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05 Dec, 2021
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tooth wear

Tooth Wear – Ask Dr. Farooq Sorathia

Do Teeth Wear Out Over Time?

Tooth enamel is considered the hardest substance in the human body. Yes, it is even harder than bone. One wonders, if the hardest part of the human body is tooth enamel, how can It wear? On the Mohs hardness scale, enamel, which is primarily composed of hydroxyapatite crystals, scores a 5 out of 10 as compared to the hardest known substance on earth, a diamond, which scores a 10 out of 10 in hardness.

Enamel is the hard outer covering of a tooth. It protects the sensitive underlying dentine and the pulp tissues. Enamel undergoes normal wear and tear as we go through life. The wear and tear, however, can be expedited by habits that we knowingly or unknowingly do throughout the day or while sleeping.

Tooth wear can be classified into four different categories, and these are physiologic wear, erosion, abrasion, and attrition.

Physiologic wear occurs when the teeth exhibit normal wear and tear. Just like anything in this world, there is normal wear and tear with use. Studies conducted show that our teeth wear at a microscopic annual rate of approximately 11 micrometers per annum under normal function. Dentists have been trying to develop materials that wear at approximately the same rate as enamel. This is important because the restoration needs to wear at the same rate as enamel, otherwise, it would result in high spots or voids, which can cause harm to the supporting muscles and joints.

Erosion is one of the most common findings in the dental clinic. Erosion is caused by the chemical wear of the teeth. This is normally due to acidic foods which weaken the enamel. Sometimes, our diets such as sodas, lemon, or fruit juices, are acidic and as a result, cause the teeth to weaken and wear at a faster rate. Erosion is also seen in pregnant women who suffer from morning sickness. The acid in the stomach comes into contact with the teeth and weakens the enamel. The biggest mistake people make after a reflux attack is to brush their teeth. Remember, acid weakens the teeth, and brushing would just abrade the softened enamel away. The best piece of advice I can give to pregnant women is to rinse your mouth thoroughly with water and give the saliva some time to neutralize the acid in the mouth.

Abrasion is caused by mechanical forces that make the enamel thinner and eventually expose the dentine. An example of abrasion is the hard brushing habits that some of us have developed. We may think that brushing with a lot of force will keep our teeth clean, however, hard brushing and improper brushing techniques will accelerate the rate of wear and eventually cause sensitivity.

Attrition is the wear of teeth when the teeth grind against each other. This classic example is seen when newly erupted front teeth, top or bottom, we notice that the teeth have some rounded humps on the top. These are called mamelons. Over time, as we grow, these mamelons are ground down naturally just through daily use. This is an example of attrition.

It is important to keep visiting your dentist regularly so that the dentist may diagnose the condition correctly, and then intervene before it becomes too late. Different diagnoses have different treatment options and it is important to recognize and intervene at the earliest.

Article Written by Dr. Farooq Sorathia (BDS – University of the Witwatersrand, Johannesburg)

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