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Fixing Wear of Teeth

10.12.16 in General

Healthy Mouth Sounds- Part5

Yes, there are many possible solutions to fixing wear of teeth. And yes, we should first identify how teeth are being worn. But there is yet another level of questions we must ask, and seek their answers.

If we are wearing enamel, because we rub upper teeth on lower teeth…WHY do we rub teeth on teeth? If we are eroding enamel with stomach acid…WHY do we see signs of Gastro-esophageal reflux disease?

In the words of Dr. John Cranham,” though we may have an uneven bite, if we don’t “fiddle” with it, it may not cause a problem.” So what makes some of us fiddle with the way our teeth come together, and others-not?

One of the answers comes from the fact that all of these worn teeth that we are talking about are attached to the rest of a person, with other things going on. Things that just may have an influence on health of the mouth.

For instance, sleep studies clearly show people who have episodes of non-breathing (apnea), very often rub their teeth together(brux) just as they end the apneic episode and gasp for their next breath. Now, not all people with sleep apnea grind their teeth, and certainly not all grinding of teeth is due to sleep apnea; however, there is sometimes a correlation between the two events. The question then becomes, do we consider sleep apnea as part of the differential diagnosis, when we see worn enamel?

There are often small “cupping” defects in the tips of molar cusp, worn right into dentin. Many times these are related to acid erosion of enamel secondary to GERD. When dental teams see worn cusp tips, do they automatically think, “this could be a consequence of gastro-esophageal reflux disease?” And if that is happening, what else is going on that may be the source of the cause? All of this, from a flat spot on teeth?

Today I want to talk about- what if we do nothing? “What if I don’t find a reason or solution for this wear?” “It doesn’t hurt.”

I think it was Einstein who said, “insanity is continuing the same process and expecting a different outcome.” It is very likely that the tooth wear will continue unless we identify and eliminate the cause. That poses a few problems.
Once we have worn into dentin, we find ourselves in a material which is 7 times “softer” than enamel. More likely to decay, be sensitive, and continue to wear. So there is a price to pay for doing nothing.

The bottom line is that we often see signs of abnormal that can tell us its time to find a treatment, before the symptoms of abnormal rear their heads.

Next blog we will visit the topic of dental radiation. So, stay tuned in and keep smiling. Dr. W.


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Gary Williams, DMD

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