Tooth Surface Loss

There are factors like inadequate brushing leading to gingival (in the area near to gums) recession, corrosive food and drink consumption, habits such as bruxism and tooth clenching which can lead to tooth surface lesions and loss of tooth structure. There can be loss of tooth substance in area of stress concentration in the mouth.

Problem Identification

The lesions on the surface of teeth can lead to tooth sensitivity, plaque retention, tooth cavities/ caries. It can also lead to dental pain. Thorough understanding of oral habits, clinical examination and history is necessary to identify the exact cause of these lesions.

Causative Factors

• One or more of the following factors can act as causative factors
• Loss of the tooth structure caused by friction from food such as nuts, all bran cereals, food with high sugar content, acidic juices
• Highly acidic foods such as citrus fruits, carbonated soft drinks in combination with poor oral care
• Harmful habits such as chewing tobacco
• Overzealous tooth brushing
• Improper use of tooth pick 
• In case of patients suffering from “Hyperacidity”, tooth structure is lost on the inner surface of the teeth 
• Sometimes taking certain medications such as for high blood pressure, pain killers, anti allergic medications can lead to dry mouth, over a period of time this can be a factor for tooth structure loss and caries

Treatment: Prevention and Cure

• Complete understanding of the multifactorial etiology leads to formulating an appropriate treatment plan.
• Orientation about correct brushing techniques
• Sensitivity reducing tooth paste is advised, fluoride containing mouth rinse is prescribed
• With the participation of a physician the treatment for ‘hyperacidity”, eating disorders is sought, education is given on preventing intake of unhealthy food
•  Tooth colored restorations are given
• Treatment of Bruxism or tooth clenching is initiated

References:

• J. O. Grippo, M. Simring, and S. Schreiner, “Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions,” Journal of the American Dental Association, vol. 135, no. 8, pp. 1109–1118, 2004.
• L. Osborne-Smith, F. J. Burke, and N. H. Wilson, “The aetiology of the non-carious cervical lesion,” International Dental Journal, vol. 49, no. 3, pp. 139–143, 1999.
• Verrett RG. Analyzing the etiology of an extremely worn dentition. J Prosthodont 2001;10:224-33

Replace your toothbrush after you have been sick

Appropriate toothbrush care and maintenance are important considerations for sound oral hygiene.

Studies show that it is important to change your toothbrush after you have been sick, had cold, flu, mouth infection or sore throat. Even those patient who undergo major surgery are advised to change their toothbrush.

This will avoid re-contaminating yourself with germs every time you brush.

Maintenance, proper air drying of toothbrush is necessary to avoid their contamination from micro-organisms

References:

• Filho PN. Microbial contamination of tooth brushes and their decontamination. Pediatr Dent.2000;22:381–4.
• Denny FW. Risk of toothbrushes in the transmission of respiratory infections. Paediatr Infect Dis.1991;10:710–1.