Posts for: May, 2014
What is tooth wear?
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
What causes tooth wear?
Tooth wear can be caused by any of the following:
- Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough. A removable dental appliance, such as a partial dentures or retainer, can also abrade teeth. Abrasion can also result from habits such as nail-biting and pen-chewing.
- Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time. That’s because they can subject teeth to 10 times the normal forces of biting and chewing.
- Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices. Eating sugary snacks also raises the acidity level in your mouth. If you can’t give up these snacks and drinks entirely, it’s best to confine them to mealtimes so your mouth doesn’t stay acidic throughout the day. Swishing water in your mouth after eating or drinking acidic or sugary substances can also help prevent erosion.
- Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.
How is it treated?
The first step in treating any type of tooth wear is to determine the cause during a simple oral examination right here at the dental office. Once the cause has been identified, we can work together to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, we can make you a nightguard that will protect your teeth during sleep or periods of high stress. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.
If you follow the hit TV reality show Amazing Race, you know that professional-hockey-playing brothers Bates and Anthony Battaglia won the $1 million prize in the latest globe-spanning competition. You may also have witnessed Anthony removing his false front teeth from time to time — like when he had to dive for pearls in Bora Bora. Since he plans to resume his sports career, Anthony wears a partial denture to fill the gap in his classic “hockey mouth.” He has said that when he finally hangs up his skates, he will use some of his Amazing Race prize money to get new, permanent teeth. When it's time to get that new smile, Anthony, like many people, will have to choose between two good options for permanent tooth replacement.
The preferred option for most people is dental implants. In this system, tiny titanium posts substitute for the root part of your missing tooth (or teeth). These are placed beneath your gum line in a minor surgical procedure we perform right here at the dental office. The amazing thing about dental implants is that they actually fuse to your jawbone, allowing your replacement teeth to last a lifetime.
The titanium implant itself is not visible in the mouth; the part of an implant tooth that you see is the lifelike crown. Virtually indistinguishable from your natural teeth, the crown is attached to the implant above the gum line. Dental implants can be used to replace a single tooth, multiple teeth, or even all your teeth. You don't necessarily need one implant for every tooth because implants can support bridgework or even a complete set of prosthetic teeth.
The second-best option is a natural-tooth fixed bridge. In this system, we use healthy natural teeth on either side of the empty space left by a missing tooth (or teeth) as supports for one or more of the prosthetic teeth that will fill the gap. The downside is that in order to turn these healthy teeth into supports (which are referred to in dentistry as “abutments”), we need to remove some enamel and then cap them. This procedure can leave those teeth more prone to decay than they were before. But with regular dental exams and good oral hygiene on your part, bridgework can last many years.
Which system is right for you? That's a question we would be happy to help you determine... even if you haven't won a large jackpot or gone pearl diving in Bora Bora. If you've been looking forward to the day when you can have permanent replacement teeth, why wait? Contact us or schedule an appointment for a consultation. We will help you find your ideal solution to the problem of missing teeth! For more information, please see the Dear Doctor magazine articles “Dental Implants vs. Bridgework” and “Dental Implants: Your Third Set of Teeth.”
Q: I often seem to have noticeably bad breath — not just in the morning. How unusual is this problem?
A: Persistent bad breath, or halitosis, is a very common complaint that is thought to affect millions of people, including perhaps 25 to 50 percent of middle aged and older adults. It’s the driving force behind the market for breath mints and mouth rinses, with an estimated value of $3 billion annually. It’s also the third most frequent reason people give for seeing the dentist (after tooth decay and gum disease). So if you have bad breath, you’re hardly alone.
Q: Can bad breath come from somewhere other than the mouth?
A: Most of the time, bad breath does originate in the mouth; its characteristic smell is often caused by volatile sulfur compounds (VSCs), which have a foul odor. However, it can also come from the nose, possibly as a result of a sinus infection or a foreign body. In some cases, pus from the tonsils can cause halitosis. There are also a few diseases which sometimes give your breath an unpleasant odor.
Q: What exactly causes the mouth to smell bad?
A: In a word: bacteria. Millions of these microorganisms (some of which are harmful, and some helpful) coat the lining of the mouth and the tongue. They thrive on tiny food particles, remnants of dead skin cells, and other material. When they aren't kept under control with good oral hygiene — or when they begin multiplying in inaccessible areas, like the back of the tongue or under the gums — they may start releasing the smells of decaying matter.
Other issues can also contribute to a malodorous mouth. These include personal habits (such as tobacco and alcohol use), consumption of strong-smelling foods (onions and cheese, for example), and medical conditions, like persistent dry mouth (xerostomia).
Q: What can I do about my bad breath?
A: Those breath mints are really just a cover-up. Your best bet is to come in to the dental office for an examination. We have several ways of finding out exactly what’s causing your bad breath, and then treating it. Depending on what’s best for your individual situation, we may offer oral hygiene instruction, a professional cleaning, or treatment for gum disease or tooth decay. Bad breath can be an embarrassing problem — but we can help you breathe easier.