- Teeth treatment
Tooth wear treatment
Modern dentistry can be considered to know how to effectively manage the “eternal” oral disease which is tooth decay. Fluoride products, proper personal and regular professional oral hygiene as well as eating habits provide real opportunities for preserving teeth throughout one’s entire life. While we know how to fight diseases caused by ‘dirt,’ we are also seeing how pathologies caused by the “achievements of civilisation” are becoming more apparent. The lifestyle of many people is changing radically. Our daily lives are characterised by speed, an abundance of information, constant decision-making, i.e. constant stress or anxiety. Today, dentists observe a group of oral diseases that is becoming more common and, worst of all, affecting younger people which is pathological (faster than normal for a given age) tooth wear. Tooth wear affects 97% of the population, with 7% of them requiring treatment to prevent the tooth structure from completely disintegrating due to this condition.
Natural (age-related) tooth wear accelerates due to three main reasons: frequent exposure to acids in the mouth (erosion), teeth grinding (see “Prevention of the consequences of teeth grinding”) and improper cleaning of teeth or their abrasion with other objects (pipes, fishing hooks, needles, etc.). (see “Prevention of oral diseases” ). One cause is predominant here. Teeth are most likely to wear down due to exposure to food or stomach acids. When the tooth tissue is softened by acids, it is much easier to brush it away with a toothbrush or scrape it off with the teeth. Tooth tissue begins to decay when the pH of saliva falls below 5.5 (normal saliva pH is around 7). The table below shows the acidity of some foods.
| Fruit | pH | Drinks | pH |
| Apples | 2.9 – 3.5 | Tea | 4.2 |
| Grapes | 3.3 – 4.5 | Coffee | 2.4 – 3.3 |
| Peaches | 3.1 – 4.2 | Beer | 4.2 – 5.0 |
| Pears | 3.4 – 4.7 | Wine | 2.3 – 3.8 |
| Plums | 2.8 – 4.6 | Pepsi | 2.5 |
| Lemons | 1.8 – 2.4 | Coca-Cola | 2.4 – 2.7 |
| Oranges | 3.0 – 4.0 | Sprite | 2.8 |
| Cherries | 3.2 – 4.7 | Yoghurt | 3.8 – 4.2 |
| Strawberries | 3.0 – 4.2 | Distilled water | 5.6 |
There is currently sufficient evidence that gastric juices cause tooth erosion. Compared to food acids, whose effects can be easily eliminated after eating by rinsing the mouth with water immediately, gastric acid (pH 1-2) causes the most severe damage to teeth. Acid from the stomach enters the mouth through vomiting (in cases of anorexia nervosa, bulimia, alcoholism, cancer, pregnancy, etc.) or gastroesophageal reflux (GER) caused by a faulty lower oesophageal sphincter.
The effect of stomach acid will be significantly reduced if, after vomiting, you do not brush your teeth with a toothbrush and toothpaste, but rather rinse your mouth immediately with water or an alkaline liquid such as milk.
It is much more difficult to prevent chronic stomach contents from entering the oesophagus in cases of reflux. In addition to the main symptom of this disease, heartburn, other symptoms may also occur. Typical and atypical symptoms are shown in the figure below.
The treatment strategy for pathological tooth wear caused by stomach acid entering the mouth is to refer the patient to a gastroenterologist or other general pathologist for consultation and a combination of dentistry measures: restoration of damaged teeth with fillings or prostheses and prevention (explanation of how to behave, mineral replacement therapy, protective mouthguards).
Therefore, unlike dental decay, which is a localised problem in the oral cavity, the causes of pathological tooth wear are often related to factors outside the oral cavity, and we are faced with a multidisciplinary pathology. People usually have appointments with dentists more frequently than with other medical specialists. This is why a competent dentist can determine the cause of tooth wear based on its specific pattern, perform the necessary oral procedures and refer the patient to the appropriate specialist for consultation.
