Increased abrasion of teeth: why hard tissues are pathologically worn down, reasons for abrasion

By length

This is a classification according to Kurlyandsky. According to this criterion, pathology is divided into the following types:

• Localized. Individual units or groups of them are erased. It is diagnosed mainly from the front side, for example, with a deep bite. Local compensation occurs due to the appearance of a hypertrophied alveolar process.
• Generalized. All rows are involved, the height of the bite changes significantly. Whether abrasion will be compensated by the body is determined by its individual characteristics.

Complications

What to do if teeth are worn out depends on the provoking factors. As discussed above, the lack of timely therapy leads to cosmetic defects and disruption of the chewing process. In addition, there are other consequences that affect the quality of life of patients:

• inflammation of the gums in the interdental spaces;
• gingivitis;
• diseases of the temporomandibular joint;
• loss of teeth;
• damage to nerve fibers and muscle tissue;
• uneven load distribution leading to traumatic articulation;
• malocclusion.

What to do if your child's teeth are worn out

Treatment for tooth wear is developed individually. At the appointment, the pediatric dentist analyzes the causes of the pathology, determines the stage of erasure, the nature of the disease and the characteristics of the development of the child’s body.

Diagnostics

Most people aged 50 years and older experience the physiological type of abrasion. The doctor needs to determine in time when the natural process turns into a pathological one. One of the main methods remains measuring the actual parameters of crowns. In addition, it is important to carefully study the shape of the dental units and determine areas of contact with antagonists. The height of the coronal part is compared with age standards established scientifically.

Diagnostic measures include assessment of fissures and enamel condition. The doctor pays attention to the patient’s facial expressions and appearance. It is important to talk in detail about your complaints and describe your feelings.

To assess how correctly the temporomandibular joint functions, electromyography is indicated. X-ray examination, electroodontodiagnosis and other procedures are carried out.

Modern and classic classification of abrasion

In modern Russian practice, the most widespread and popular is the Bushan classification of abrasion, which distinguishes:

✔

physiological abrasion (only enamel is affected);

✔

transitional (enamel + dentin suffers);

✔

pathological abrasion (dentin is damaged).

The benefit of the classification is that, in addition to the degree of pathology, it considers the surfaces (vertical, horizontal) that have undergone changes, the prevalence of the disease and the tooth sensitivity accompanying the process.

As for the types of pathological abrasion, the classical classification was developed by A. G. Moldovanov and L. M. Demner. According to their data, the rate of abrasion is 0.402 mm per year.

1. The first degree of abrasion
   is achieved by the age of 25-30 and is characterized by smoothing of the cusps and cutting edges of the teeth.
2. The second degree of abrasion
   is observed in patients aged 44-50 years and is expressed in the abrasion of the enamel.
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3. The third degree of abrasion
   is noted if by the 50th anniversary the enamel limit has been reached and 10 pairs of chewing teeth have been preserved.

Treatment in dentistry

To eliminate pathological abrasion of hard dental tissues, you need to establish its cause and then get rid of it. The next step is to restore the configuration of the dentition. In the early stages, treatment with medications may be sufficient. If the symptoms are pronounced, only an orthopedist will help.

Medicines

The techniques used are based on the process of remineralization of the enamel layer. In this way, compensatory reactions are activated and mineral metabolism in hard tissues is normalized. Experts prescribe vitamin and mineral supplements with a high content of calcium and phosphorus. Additionally, pastes are used to reduce sensitivity. If the destruction has just begun and the dentin has not been damaged, this option for treating tooth wear can be very effective.

Orthopedic methods

If the defect is serious, medication alone is not enough; more radical correction is required. Most often, doctors use inlays and artificial crowns. If some units fall out, a bridge structure, clasp prosthesis or other types are installed. This therapy allows you to completely restore the functioning of the rows and evenly distribute the chewing load.

Teeth wear for physiological reasons

When does the process of tooth wear begin?
The process of wearing away tooth enamel begins almost immediately after teeth erupt. This is natural and normal, as it allows the body to adapt to the resulting load. Physiological abrasion is necessary so that the load on the teeth and jaws is distributed evenly and there is no overload of individual areas. Point contacts of teeth turn into planar contacts and the angle of inclination of the teeth changes. This is necessary for a more physiological functioning of the dentofacial apparatus.

It is important to understand that proper physiological tooth wear affects only the outer enamel, without damaging the inner dentin, and occurs only at the points of contact of the teeth.

Wearing of baby teeth in children

Not only molars and permanent teeth in adults wear out, but also baby teeth in children. By about four years of age, the child’s teeth on the incisors, as well as the cusps on the canines and chewing teeth, completely wear out. It is considered normal for the enamel to wear away by the age of six, even down to the dentin.

And in the period until the complete change of baby teeth - up to 13-14 years, the dentinal layer may also be worn out.

Increased abrasion is considered when the tooth cavity becomes visible or the tooth crown is lost.

Prevention

To prevent pathology, it is necessary to regularly visit the dentist for preventive examinations at least once every six months. It is also important to promptly replace dental defects. In addition, all experts advise correcting malocclusion pathologies in a timely manner already in childhood or adolescence. Orthodontic therapy will help cope with the abnormal position of the teeth and prevent wear of the crown part.

You won’t have to decide what to do when the hard tissues of your teeth are worn away if you treat all the diseases that lead to it. For example, this includes bruxism, mineral metabolism disorders, thyroid pathologies, and problems with the digestive organs.

If the patient is at risk due to professional activities, it is necessary:

• use personal protective equipment;
• take a responsible approach to regular hygienic oral care;
• take courses of vitamins and minerals prescribed by your doctor.

The most important point remains the qualitative diagnosis of the transitional stage between physiological and pathological erasure. For this purpose, regular examinations and timely treatment of identified disorders are indicated.

Stages of dental destruction: when are consultation and diagnosis necessary?

By degree of destruction:

• Stage 1: there is a smooth smoothing of the tubercles on the enamel and the cutting edges of the teeth;
• Stage 2: tooth enamel is completely erased, the destruction process reaches dentin (the inner part of the tooth);
• Stage 3: the size of the part of the tooth located above the gum and clearly visible is only two-thirds of the norm;
• Stage 4: the crown of the tooth is completely destroyed and falls to the level of the gum.

Due to increased abrasion, the most unimaginable patterns may appear on the surface of tooth enamel, indicating damage to the enamel in the vertical, horizontal directions, in the form of dots, etc.

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Let's sum it up

What to do if the lower front teeth or upper teeth are worn out, pain and other unpleasant symptoms appear? First of all, you need to go to the dentist to conduct a thorough diagnosis and identify the exact causes of the pathology. The longer the patient ignores the presenting signs, the more severe the consequences for him. In order not to encounter this phenomenon, it is necessary to take preventive measures, especially for those at risk.

Sometimes the enamel wears away due to age-related changes. In this case we are talking about a natural process. Which group should the problem be classified into, and whether treatment should be prescribed, should be decided solely by the doctor.

Causes of pathological abrasion

There are several main reasons for the development of abrasion pathology, and in the first place among them are bad human habits. For example, the habit of gnawing seeds, holding small objects in the mouth (pins, cloves, pipe mouthpiece), love for foods with high acidity may well become catalysts for the process.

Often the cause of increased abrasion is diseases: bruxism, diseases of the gastrointestinal tract, nervous, cardiovascular, endocrine systems, from the side of the TMJ - malocclusion. The cause may also be improper dental treatment - an incorrectly manufactured orthopedic design can provoke severe abrasion of the antagonist tooth.

Sometimes the cause of pathology may be the chosen profession. Some employees of the metallurgical, cement, granite industries, and representatives of the mining workshop suffer from increased abrasion.

Why does enamel wear off?

Minor deformations do not lead to the development of hyperesthesia, but the longer the disease develops, the more painful the consequences. Common reasons why enamel wears off:

• calcium absorption disorders;
• poor nutrition;
• genetic disorders;
• pathology of the thyroid gland.

There may also be congenital defects that lead to a thinning of the protective layer with age. The cause may be bad habits, increased consumption of fiber-depleting drinks, and smoking tobacco. The process can be affected by improper treatment, contact of the crown with the walls of the teeth, incorrect installation of the prosthesis or braces.

Having found out the reason why the enamel on the teeth is worn away, the doctor can choose a treatment. The patient may notice changes before pain appears. Discomfort appears when eating cold, hot, or sweet foods. Sensitivity gradually increases, roughness and thinning appear. The surface darkens and characteristic layers form.

Tooth wear, pathology photo

If you look at photos of patients, you will notice that abrasion has different forms. Tooth wear is also classified according to this criterion. A photo that shows, for example, that some teeth are below normal, indicates horizontal abrasion.

Directly based on the worn surface, horizontal and mixed abrasion of teeth is also distinguished. Photos show the area of ​​its distribution. Based on this feature, limited or generalized abrasion is distinguished.

On specialized websites there are photos depicting not only different forms of tooth wear, but also contours that correspond to the norm, so that you can compare. So the photo shows the extent of the problem.

Crown as a way out

Pathological tooth wear can be eliminated with the help of crowns. They can be installed both on the front teeth and on the chewing teeth and restore the aesthetics and functionality of the oral cavity. Crowns can be made from various materials, each of which has its own advantages and disadvantages:

When choosing a certain material, the patient must understand that he will need to replace a large number of crowns (perhaps even all). Therefore, it is worth giving preference to those materials that have good aesthetic qualities and a long service life.

After all the nuances of prosthetics have been agreed upon, we proceed directly to the procedure itself. At the first stage, the oral cavity is sanitized and teeth are prepared for crowns. Next, the doctor takes impressions of the jaws, based on which the dental technician makes a prosthesis. These operations may take some time, so the patient may be offered temporary plastic crowns. They will protect prepared teeth from the aggressive environment of the oral cavity and help adapt to new teeth. After the final version of the prosthesis is ready, it is tried on again and fixed with permanent cement.

When should you start taking care of your teeth?

The correct answer is from the prenatal period. It is from this time that the expectant mother should saturate her body with vitamins and calcium and take vitamin and mineral complexes specially created for pregnant women. A professional dentist will help in this matter.

Breastfeeding is important for a newborn baby, because mother's milk will provide the baby with everything necessary for proper development, including teeth.

When the child gets older, parents introduce him to sweets - this is the first factor that destroys teeth. From this moment on, there is a danger of caries. If there is not enough calcium, the enamel will be destroyed in childhood.

To avoid such danger, the mother must:

• Reduce consumption of sugar and fructose;
• Protect yourself from any diseases so as not to cause hypoplasia in the unborn child - underdevelopment of tooth enamel;
• Feed your baby breast milk, because the share of sugar in infant formula is up to 30%;
• Minimize the amount of cookies and sweets in the child’s diet;
• Take vitamins as prescribed by your dentist.