Tooth abrasion during chewing is called. Why do teeth wear out and what to do about it? Physiological wear of teeth

Oral health is a very topical issue for many. From how beautiful and healthy a person's teeth look, one can judge his health, grooming and status. Ecology, stress, neglect of problems oral cavity and non-systematic visits to the doctor contribute to the education various problems and dental diseases.

Pathological abrasion of teeth is an actual problem. This is a normal physiological process of the body. In people who have correct bite, brushing tooth enamel upper teeth begin with inside, and the lower ones, respectively, outside. The problem may arise when a person reaches more than middle age and develop into a pathological process.

According to statistical studies, 12% of the world's population is prone to pathological abrasion of teeth (men are at greater risk - 63%). By the age of thirty, a certain layer of enamel is gradually erased, and after fifty, the erasure of the dentin layer is often recorded. If such problems begin to appear at a younger age, we can talk about pathological character this problem.

The main reasons for the appearance

Anatological abrasion of teeth is commonly called the systematic erasure of enamel (in some cases, enamel and dentin) of all or several teeth. The level of neglect of this process can only be determined by a doctor, using the main methods:

Examination of the model of the jaw on the cast.
Electrodiagnostics.
Electromyography.
Orthopantography.

Causes of dental pathology

Specialists combine the main causes of this anomaly of tooth enamel into two groups, namely:

- Functional lack of hard tissues of teeth:

- Wasting of human teeth due to problems associated with:

loss of teeth (partial);
bad habits, which very often cause systematic injury to a person’s teeth;
the resulting hypertonicity chewing muscles a person (may be formed due to tense facial muscles);
foodless chewing.

Classifications of increased tooth wear

The classification of this pathological disease is made depending on the forms and complexity. this disease.

The main degrees of abrasion are distinguished:

Given the level of the erasure plane, the following types are distinguished:

Vertical, most often found in patients with malocclusion. Only the outer side of the tooth enamel is erased.
Horizontal. With the erasure of teeth, the height of the crown decreases.
Mixed. Upon reaching this level of the disease, the erasure of the two previous types is characteristic.

In accordance with the complexity of the process, there are:

local erasure. In this case, one specific area is subject to erasure;
generalized. In this case, the process affects completely all areas of a person's teeth.

Summing up, we can talk about the numerous manifestations of the indicated pathology of the teeth, in which all the enamel can be completely erased or only some part of it, one side - or both at once.

Symptoms of the disease

The symptoms of this disease depend both on the degree of the disease and on its nature.

Violated from the start primary view teeth. If you do not take action, the disease develops, due to which the length of the tooth becomes much shorter than before. The chewing function of a person is impaired. Patients note the discomfort that has appeared when taking hot, cold, sweet or sour foods, which indicates the onset of hyperesthesia.

Impaired chewing function is a sign of a disease called increased tooth wear. Tooth enamel is about five times stronger than dentin, therefore, until the enamel is completely worn away, the symptoms are mild, but as soon as the enamel disappears, the symptoms will become more pronounced.

This pathology requires immediate medical attention, while the symptoms indicate initial stage diseases. The consequences of the disease, if left untreated, can be deformity of the joints, a change in the lower part of the face, the appearance of severe pain.

Diagnosis of the disease

Diagnosis of pathological abrasion of tooth enamel includes a deep analysis of the symptoms. because of a wide range symptoms, only a dentist can diagnose abrasion, taking into account all factors and possible availability other pathologies.

The survey plan includes:

Complete examination and questioning of the patient, study of the history of the disease to determine the forms and stages of pathology.
Inspection of external signs.
Full examination of the oral cavity, the condition of the masticatory muscles of the patient.
Study of the functions of the temporal and mandibular joints.

X-ray, tomography, electromyography can be used to study the picture of the disease.

The initial examination of the patient's face includes the study of the contours of the face, its symmetry and proportionality. Specialists analyze the degree of destruction of the mucous membrane, the level of tooth wear, the state of hard tissues to determine possible complications during treatment.

Examination of the chewing muscles allows you to study their condition, possible asymmetry and hypertonicity. In this case, electromyography is often used. All this helps to minimize possible complications.

The study of the temporal and mandibular joints allows you to determine the various types of pathologies that can form with this type of disease.

Electroodontodiagnostics, or EOD. This type diagnosis is necessary, since in the pathology of tooth abrasion, pulp death very often occurs, while the patient did not observe any signs of deviation. EDI is prescribed only for the second or third degrees of the disease, since in the initial stage the symptoms do not appear.

Diagnosis allows you to identify the main causes of the formation of increased abrasion of teeth. In addition to the oral cavity, doctors focus on the condition of the temporal and mandibular joints.

Forms of treatment

The treatment of this problem takes a lot of time, this is due to the huge variety of factors that affect the problem. In addition, it is important to determine the stage of development of the disease, this will help to choose proper treatment and speed up the process.

To cure pathological abrasion of the first and second degrees, doctors first of all stabilize already running process so that the disease does not develop.

At the initial stage, doctors install temporary prostheses (to start the recovery process and maintain chewing functions). After positive dynamics can be traced, temporary prostheses are changed to permanent ones.

Treatment over running stages disease (third and fourth) begins with the restoration of the bite. At this stage, experts strictly prohibit the installation of crowns, as this can cause malocclusion at the patient. As a result of their establishment, tooth tissues can be violated.

The manufacture of prostheses is an important issue. On the entry levels In the development of this disease, prostheses are most often made of plastic, ceramics, sometimes the choice falls on prostheses made of precious metals. In the case when the disease has gone far, prostheses made of ceramics or metal-ceramics are often used.

When installing prostheses, it is important to remember that the prostheses must be made of the same materials, otherwise you can come to the reverse (repeated) correction of the bite.

If the cause of pathological abrasion of teeth is a strong load or periodic contraction of the masticatory muscles, experts recommend installing prostheses that are not prone to cracks (more durable): made of metal-plastic or metal. Metal ceramics in this case is strictly prohibited.

The main stages of treatment:

By installing temporary prostheses, doctors correct the height of the bite.
Analyze the adaptation of the teeth to the new position.
After positive results temporary dentures are replaced with permanent ones.

Restoration of the height of the occlusion at the first stage occurs through the establishment of the so-called plastic caps.

The adaptation period is the adaptation of the patient to other positions of the jaw. Most often, this period is characterized severe discomfort. The patient must attend dental office at least twice a week, this is necessary for strict control and research of the results of wearing mouthguards by the dentist. Most often average duration Wearing temporary mouthguards takes about two to three weeks. It should also be taken into account that adaptation begins from the moment when the patient stops complaining about discomfort in the temple area, mandibular joint, as well as in the area of chewing muscles when eating.

The third stage of treatment is the installation of permanent prostheses (final prosthetics). At this stage, special materials are selected in order to achieve the preservation of a correctly set bite. To achieve maximum good results doctors in the manufacture of prostheses take into account the results obtained when wearing medical mouthguards, which were installed temporarily.

The process of permanent prosthetics can take place both immediately and in stages. Mouthguards help determine the exact occlusal height for the patient. Prostheses for the remaining sections begin to be made after the complete fixation of the first permanent prostheses.

Prevention of tooth wear

To protect yourself from the disease or from the appearance of its re-emergence, you must adhere to the following rules and recommendations:

Treatment prognosis

The prognosis for the treatment of this disease is generally positive. Of course, treatment takes a much shorter period of time if the patient applied in the early stages of the disease. In addition, younger patients are more likely to recover quickly. However, recurrences of the disease of pathological abrasion of teeth often occur, so dentists talk about the need to register patients suffering from such a pathology.

Healthy and beautiful teeth this is main factor human health, as well as its full existence. It is extremely important that the oral cavity and dentition is always normal. But sometimes it is quite difficult to keep teeth in normal condition throughout his life. Various negative factors- harmful ecology, use junk food, poor hygiene oral cavity, stressful situations, the presence of bad habits - all this can lead to increased wear and tear of the teeth. In addition, with age, wear of tooth enamel is observed. However, sometimes increased abrasion can be observed at a young age, in these cases it is worth contacting a doctor immediately, because this violation indicates various pathological processes in the body.

The process of erasing teeth is common physiological phenomenon. It is observed throughout the life of every person. If there is a correct bite, then the upper teeth are erased from the inside, and lower units from the outside. This erasure is considered physiological, and while human body still young, it proceeds normally.

The erasure of tooth tissues occurs in every person, this occurs as a result of a natural physiological function - chewing.

Features of the physiological abrasion of teeth:

At the age of 30, the erasing process occurs completely imperceptibly, because it is quite insignificant. During this period, there is a slight abrasion of the crowns, also the tubercles become a little smaller, all the irregularities are smoothed out. As a result, the crowns of the incisors take on an even and smooth structure;
By the age of 50, the wear process increases, but the structure of the tooth enamel remains in perfect order;
At the age of 50 there are major changes. First, the process of erasing the enamel layer to the maximum level is observed, and after that, the erasing of the dentin occurs. Sometimes there can be more severe losses.

However, with age, this condition can become pathological. Usually this process is observed at the age of 25 or 30. This state may come on abruptly. It is usually referred to as a non-carious pathology of the oral cavity.
According to latest research, about 12% of the inhabitants of the entire earth are subject to pathological wear of the structure of the teeth. Men are more affected by this disorder, almost 63% of cases.

What it is

Increased abrasion of teeth is a high abrasion of the structure of dental tissue. As a result, all this causes a slow decrease in the height of the crown. As a result pathological condition there is an increase in sensitivity, a change in the shape of the crowns, which leads to occlusion of the jaw.
The severity of this pathological process determined only by the attending dentist. He must inspect general state dentition.

Pathological tooth wear is the result of mechanical, biophysical and chemical exposure on the teeth, in connection with which defects are formed, the height of the teeth decreases.

Apart from visual inspection procedures must be followed:

An impression of the dentition is made. The resulting models must then be carefully examined;
Electrodiagnostics are carried out;
Examination using electromyography;
Orthopantography is done.

The reasons

The pathological erasure of the dentition can be influenced by absolutely different factors. Therefore, it is worth considering the main reasons that cause this unpleasant process:

Removal of a single dentition, installation of a prosthesis or braces. In this case, an uneven load appears on neighboring and other teeth. For example, when removing the root chewing rows, the main pressure will be on the area with canines and incisors;
The presence of increased wear of the teeth in cases where there is an abnormal bite or violations in the structure of the jaw. For example, with a direct bite, there is a rapid wear of the area with the cutting and lateral edges of the frontal units of the dentition;
Bruxism.
Attention! This is a disease in which an unconscious person grinds his teeth at night. As a result of this, the structure of the enamel is destroyed;
The occurrence of erasure during professional activity. Some professions, namely confectioners, chemists, factory workers, oblige people to work in adverse conditions. During work, it is often necessary to use various harmful chemicals, materials, particles of which can settle on the surface of the skin, as well as on tooth enamel. All this can accelerate the process of enamel destruction;
Low tissue hardness. In the presence of such unpleasant diseases as hypoplasia, the state of erosion of the enamel structure, a wedge-shaped defect or fluorosis, the process of thinning of the enamel structure occurs, and a decrease in the degree of hardness is also observed. bone tissue. As a result, all this causes an acceleration of the wear process;
Various systemic diseases. Metabolic disorders, disorders in endocrine system, as well as the presence of certain pathologies of a specific nature, all this leads to a decrease in the properties of the resistance of the tooth tissue;
If the diet is poorly regulated, and also if it contains a large number of harmful products. A large predominance in the menu of solid foods - apples, carrots, seeds, nuts and so on. In addition, if the menu has a large amount of soda, confectionery, sweets, muffins, sour foods and drinks. All this causes a deterioration in the condition of the teeth, reduces their hardness and causes increased abrasion;
Having bad habits.
Attention! Smoking, drinking alcohol negatively affects the condition of the bone tissue of the teeth. These factors cause premature abrasion and tooth decay. In addition to this to bad habits it can be attributed to holding various objects in the oral cavity, opening bottles, cans with teeth, as well as using them for unsuitable purposes can lead to the appearance of cracks, chips on the teeth and premature abrasion;
The use of certain aggressive drugs. Especially when using drugs containing hydrochloric acid;
Doing heavy physical activity. Often athletes, and sometimes loaders, have increased tooth abrasion. This is due to the fact that lifting weights these people have to tightly close their teeth.

Classification

Usually, increased erasure is divided depending on the nature and degree of development of the pathology.
There are several degrees:

First degree. At this stage of the pathological process, the upper layers of the enamel coating of the incisors are obliterated, while the dentin is not affected;
Second degree. There is a complete erasure of the enamel. In addition, all chewing tubercles are erased, the structure of the crowns is erased until a layer of dentin appears;
Third degree. More than half of the crowns are worn out. The tooth cavity is visible through the row;
Fourth degree. This is the last step. In this case, there is a complete erasure of the crowns of the teeth to the neck area.

According to the second classification, this violation is considered depending on the erasure area:

Vertical. This species is characterized by deletion outside dental unit. This condition is usually observed with malocclusion;
Horizontal. The erasing process occurs with a decrease in the height of the crown;
Mixed. This process is characterized by the combination of two pathological processes of erasure.

Vertical abrasion of tooth enamel is one of the clinical forms of increased tooth abrasion.

Depending on the nature of the course and distribution of this violation, two varieties are distinguished:

Local. In this process, only one area of the surface of the dentition is erased;
Generated. The process of erasure is observed throughout the dentition.

Symptoms

This process is usually accompanied increased erasure top enamel layer. In the future, wear of soft tissues - dentin - is observed.
During the release of dentin, tissue wear occurs at an accelerated rate. At the same time, places with chips appear, sharp corners, dents. All this causes the appearance of various microtraumas of the tongue, mucous membrane, lips.

Wounds on the tongue can be caused by trauma to the mucous membrane with chips, sharp corners, roughness of the teeth as a result of their increased abrasion.

At the initial stage of this process, the following symptoms are observed:

Appearance hypersensitivity the enamel layer to temperature changes, as well as mechanical, chemical influences;
There may be sharp pain when consumed very hot or cold food or drinks;
Unpleasant sensations can cause various sour, spicy, salty dishes;
Pain can occur when the brush touches the teeth when performing morning hygiene procedures.

During the appearance of dentin, sensitivity may decrease, one progression of wear increases several times.
With the intensification of this pathological process, shortening of the painter is noted. Patients may experience symptoms of drooping of the corners of the lips, the appearance of problems and discomfort in the temporomandibular joint. Sometimes there may be hearing problems, pain in the tongue.
In addition, there is a change in bite. This causes problems when chewing or biting food. It happens that all these violations have negative impact on the state of the digestive system.
During increased abrasion, the entire process can eventually shorten the tooth down to the neck. In this case, through the defects in the dentin, it will be possible to see the cavity.
Special attention should be paid to the symptoms in workers on hazardous industries:

When exposed to various chemicals, uniform damage to the enamel occurs;
The formation of the same surface is observed, while there are no fissures;
The surface of the teeth has a matte finish without plaque and calculus;
Occasionally, exposed, flattened dentin may appear;
If a person works in the production of harmful chemical acids, then he often has tooth wear to the very neck;
Under influence harmful acids the appearance of roughness, pain, discomfort during chewing may be noted.

On the last stage often there is mobility of the dentition, a change in the position of the units and their loss. Sometimes there is a resorption of hard tissues at the dental roots and partitions.

Inspection and diagnostics

First of all, it is necessary to assess the general condition of the patient, determine the degree of the pathological process, and conduct a diagnosis.
When diagnosing, the dentist performs the following procedures:

He consults with the patient, collects all the data of the anamnesis, listens to all his complaints;
The doctor must definitely find out whether there are factors such as pain, whether there is hypersensitivity, aesthetic changes, as well as functional changes;
A visual examination is carried out, in which the proportions of the face are evaluated, and the condition of hard tissues and oral mucosa is studied;
Palpation of soft tissues is done. This will help to identify the presence of underlying pathological processes;
Palpation and auscultation of the jaw joint is performed;
Mandatory computer examination, with which the doctor will be able to study the model of the jaw, determine the shape, as well as the degree and depth of damage to the tooth;
Application additional surveys- X-ray, consultation with a neurologist and so on.

A regular visit to the dentist will allow you to identify the problem of increased collection of teeth at an early stage. And accept necessary measures for treatment and prevention.

Treatment

Treatment of this pathological disorder usually carried out by dentists, as well as a therapist, orthodontist, orthopedist.
At the beginning medical therapy the first causes of erasure are eliminated. In this case, the following procedures are carried out:

Various dental and systemic pathologies are cured;
A normal bite is established;
Prostheses or implants are changed;
are recovering extracted teeth. Artificial crowns are installed on their sites.

Together with the treatment, the application is prescribed additional medicines, food additives, vitamin and mineral preparations. All these funds will be able to quickly replenish all necessary components normalize the intake of calcium, mineral salts, fluorine, as well as others useful elements for teeth.
Then elimination is performed. For this, remineralization is used. But at the same time, the patient continues to use vitamin preparations, attends physiotherapy procedures. Also, applications are additionally made, which basically have fluorine-containing components.
All sharp edges, chips, protrusions must be sanded. They should have a smooth and safe surface for the soft tissues of the oral mucosa and tongue.
In the presence of defects, gaps in the dentition, correction is carried out with the help of prosthetics and implants.
If there is burksism, then in these cases the doctor prescribes night guards. These components will help protect the fabric from wear and tear during nighttime teeth grinding.

Kappa is the most effective method treatment of bruxism, night mouth guards do not allow the teeth to close during a spasm of the jaw and facial muscles and, as a result, prevent their erasure.

At the final stage of treatment, the natural shape of the teeth is restored. Various means are used for this:

filling materials;
Stump tabs;
Veneers;
artificial crowns;
Lumineers;
Artistic restoration.

Prevention

In order to prevent recurrence or the onset of the process of increased tooth abrasion, the following important preventive measures should be taken:

If there is an abnormal bite, then it is necessary to consult a doctor in a timely manner to correct this violation;
When teeth are removed, dentures must be placed in their place. This will prevent stress on adjacent teeth;
If there is burksizm, then it is necessary to take all possible measures to eliminate this pathology;
Be sure to observe the necessary oral hygiene;
When working in hazardous industries, use protective equipment;
It is necessary to take drugs that are prescribed by dentists to strengthen tooth enamel.

It is important to identify pathological abrasion at the very first stage. When the first signs of this disorder appear, it is necessary to consult a doctor in a timely manner. It is worth remembering that with delay, there may appear serious pathologies teeth, up to and including their complete erasure.

We all know that teeth are a reflection of the body, however modern world cruel, and the environment affects the condition of the teeth is not the best way. Constant stress, irregular sleep, poor nutrition, all this adversely affects the body and even leads to early mortality, all this makes us think about our health and the condition of our teeth. Modern technologies have stepped far forward, and if 50 years ago the word “dentist” inspired quiet horror, now this doctor does not cause any concern, since the latest technologies make it possible to treat teeth almost painlessly. Everything today less people afraid to go to the dentist, not only for consultations, but also for dental treatment. AT recent times Quite often, dentists are approached with the problem of tooth wear, but how does this happen and how to deal with such an unpleasant situation?
Today, in order to be successful, you must have beautiful smile, a bad smell from the mouth or a damaged tooth can prevent climbing the career ladder or cause unpleasant situations in personal life. However, the bad odor the only problem Nowadays, more and more often dentists are asked what to do if teeth are worn out?

Why do teeth wear out?

This problem has become very younger, if earlier 50-year-olds dealt with similar questions, today you can even meet teenagers with worn enamel. The whole point is that modern man used to a variety of sweet carbonated drinks and candies, and they contain quite a lot of acid, which gradually destroys the structure of the tooth. Increasingly, it is observed that stressful situation people clench their teeth tightly, which is also one of the factors in the rapid erasure of teeth, and often this very stress is transferred to sleep and then a person grinds his teeth in a dream.

However, do not immediately abandon delicious drinks and sweets and drink handfuls of sedatives. It will be enough to drink acid-containing drinks not from a glass, but through a straw, and at a stressful moment, control yourself as much as possible. If you work in production, then you should use protective equipment, for example, respirators, which will prevent abrasive particles from entering the oral cavity, but if production is associated with acids, then you need to rinse your mouth regularly soda solution. And of course, visiting a qualified dentist increases the chances that the problem of tooth wear will affect you as soon as possible. Therefore, if your teeth are erased, go to the doctor immediately.

From the very moment of teething, the gradual grinding of the upper layers of hard tissues begins. This is a completely normal physiological phenomenon that continues throughout life. But sometimes under the influence of any internal or external factors, habits or other reasons, the teeth begin to wear out faster. Today we will tell you what pathological abrasion of teeth is, why enamel is erased and how to restore the ideal appearance with modern dentistry.

Physiological aspect

Teeth wear very slowly, even in babies. This is a natural process that the body needs in order to adapt to the loads on the dentoalveolar system, to evenly distribute them. So partial tooth abrasion is not a critical problem. Due to this, the dentoalveolar apparatus is not overloaded in certain areas, periodontium does not suffer.

Partial wear slowly leads to a change in contacts when closing the jaws from point to planar. Even the slope of the teeth may change. Normally, only a certain amount of enamel is erased in the area of contact planes without affecting the dentin. This happens gradually from birth to old age.

Up to 30 years, the front teeth are slightly worn out, the tubercles of slightly worn premolars and molars become smoother.
By the age of 50, only enamel is erased without damaging other tissues.
In old age, the situation becomes more serious - you will erase not only fragments of enamel, but also dentin. Sometimes the dentin itself can be damaged.

If a physiological processes accelerate, then this is pathological abrasion of teeth. It is accompanied by unpleasant manifestations and needs serious restoration.

Why do teeth wear out faster?

Increased tooth wear can be caused by dozens of factors. Only a doctor can determine why the enamel on the teeth is being erased on the basis of a visual examination and a detailed conversation with the patient. We can only list the most common causes.

Violated bite - teeth begin to wear out due to uneven load. The most negative effect is a direct and deep bite.
Loss of several teeth, resulting in an uneven distribution of the load.
Bruxism is the involuntary clenching and grinding of the teeth, predominantly at night.
Incorrect prosthetics.
professional costs. For example, if a person works in a factory with constant contact with acid or in rooms with air polluted large quantity abrasive particles.
With some diseases, the enamel becomes soft, so the teeth can wear out much faster.
The presence of a hereditary factor cannot be excluded.
If your enamel on your teeth has worn off prematurely, then this may indicate some systemic diseases. This is what happens when you get sick. endocrine gland, central nervous system, frequent or constant intoxications.

As you can see, there are a lot of possible reasons. Therefore, only a qualified doctor, knowledgeable of classification pathological abrasion of teeth, will be able to find out why there was an acceleration natural processes exactly in your case.

What are the symptoms?

Pathological abrasion of teeth never goes unnoticed, as patients begin to notice a number of very unpleasant symptoms accompanying worn enamel.

The edges of the teeth are destroyed, forming very sharp forms permanently damaging the delicate membranes of the mouth and tongue.
Teeth become shorter, which inevitably leads to malocclusion. The contours of the lower part of the face can also change.
The position of the TMJ changes, often leading to various injuries or simply painful sensations in this region.
Attacks of toothache can occur from any irritant: cold, hot and spicy food or slight mechanical impact.

Stages of development of pathology

Pathological abrasion of teeth, depending on the intensity of damage, is divided into four stages. Each of them requires a specific treatment.

At the first stage, there is not very strong abrasion of the enamel and a small part of the dentin. Damaged mainly enamel on the front teeth, canines, tubercles of molars and premolars.
At the second stage, chewing tubercles are completely erased. This exposes the dentin tissue, but without the formation of cavities.
In the third stage, the height of the crown is reduced by a third of the original volume. Replaceable dentin tissues are damaged, tooth cavities begin to shine through.
In the fourth stage, the entire tooth crown is completely erased.

By localization, only a few teeth or the entire row can be damaged. The form of abrasion can also be different: horizontal, vertical, patterned, cellular, faceted, stepped or mixed.

Diagnostic methods

Increased tooth wear requires a detailed diagnosis in order to determine what to do and which ones to choose. medical measures to fix the problem.

First of all, the dentist will assess the condition of the enamel, the degree of reduction in its volume and dentin.
This will be followed by a check of the work of the TMJ.
An inspection will be carried out skin, nasolabial folds, mucous membranes of the tongue and cheeks. Be sure to perform palpation of the masticatory muscles to identify possible soreness.
The position of the jaws is checked central occlusion and symmetry of mouth opening.
The doctor will ask you to close your teeth in central position to listen to the sound playing at that moment. A creak will tell him about the degree of disruption of the temporomandibular joint, a dull and prolonged sound - about problems of a different nature. Normally, a sonorous, clear and short sound should be heard.
Hypersensitivity of teeth almost always indicates pathological abrasion.

Based on the results of the conclusions made, the doctor may prescribe additional research to determine the cause of the problem.

Treatment Methods

Depending on the nature and degree of pathology, the treatment of tooth abrasion will be different. In general, this is a rather complicated process due to the fact that there can be a lot of reasons for the rapid erasure of enamel. In each individual case, treatment will be selected individually, based on the identified causes, the nature and extent of the disease, and the characteristics of the patient himself. First of all, they try to eliminate precisely the causes that could lead to this unpleasant phenomenon. This may require:

correction of malocclusion;
carrying out a complete with treatment of all concomitant diseases;
prosthetics damaged teeth;
treatment of bruxism with the use of special caps;
if the disease is associated with working conditions, it is recommended to change professional activities.

In any case, measures are taken to strengthen the enamel by treating them with fluorine-containing preparations. Before proceeding directly to the treatment of increased tooth wear, all sharp edges are carefully smoothed so that they cannot injure the mucous membranes of the cheeks, tongue and lips. After that, depending on the degree of the disease, appropriate treatment is prescribed.

On the initial stages after elimination of the main cause, metal-ceramic crowns are installed. In some cases, teeth are restored not with crowns, but with composite materials. But if the underlying cause is not eliminated, then the enamel will continue to wear off. On the late stages prosthetics are also used, but in combination with orthodontic treatment, thanks to which the correct bite is restored.

Throughout the entire period of treatment, it is often recommended to wear special mouthguards that will make the desired bite height. All tissues that take part in the chewing process should get used to the new position after prosthetics: temporomandibular joint, muscles, periodontium.

How to prevent pathological abrasion?

If you have pathological tooth wear, then you will not stop it completely, but you can very well slow down this process if you carefully monitor your health.

Contact your dentist in a timely manner if you experience increased tooth sensitivity, pain in the temporomandibular joint, and other unpleasant symptoms.
Periodically carry out the procedure of strengthening the tooth enamel with fluoride preparations.
If you have even minor malocclusions, then contact an orthodontist to correct them.
If you lose a tooth, do not hesitate to install a prosthesis. This will help to avoid malocclusion.
Don't ignore bruxism. This is a disease that requires mandatory treatment and wearing special caps.

Even if you have a predisposition to increased enamel wear, you can slow down this process and keep your teeth healthy. The main thing is to contact the dentist in time. In conclusion, we recommend that you look informative video in which the specialist will talk about this pathology.

Tooth decay is a problem that anyone can face. This is a pathology that concerns all surfaces of a tooth (or a group of teeth) in the form of an intense loss of its hard tissues. More often this problem occurs in men, less often in women. In general, it occurs in almost 13% of the population and occurs in people over 30 years of age. If you seek help from a specialist in time, tooth decay can be prevented and cured in the early stages.

Increased tooth wear can occur for various reasons. Therefore, first the specialist must determine the nature of its origin and fully diagnose the pathology. For this, patients are given clinical examination both complex and sequential. The patient's sensations are recorded, as well as the results of diagnostics of other specialists. This will help determine which treatment option is needed in a particular case.

Increased tooth wear

What causes tooth decay?

Increased abrasion of teeth can appear as a result of overload after the loss of teeth, if improperly selected, there are harmful effects associated with professional activity, and also - with malocclusion and fragility of dental tissues (hypoplasia, fluorosis).

Overloading of the teeth falls, for the most part, on the canines and incisors in the absence of molars. Usually, tooth wear occurs evenly over several years in such a way that by the age of 40 the length of the teeth is reduced by 20-30%. With a properly formed bite from childhood, the main erasure falls on the front teeth (cutting edges) and chewing areas of the lateral teeth.

Increased abrasion of teeth is observed in persons employed in the production of inorganic and organic acids. Also, people whose work is associated with the release of metal particles into the air are most susceptible to such a disease.

The resistance of teeth to abrasion is reduced in people who suffer from systemic diseases. from this type of pathological phenomenon is often required by those who have Stainton-Capdepon syndrome and endocrine disorders.

Pathological abrasion can usually be caused by characteristic chewing, in which excessive load affects some teeth (groups of teeth). As a result of this exposure, complications arise:

periodontal,
pathological abrasion due to lack of functionality of hard dental tissues.

It is not uncommon for the abrasion of individual teeth that antagonize with those sealed with composite materials teeth. As a rule, due to the abrasive properties of such materials, fillings begin to protrude, affecting adjacent teeth, exposing them to abrasion.

When is it necessary to start treatment?

In the early stages, pathological abrasion of teeth manifests itself as a decrease in the occlusal height of the teeth. Discomfort and discomfort the patient usually does not. However, treatment is necessary to prevent progression of the process. Depending on the degree of neglect of increased pathological abrasion, the treatment plan may differ in accordance with individual needs and the etiological factor.

For patients with mild signs of abrasion, selective grinding is prescribed as a preventive measure. Physiotherapy and drug treatment recommended for patients with dentinal hyperesthesia. When conservative methods do not have the desired effect, patients are prescribed, the action of which is mainly aimed at restoring the functions of the teeth due to their prosthetics.

Metal stamped crowns are not currently a popular material. Treatment of increased pathological abrasion of teeth with the use of such crowns can aggravate the onset destructive process. This is due to the shortcomings of the material:

metal crowns can wear out over time
can move into the gum pocket, destroying the circular dental ligament,
capable of causing chronic inflammation marginal periodontal teeth, if the circular ligament is damaged.

Therefore, now they occupy a leading position in the prosthetics market.

Metal cast crowns.

The type of prosthesis is selected individually, according to the indications of examinations. If the abrasion of hard tissues of the teeth at the time of the examination is about 2-3 cm and does not violate them anatomical shape from the vestibular side, treatment using tabs is prescribed. The worn occlusal surface is covered with such material. For this reason, tabs can be various forms. As sites for strengthening the tabs can be:

retention pins,
pits in dentite
cavities affected by caries.

With small amounts of abrasion, treatment can be carried out using artificial crowns all types.

If the patient has a pathological increased abrasion sunk hard tissues teeth in a generalized form, treatment may include the use of both inlays and crowns. Usually this form of treatment involves covering the teeth of the opposite row. It concerns the teeth, which are located in 3 groups:

front
chewing right
chewing left.

In situations where increased abrasion is seen in children or adolescents, treatment is prescribed using one of the varieties of artificial crowns. This system, created by T.V. Sharov in 1990, is a combined cap-loop design. It is used if patients have broken off the corner or the entire cutting edge of the tooth, as well as the loss of half or ¾ of the length of the crown. The name of the design is associated with the principle of its attachment, since the cap covering the chip fixes the loop, and then an individual cast is made. Such a system is produced following a simple technology. It can be executed at any dental laboratory titanium and titanium wire.

Below is detailed video about tooth wear :

Crowns as a way out

Treatment in the form of restoring the anatomical natural shape chewing teeth is made using one of the variants of cap-occlusive crowns, in which the fixing part is made of metal in the form of a thin-walled cap. And the restoring part can be represented by three varieties:

1) cast metal,

2) plastic,

3) combined.

The specialist faces two tasks at the same time to restore and create the correct form of the occlusal height, if the patient is found to have pathological abrasion, which is accompanied by a rapid decrease in the occlusal height in the dentoalveolar system as a result of the abrasion of the lower and upper teeth. The treatment of abrasion in this case will be orthopedic. Prostheses are created by technicians based on individual diagnostic models.

Restoration and normalization of the dental system

If a patient is diagnosed with a pathological increased abrasion of teeth, rapidly changing bite, he is prescribed step-by-step treatment. The main task for a specialist, this is:

adjust the occlusal height,
establish occlusal-articulatory relationships between the rows of teeth,
restore the functioning of the neuromuscular system,
save the temporomandibular joint from overload, as well as eliminate complications.

To do this, at the first stage, the doctor restores the functioning of the temporomandibular joint and muscles, by returning to the normal mode of interalveolar height. The second step is the restoration of the correct shape of the teeth due to their prosthetics.

Dental prosthetics - a panacea for abrasion

Treatment of abrasion in stages can be carried out using different methods. Each doctor chooses a technique depending on the specific case.

If a patient has an increased pathological abrasion of teeth formed big difference(6 mm) between the height of 1/3 of the lower part of the patient's face when the jaws are closed in the rest position without the formation of a distal shift, treatment to restore and increase the interalveolar height can be performed simultaneously. To do this, the author, using removable mouth guards, raises the height to the normal position. If within 2-3 weeks the patient does not have other pathologies and there is no disorder of the temporomandibular joint, the doctor proceeds to the final prosthetics according to the method chosen by him. In cases where, during this period of time, the patient complains of pain in the joint, the specialist works to reduce the height in order to bring it to the required level by another rise after some time.

The treatment of abrasion, which has led to a violation of the height of 8 mm or more, should be carried out in several stages. Thus, it will be possible to exclude unwanted muscle reactions. jaw system in response to the new position of the joints. Increased pathological abrasion, reaching 8 mm, is treated according to a method that includes the use of bite plates with healing effect. In such situations, before treatment, the patient is prepared by monitoring the movements of the jaws and their condition under X-ray control.

To restore and fix the occlusal height with increased pathological abrasion, the doctor can use both conventional stamped crowns and crowns with a soldered or cast overlay designed for the chewing surfaces of the teeth. In addition to the fact that such structures are able to withstand loads, they are quite wear-resistant, which ensures a long service life. Such crowns are recommended if pathological abrasion of teeth is accompanied by bruxism. Doctors also use them when the use of other structures (cast, metal-ceramic, etc.) is excluded. When installing stamped crowns on the front teeth, the occlusal surface of which is cast, they should be additionally veneered.

Production of metal-ceramic crowns

Before proceeding with the manufacture of individual models of metal-ceramic crowns for the anterior teeth, the specialist must first restore the occlusal height and hold in order to stabilize the correct bite. Designs of prostheses are selected based on clinical indications. This creates a space for the installation of metal-ceramic crowns on the front teeth. In such situations, if the bite is straight, the cutting edges of the anterior teeth are not subject to grinding.

More hard work to a specialist if the pathological abrasion has touched more than half (2/3 of the part) of the crown of the teeth. The main task for the author in such situations is that it is necessary to set the occlusal height to a normal level in order to restore the anatomical shape of the teeth. To do this, stump-shaped cast pinned tabs are strengthened on the anterior and lateral teeth, which were affected by abrasion. Solid crowns, which will subsequently be installed on top, can be plastic, porcelain or lined. The difficulty of the work lies mainly in the manufacture of stump inlays, since the increased pathological abrasion of teeth by 2/3 or more of the length of the crown significantly reduces the volume of the oral cavity. This is because replacement dentin is deposited in the lower incisors or premolars (molars). Often, obliteration (partial or complete) of the root canals also occurs in these areas.

Treatment and prosthetics of teeth, if the length of the crowns is erased, by more than 2/3 of the part, occurs using removable structures with overlays, if possible root canals no such teeth.

Orthopedic treatment - nuances

Orthopedic treatment of pathological abrasion, if the integrity of the dentition is preserved, and the pathology is organic, also presents certain difficulties. As a rule, at the same time, contact with antagonists is maintained in teeth subject to abrasion, due to vacant hypertrophy of the alveolar process. And the violation of the interalveolar height does not occur. Treatment of patients with this pathology is carried out by specialists in two stages. The first is to create a place under the prosthesis. The second is the installation of a prosthesis. In most cases, pathological abrasion concerns the anterior teeth. At the first stage, they are covered with a plastic mouthguard when the lateral teeth are separated. Perestroika in alveolar process stimulated by the functional load that occurs in the area of worn teeth. Thus, there will be enough space for the prosthesis after 3-4 months. Treatment of teeth in patients of mature age by this method is not performed. This is due to the fact that in old age it is almost impossible to achieve restructuring. Therefore, increased tooth wear is prevented in such patients by increasing the interalveolar height in accordance with the height of the crowns within the optimal height at rest.

Below is a video about the fight against tooth abrasion, through the eyes of a specialist :

Pathological abrasion of teeth can be eliminated in the early stages of manifestation. Therefore, at the first concern and signs of malocclusion, consult a dentist. The specialists will complete diagnostics advise and help you choose best option treatment.