Are your teeth being worn down?
Well actually you have worn them down yourself. The actual procession is likely a combination of attrition and erosion.
Attrition is the wearing away of tooth structure from grinding the top and the bottom together. This condition, when excessive, is called bruxism. Usually individuals with bruxism have at least heard their dentist recommend a night guard. All individuals with teeth like these are doing most of the damage at night. Many times a spouse will inform them because the grinding makes an incredibly irritating noise.
Erosion is the wearing away of tooth structure due to acid. The major form we see is from our own stomach acid being regurgitated. This also happens at night while we are laying down and the stomach acid can more easily flow into our mouth. Individuals with heartburn, especially at night, are prone to this. Most people have a combination of both bruxism and stomach acid issues to get to the point of the photos above. It does not take very much acid regurgitation when you grind at night to damage your teeth. In fact the stomach acid may not cause any other symptoms other than the wear of the teeth. There also exists some individuals that introduce the acid through their diet. Mostly that would be individuals that drink large amounts of juice or soda throughout the day and individuals that suck on lemons, a popular habit in central America.
So enough background what does it all mean? Well it is obviously less attractive. It makes the individual appear much older as we associate wearing away of teeth with old age. It also gives many people an unattractive gummy smile. This occurs because as the teeth are worn away your body compensates for that by pushing the entire tooth, with it’s ligaments and gum tissue, up so as to stay hitting the opposing tooth. As the teeth are pushed up you start to show more and more gum when you smile, instead of teeth. Also it does make it more difficult to chew and speak normally. Although most people do not really notice this too much because it is a slow process and they adapt over the years. Usually biting into things has become more difficult and people sub-consciously tend to avoid certain foods, part of the adaption.
So what can I do to restore my smile and all of it’s components to the ideal attractive smile I had in my youth? Well fortunately this is one part of the body where we truly can turn back the hand of time in a very non-invasive way. There is almost always 3 steps to return you to normal. The first is getting the gums to go back to where they belong. This is done with either a minor surgery or with braces. Occasionally, if the gums are not too bad, everything can be done in just one step and we can use our laser to make minor adjustments to the gums. The second step is to build back what was lost. This is done with all ceramic crowns or veneers. The final step is to protect your new smile. If you didn’t where a night guard before you need to start. Unless your wear was primarily due to erosion then you ARE a bruxer. You can not grind away the ceramics like you did your teeth but you can break them. It is not easy to do and I haven’t even had anyone do it yet. Of course we are using newer ceramics that are much stronger than older ceramics. But perhaps everyone is listening to me and wearing their night guard!!
Below is a patient I completed recently.
he is able to bite into his food again and his smile looks a lot better!
|Before all the lower teeth|
|After all the lower teeth|