was there for a reason. It is hard and impervious, like glass, and it protects the softer part of the tooth from rapid wear. So teeth that are missing enamel are destined to wear rapidly until much bigger complications or tooth loss occur unless, they are treated as early as possible to slow down the wear cycle. Simple fillings can restore the missing enamel and preserve the tooth healthy while halting or greatly reducing the rate of wear.

As a dentist that practiced in Queensbury, NY for many years and now practices in Saratoga Springs, NY, I try to help my patients maintain their teeth healthy for their lifetimes. I always prefer the least invasive procedures to achieve long-lasting and trouble-free results.

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