Tooth wear is one of the most prevalent dental conditions that we see in practice day to day. It would not be an exaggeration to say that almost 90% of adult patients suffer from some form of tooth wear albeit to varying degree of severity. Minor tooth wear can lead to issues such as sensitivity to hot and cold whereas severe tooth wear can impair everyday function of chewing and mastication. Severe tooth surface loss will also cause a reduction in the occlusal vertical dimension (OVD) which is a measurement from under the nose to the chin. This will lead to a change in the shape of ones facial structure which is not desirable. The good news is that there are a number of treatments available that are minimally invasive, pain free and far less costly than traditional methods of reconstruction.
 

Do you know what the one of the most common dental problems is in the United Kingdom? It's not cavities or gum disease. It's tooth wear! Tooth wear can be caused by a number of factors including acid erosion, bruxism (teeth grinding at night ), and poor oral hygiene. In this blog post, we will discuss the causes, treatment, cost, and prevention of tooth wear. We will also answer some common questions about this condition. If you have tooth wear, you must simply read this article.
 

Our case of the month for November 2021 was a classic tooth bonding case involving severe tooth wear. Tooth wear is an increasing problem with grinding at night becoming an ever increasing problem coupled with acid in the diet. The combination of these two factors can lead to the softening and dissolving enamel leading to thin edges, chipping, fractures and exposure of the underlying dentine which can be very sensitive. 

The beauty of cosmetic bonding is that we can treat the wear, protect the teeth and improve the aesthetics in one visit. We do not need to cut the teeth down at all, there is no need for any needle, the procedure is pain free and easy to maintain.
 

Our case of the month for November involves a re-construction of the bite over a number of years. The main reason for treatment was due to severe tooth wear due to bruxism. Bruxism is essentially grinding at night to such an extent that the enamel is worn over a number of years. This can cause a number of problems such as:
 

• Tooth sensitivity
• Difficulty in eating
• Lack of a coherent bite
• Aesthetic issues
• Pain leading to root canal treatment in severe cases

Tooth wear, on the whole, can be prevented or at least treated with relative ease in the early stages. However, severe tooth wear is a complex subject and requires a dedicated and staged treatment process. Here is a smiling view of our patient before any treatment:
 

Our case of the month for February 2018 involves the treatment of tooth wear. Tooth wear is an increasing problem with modern day life. Stress, night time grinding and acidic diets all lead to loss of tooth enamel which is the hardest tissue in the body! The loss of tooth enamel leads to a weakening of the overall tooth structure exposing the underlying dentine which is much weaker and more susceptible to tooth decay and sensitivity. In the first instance, prevention is better than cure. Therefore, if you love acidic drinks and food, sorry, but you will have to change your diet. If you grind at night, a simple night guard will protect your teeth. 
 

Our case of the month for July involves the restoration of severe tooth wear using the Dahl technique.

The Dahl technique is a great concept for the treatment of localised tooth wear, especially on the front teeth. The concept involves potentially a number of methods but we prefer direct bonding. For example, if the upper front teeth are worn but there is no space to restore them, we may use the Dahl concept to restore them. Direct composite restorations are placed to restore the teeth to the original anatomy and contours. This is done very carefully in accordance to occlusal planning (bite). This will cause premature contact on the new restorations and create space between the upper and lower back teeth. However, over time, this space closes and the jaw re adjusts to create contact once more. This can take a number of months. Therefore this treatment is often completely non invasive. Whereas in the past, teeth were cut down to pegs for crowns and veneers to restore tooth wear, we can now use adhesive technology to replace the lost tooth tissue.
 

Our case of the month for May is one involving tooth wear. Tooth wear is a very common problem caused buy a number of factors and usually a combination of them all. The most common cause is night time grinding or bruxism. This can be hugely damaging to teeth. Did you know that on average our teeth make contact for only about 10-20 minutes of the day. During night grinding, the average contact time is 4 hours! It does not take a rocket scientist to figure out this is far too much contact which will lead to loss of tooth enamel. Just take a look at our case:
 

Our case of the month for October involves composite bonding of the lower front teeth which were heavily worn and using a principle called the Dahl technique. This technique is not very well known but it is fantastic method for treating worn down teeth where there is no space to restore them. For example, when your front teeth wear down due to grinding, acid erosion, bad habits (biting pens, nails etc), there is often little space to restore the teeth using conventional fillings. In the old days, the teeth may have been cut down for invasive procedures such as crowns or veeners. The Dahl technique involves the careful restoration of the worn teeth directly or indirectly with little, if any, tooth preparation. This must be with precision so that the contact on the new restorations is in such a way that the unworn teeth can slowly re-position and make contact over time. Usually this takes 12-16 weeks to occur but what a concept! For example, just take a look at our case below:
 

Our case of the month for June involves repairing worn and fractured edges of the upper front teeth using composite bonding. Cosmetic bonding is a fantastic technique to repair teeth using minimally invasive dentistry. The process involves NO drilling, NO needles and NO pain. Please take a look at our case: