How do abrasion and erosion differ?
Abrasions, erosions and their treatment in function and aesthetics
Severe signs of wear and tear on the teeth are a form of dental disease that has recently become more and more common. This not only affects older people, as one might assume, but also very young adults. This wear and tear on the teeth, in which the complete enamel (outer, white layer of the tooth) disappears, occurs for various reasons. What they all have in common is that, in contrast to tooth damage caused by tooth decay, no bacteria or sugar have to be present in the oral cavity and these can therefore also arise in patients with very good oral hygiene. In addition, this wear usually does not affect individual teeth but entire groups of teeth, such as all front teeth or even all teeth. This already shows the effort involved in treating such a set of teeth, but also the high demands placed on the quality and skill of the dentist.
Different signs of wear and tear and how they arise
Abrasions are caused by mechanical wear and tear (abrasion) of the enamel. It is in the nature of things that these are more common in older patients due to the long use of their teeth. Grinding and pressing (bruxism) can cause this phenomenon to come to light much earlier. Especially in the modern world, in which a lot of influences, especially through the new communication systems and media, act on our brain, a great, often unnoticed stress arises. In many cases, this stress is relieved through increased clenching and rubbing of teeth, especially at night. Dr. Diether Reusch notes: "The chewing organ serves the organism as a tool to relieve the psyche." This is the reason for premature mechanical abrasion of the tooth enamel in young patients aged 20-25.
Erosion is caused by the direct attack of acid on the tooth enamel. Here, the minerals that are in the enamel are removed. As a result, the inner, much more sensitive tooth layer (dentin) is then exposed. The acid attacks can be caused by various factors. Some are mentioned here:
- Stomach diseases / heartburn: This is where stomach acid constantly gets into the oral cavity and causes a continuous attack on the tooth enamel.
- Eating disorders / bulemia: Frequent vomiting also creates an acidic environment in the mouth, which leads to the dissolution of the tooth enamel. Mostly with young women.
- Eating habits / diet: Lots of fruits / fruit juices / lemonades with fruit acids: Most fruits contain fruit acids that damage tooth enamel directly. Lots of salads: These are usually dressed with vinegar. Vinegar is again an acid that attacks tooth enamel directly.
- Isotonic sports drinks or energy drinks such as Red Bull: These also contain acids that attack the enamel directly, but also a lot of sugar, which is converted into acid by bacteria.
You can see here that an extremely healthy diet often leads to damage to the teeth. This effect can only be compensated for by taking special oral hygiene measures. This is particularly addressed in our professional teeth cleaning. You will be given tips on how to slow down enamel degradation.
3. Combination of erosion and abrasion:
If the enamel is loosened by the above-mentioned addition of acid, it becomes rough and brittle and therefore vulnerable. If there is now a strong crunch on this weak enamel, it wears out in a very short period of time.
Consequences of wear and tear:
- The lack of tooth enamel often causes irritation of the tooth nerve and thus sensitive to very painful teeth arise
- Often the patient notices thinning front teeth with a grayish shimmer, the edges of the teeth fraying or partially breaking off
- Posterior teeth can also crumble and break off
- Due to the loss of enamel, the affected patient bites deeper. Often this is a loss of up to 8 mm in the bite height. This can lead to compressions or other changes up to osteoarthritis in the temporomandibular joint, some of which can be very painful.
- Plastic splints can slow down the abrasion in bruximus.
- Professional teeth cleaning with individual nutritional advice can slow down the progression of erosions. However, the above-average cooperation of the patient is required here.
- In simpler cases, the over-sensitivity and further decay of the individual tooth can be stopped by crowning and possible root treatment of individual teeth. However, the process of enamel loss on the untreated teeth will continue and treatments of further teeth will follow again and again. The lowered bite height is not corrected.
- With heavy wear and tear, with loss of bite height. An overall concept with precise diagnostics should take place here. The lost enamel in all teeth has to be replaced by ceramic. The teeth are built up to the original height, the loss of the bite height is compensated for. The original natural function and aesthetics of the entire dentition are restored here. With a minimally invasive (tooth substance-friendly) procedure, hardly any other healthy tooth substance is sacrificed, on the contrary, this is replaced by ceramic. Further damage to the teeth is avoided. A TMJ disease is prevented.
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