Reasons for deletion. Pathological (accelerated) tooth wear: causes and consequences. The difference between natural and pathological tooth wear

Physiological and increased abrasion natural teeth.

I. Human teeth are an organ that performs the primary mechanical processing of food. Main function teeth identified morphological features their tissues. The crown part of them consists of enamel - the most durable mechanical tissue. withstanding great pressure when chewed, the enamel, however, has considerable fragility, and resists sudden loads in the form of a blow. The latter lead to spalling of the enamel and exposure of the dentin.

The thickness of the enamel layer is not constant: at the neck of the tooth it barely reaches 0.01 mm, at the equator - 1.0-1.5, in the region, the bottom of the fissures - 0.1-1.5, at the cutting edge of unworn teeth - 1.7 , on the hillocks - 3.5 mm. The specific heat capacity of the enamel is 0.23, the thermal conductivity is low (Ktp is 10.5-10 -4). Outside, the enamel is covered with a very dense and resistant to acids and alkalis film with a thickness of 3-10 microns, which at the neck of the tooth is connected to the epithelium of the gum mucosa, being, as it were, its continuation. Shortly after teething, the enamel film wears off, especially on contact surfaces. Structural element enamel is an enamel prism. It is formed in the process of tooth development from adamantoblasts - cells of the inner epithelium of the enamel organ.

With age, the macro- and microstructure of the teeth change. Chewing tubercles, cutting edges and contact surfaces of teeth, both milk and permanent, undergo physiological abrasion. Contact points are subjected to erasure, subsequently turning into contact pads. The abrasion of the contact surfaces causes the teeth to move while maintaining contacts between them, which prevents food from entering the interdental spaces and injuring the interdental tissues. Physiological erasure of teeth is a functional adaptive response, as it contributes to the free and smoother sliding of the dentition, as a result of which overload is eliminated. individual groups teeth. The layer of hard tissues of the teeth, lost as a result of abrasion, increases with age.

Thus, the physiological abrasion of teeth is understood as a compensated, slowly proceeding process of loss of the enamel cover of the teeth, which does not pass to the dentin layer. Age-related changes in the degree of tooth wear are evaluated in points.

No wear (0 points) - up to 16 years;

Smoothness of bumps (1 point) - 16-20 years;

The appearance of dentin on the tubercles and the cutting edge (2 points) - 20-30 years;

Abrasion of the chewing surface, in which the enamel is preserved within the furrows (3 points) - 30-50 years;

Complete wear of the enamel (4 points) - 50-60 years;

Missing half of the crown (5 points) - 60-70 years;

Complete erasure of the crown to the neck of the tooth (6 points) - older than 70 years.

Age abrasion depends on the belonging of the tooth to a particular class. At age characteristic the degree of tooth wear also takes into account the individual typological feature of chewing and increased wear on the functionally dominant side of chewing. Tooth abrasion is due to many reasons, and the degree of its severity varies widely.

However, it must be remembered that as a result increased load teeth, there is not always an increased abrasion of hard tissues. Often this leads to pathological destructive changes in periodontal and pulp tissues. As a result of these pathological changes teeth acquire mobility, and hard tissues(enamel and dentin) are subject not only to increased abrasion, but also to the cessation of their physiological abrasion. This phenomenon is called delayed erasure.

Increased abrasion of teeth is characterized not only by the rapid progressive loss of enamel to the transition of the enamel-dentin border. It may be due to a violation of the histogenesis of hard tissues (enamel and dentin), which is expressed in their inferior calcification. As a result of a violation of the process of calcification, an inferior structure of the hard tissues of the teeth is formed, which is not able to perceive a significant occlusal load and is prone to intense increased abrasion.

Increased abrasion teeth is a progressive (decompensated) process of loss of hard tissues of the teeth with the transition of the enamel-dentin border, which is accompanied by a complex of aesthetic, functional and morphological changes in the dental and periodontal tissues, chewing muscles ax and temporomandibular joints. Erasure of teeth occurs under the influence of various local and common factors. Endogenous and exogenous etiological factors have a significant impact on the development of increased tooth wear. It should be noted metabolic and histogenesis disorders, occlusion features, incisal overlap depth, loss of lateral teeth, the occurrence of traumatic nodes due to the concentration of masticatory pressure, irrational prosthetics, functional disorders central nervous system (parafunctions), the presence of dento-jaw anomalies, the impact of occupational hazards.

Table 1

II. Tooth wear (in points) depending on age

table 2

III. Etiology and pathogenesis of increased abrasion of natural teeth

A.L. Grozovsky (1946) identifies three clinical forms increased abrasion of teeth: horizontal, vertical, mixed.

By length pathological process V.Yu.Kurlyandsky (1962) distinguishes between localized and generalized forms of increased abrasion.

Most fully reflects the clinical picture of tooth wear, the classification proposed by M.G. Bushan (1979). It includes various clinical aspects functional and morphological nature: stage of development, depth, extent, plane of the lesion and functional disorders.

Pathological abrasion is the loss of hard dental tissues: enamel and dentin. Most often, the occlusal (chewing) surface is erased, less often - the cervical and palatine areas. The defect can extend both to one chewing unit and to the entire row. Treatment of the disease is aimed at restoring aesthetic and physiological functions.

Throughout life, human enamel is constantly erased: there is a gradual smoothing of the tubercles and teeth. This process intensifies after 30 years. However, normally, the loss of hard tissues should not exceed 0.034 - 0.042 mm per year. When similar condition observed in children, young people, or enamel and dentin are destroyed too quickly, they speak of pathological tooth abrasion.

According to statistics, pathology occurs in 12% of patients. And more often in men (62.5%) than in women (22.7%). Among the main causes are considered mechanical factors of damage. The disease develops due to:

Important! Increased tooth wear also develops with intense physical activity or hard work. Athletes, builders, loaders while lifting weights can strongly clench their jaws, which leads to tissue loss.

Symptoms

Usually, patients seek medical help in the later stages of the development of pathological abrasion, when there is significant loss of bone tissue. The reason for the visit is the loss of aesthetic and chewing functions.

On the initial stage there is hyperesthesia - increased sensitivity of the enamel. Changes start later appearance teeth. At first, it is slightly noticeable, but as the pathology develops, it progresses.

As a rule, patients find the problem when the destruction reaches the inner layer - the dentin. Due to its lower strength than enamel, crowns are chipped, sharp corners, jagged. In some cases, abrasion helps to reduce carious processes at the initial stage.

At the initial stage, there is an increased sensitivity of the enamel.

Subsequently, speech is impaired. In particular, difficulties are noted when pronouncing the sounds "z" and "s". On the deep stage there is a change in the outlines of the lower third of the face, facial expressions and symmetry, deformation of the temporomandibular joint, malocclusion, mobility of incisors, canines or molars.

Important! One of the signs of the disease is difficulty in chewing food and the formation of wrinkles in the corners of the mouth.

Classification

Increased abrasion of teeth is classified according to several criteria:

1. Degrees of hard tissue loss:

• Stage 1 - abrasion within the cutting surface of the incisors and canines and masticatory tubercles of the molars;
• Stage 2 - the dentin layer is exposed, the crown is erased by a third;
• Stage 3 - up to 2/3 of the tissues are lost;
• Stage 4 - loss of bone tissue reaches the neck of the tooth.

2. Localization of the abraded surface:

• horizontal - the tooth is erased from the cutting or occlusal surface;
• vertical - tissue loss occurs from the lateral parts: palatine, cervical;
• mixed - the tooth is abraded simultaneously from all sides.

3. The prevalence of the pathological process:

• localized - one or more teeth are worn out, its cause is the removal, incorrect installation of prosthetic structures;
• generalized - uniform tissue loss on all chewing and cutting units.

This is what broken teeth look like.

Important! Pathological abrasion is characteristic of both permanent and milk teeth.

Diagnostics

The initial diagnosis consists in taking an anamnesis and visual examination:

1. The reasons for the development of the disease are clarified, whether there is a hereditary factor, the patient's lifestyle and habits.
2. The state of the contact surfaces, the degree of their abrasion is assessed.
3. The oral mucosa is examined and soft tissues are palpated. Excluded possible changes in the work of the temporomandibular joint.

Important! To assess the degree of abrasion, imprints of the dentition are made using wax or silicone material - an occlusiogram. Normally, traces will be visible on the cast at the point of contact of the jaws.

Additionally, the following examination methods are used:

Treatment of pathological abrasion

If tooth wear is detected, treatment is carried out by one of the following methods, depending on the degree of development of the disease:

1. Conservative. A set of measures is being taken to eliminate causative factor, recovery mineral metabolism and . Remineralizing therapy, taking vitamin and mineral complexes, physiotherapy procedures, pastes that help reduce hypersensitivity.
2. Composite restoration. The sharp edges of the crowns are polished, and the lost tissues on the cutting edges and occlusal surfaces are restored with light-curing materials.
3. in an orthodontic way. The dentition is restored with the help of stump tabs, crowns, bridges and prostheses.

Important! There is no single opinion when to start treatment of pathological abrasion of teeth and how exactly to carry it out. An important role is played by the general clinical picture, causes and habits of the patient.

If increased tooth wear is accompanied by bruxism, a protective mouthguard is made. It is worn at bedtime. AT severe cases it may be necessary to pre-elevate the occlusion with dentogingival systems.

If you have problems with the digestive or endocrine system First of all, it is necessary to treat the diseases that led to the abrasion of the teeth.

An important role in therapy is played by the patient's trust in the doctor and his willingness to fulfill the requirements of a specialist. If the patient cannot, due to certain circumstances, follow the chosen method, it is adjusted within reasonable limits, taking into account personal preferences.

Abrasion of the tissues of the teeth cannot be reversed. All therapeutic measures are aimed at slowing down the process and restoring anatomically shaped jaw row. To prevent the disease, it is necessary to timely correct bite defects, bruxism, replace lost chewing units, use protective measures while working in production.

A person's health, as well as his attractiveness, largely depend on the condition of his teeth. Now dentists are increasingly diagnosing pathological abrasion of teeth. The risk group includes men over 30 years old, but no one is immune from the development of the disease. If the doctor has revealed increased abrasion, the disease cannot be ignored, as it can lead to tooth loss. Why does the abrasion process develop? What to do when symptoms appear? How to stop grinding and prevent abrasion of dental elements? Let's figure it out together.

Symptoms of pathological abrasion of teeth

Pathological abrasion of teeth makes itself felt nearby characteristic symptoms. If the patient ignores the signs initial stages development of pathology, then over time the situation worsens, and it becomes much more difficult to restore dental health (we recommend reading:). The main symptoms of pathological abrasion:

• frequent "biting" of the cheeks and lips from the inside;
• pain during meals;
• change in the lower part of the face (if the maximum degree of wear has developed, it decreases);
• with serious erasure, the process of chewing, speech is disturbed;
• if you clench your teeth, the patient will have a feeling that the jaws are “stuck together”;
• the patient feels that the surface of the tooth has become rough due to wear;
• the shade of the enamel changes;
• increased sensitivity to temperature, and subsequently to chemical stimuli;
• there is a wedge-shaped defect (increased abrasion of teeth is sometimes accompanied by this symptom);
• pathological changes develop jaw joints and facial muscles.

Causes of pathology

This article talks about typical ways to solve your questions, but each case is unique! If you want to know from me how to solve exactly your problem - ask your question. It's fast and free!

Tooth wear can develop due to exposure various factors– both external and internal.

To the number external causes, due to which some (or all) teeth are worn out, include bruxism (a phenomenon when a person “grinds” his teeth in a dream), partial loss of teeth, installed dentures, bad habits, as well as work in conditions of increased vibration (we recommend reading: ).

Increased tooth wear caused by internal reasons, is considered more dangerous and more difficult to treat. Sometimes dental elements grind down for reasons of congenital origin. In cases where the wear of dental elements is the result of pathological changes in the body, the disease is usually detected in early age. Among the endogenous causes include:

• osteogenesis, marble disease and other hereditary diseases;
• violation of the process of mineralization and the formation of hard tissues (due to a lack of vitamins and trace elements in the mother's diet during the period of bearing a child or deficiency essential substances in the nutrition of the baby of the first year of life);
• in adults, pathology can lead to increased abrasion of teeth thyroid gland, unbalanced diet, insufficient absorption of calcium.

Ways to classify tooth wear

There are several basic ways to classify tooth wear. One type of classification is based on the form of the disease. Allocate local erasure, when the process affects small areas of the row, and generalized, in which absolutely all teeth in the jaw are erased to one degree or another.

From the point of view of the planes subjected to erasure, the classification looks like this:

• horizontal - in the process of erasing, the height of the crown part of the tooth decreases;
• vertical abrasion - damage occurs to the rear upper teeth and anterior at the lower dental elements (usually due to malocclusion);
• mixed - the teeth are erased in two planes at the same time.

There is also a classification of the pathological process according to the degree of destruction of tooth tissues.

1. If the surfaces of several teeth (usually incisors) are slightly worn, then we are talking about stage I.
2. Stage II is characterized by almost complete destruction of the enamel and exposure of the dentin of the crown part of the tooth.
3. When the affected teeth have worn off by half or more and an open cavity is visualized, stage III is diagnosed.
4. Stage IV is characterized by almost complete erasure of the hard tissues of the tooth, which is destroyed almost to the ground.

Diagnosis of the disease

For diagnosing increased tooth wear important role plays the contact between the dentist and the patient. It is not enough for a doctor to identify the very fact of the development of the disease - you need to correctly establish the cause. Otherwise, it will be almost impossible to choose an effective treatment strategy.

To establish the causes, degree and form of tooth wear, the following diagnostic methods are used:

• visual examination of the patient's oral condition;
• survey - the doctor should inquire about the lifestyle, clarify the presence or absence of metabolic disorders, hereditary diseases, ask questions about the specifics of work;
• electroodontodiagnostics;
• x-ray;
• if necessary, to identify serious illnesses palpation is often performed;
• may be required additional consultation narrow specialists, including a neuropathologist.

Treatment of the disease

You should be prepared for the fact that the process of treating tooth abrasion will be laborious, take a lot of time and require frequent visits to the doctor. You may have to visit not only the dentist, but also other specialists. Everything will depend on the characteristics of the course of the disease and the reasons that provoked it. AT general case The stages of treatment of pathological abrasion of teeth will look like this:

• stop the process of tooth decay;
• elimination of the causes of increased abrasion;
• restoration of the protective layer of enamel;
• return of the initial level of the crown part of the teeth;
• if necessary, replacement of the prosthesis;
• adaptation to the updated position of the jaw.

Restoration of the dentition can be carried out using various devices and techniques. The dentist will select the best option based on the individual characteristics of the structure of the patient's jaw, as well as on the course of the disease. These can be braces, dentures (temporary), caps, inlays or other structures.

The initial height of the restored crown is higher than that to which the patient is accustomed. For this reason, he is given several weeks to adapt. If the patient complains about pain, which do not weaken, the crown is ground down a couple of millimeters. The adaptation period is counted from the moment the pain is eliminated.

The prosthesis, which the patient will use constantly, the doctor selects only after the work of the masticatory muscles has been adjusted, and the jaw has “accustomed” to its new position. Fixed prostheses are considered the best option. When installing a removable structure, the patient often takes it out and puts it in, which can disrupt the course of the therapeutic process.

The selection of an optimally suitable prosthesis is a task for a qualified and an experienced doctor, since it is necessary to take into account many factors: from the state of opposing dental elements to the facts of the presence comorbidities. For example, with constant high loads on the dentoalveolar apparatus, metal structures are more suitable, and when it comes to chewing elements, it is not recommended to use plastic.

Prevention of excessive grinding of teeth

Main preventive measures aimed at warning and early diagnosis dental diseases, it remains to observe the rules of oral hygiene and regular preventive examinations at a specialist. In order to reduce the likelihood of developing pathological abrasion of teeth, it is also recommended to follow the recommendations listed below:

• rejection bad habits(if possible);
• soda rinses for people who work with harsh chemicals;
• balanced diet;
• regular intake of vitamin and mineral complexes;
• tooth protection special devices– for those who work in conditions of high vibration or in hazardous production;
• treatment of bruxism (for patients suffering from this disease);
• urgent restoration of teeth lost for any reason;
• correction of bite defects.

Erasure is the process of loss of hard tissues of the teeth. Erasure of teeth occurs both in a temporary bite and in a permanent one; both occlusal surfaces and proximal ones; both at low speed and at high speed. Depending on the severity of such a process, first of all, physiological and pathological abrasion is distinguished.

Physiological wear of teeth

Physiological abrasion of teeth is adaptive in nature and occurs as a result of regular contact between the teeth of antagonists. The process begins from the moment the teeth enter the occlusal relationship and, being slow, continues throughout life. The adaptive moment is that the teeth adapt to various movements mandible, causing the smoothness of its movements, reduces the load on the periodontium and improves the integrity of the dentition.

Due to the impact of contact points of antagonizing teeth on each other, areas are formed in these places that increase the contact (or chewing) surface of the teeth, facilitate the sliding of these teeth, reduce the range of motion of the lower jaw and reduce the load on the temporomandibular joint.

Functions of periodontium with the course of a person's life gradually decrease. This is due to a decrease in the trophic abilities of the neurovascular component of the periodontium, due to which there is a gradual atrophy of the alveolar bone, a decrease in the elasticity of the fibers and a change in the ratio between the intra- and extra-osseous parts of the tooth. The tooth in the hole is a lever, and the larger its extraosseous part, the more strong impact transfers this tooth to periodontal tissues. Considering that there is a gradual decrease in the bone part of the periodontium, the process should be aggravated over the years, even in a person who does not have any pathological changes in the periodontium. But this does not normally happen. And it does not occur due to the fact that the physiological erasure of hard tissues of the teeth reduces the height of the extraosseous part of the tooth. Due to this, the ratio of intra- and extraosseous parts of the tooth remains constant, and the load on the periodontium is adequate for age.

In addition to the occlusal surfaces, the proximal surfaces of the teeth are also subject to natural abrasion. Interdental papillae also undergo atrophy and a decrease in their height over time. But due to the transition of point contact between the teeth to the planar one, an increase in the area of ​​​​this site and the approach of the lower edge of the site to the gum, no gaps are formed between the teeth and the gum. This allows the body to carry out adequate self-cleaning of the oral cavity and preserves the natural appearance of the teeth. Also, an increase in the contact surface increases stability in the dentition, and its shortening is compensated by the medial displacement of the teeth.

Thus, we can make a well-founded conclusion that physiological abrasion is interdependent with the state of human health, an indispensable property of the human masticatory apparatus, contributing to the preservation of its functional and morphological integrity.

Pathological tooth wear

Pathological abrasion of teeth or, as it is also called, increased abrasion appears when tooth abrasion occurs according to a scenario different from physiological abrasion. With pathological abrasion, the process ceases to be slow, other surfaces of the teeth are abraded, and, in addition to enamel, dentin is involved in the abrasion, and, accordingly, the tooth pulp. Very often, pathological abrasion is accompanied by discomfort in the patient and the appearance of corresponding complaints in him, which almost never occurs in the natural process.

At the moment when the abrasion goes into a decompensated state, the height of the lower third of the face gradually decreases. This process is accompanied by dystrophic disorders in the temporomandibular joint, the appearance of pain in it and in the chewing muscles, and a decrease in the function of chewing. Outwardly, this is manifested by the severity of the nasolabial and chin folds, a decrease in the lower third of the face, the extension of the chin, and the person acquires the so-called senile facial expression.

Further, due to the mixing of the lower jaw upwards, its displacement also occurs backwards. In this case, the respiratory function also suffers. The volume of the oropharynx decreases due to the distal displacement of the jaw, and, accordingly, the ability to pass the required volume of air. A person reflexively begins to stoop, dystrophic disorders occur in the spine, and, accordingly, primarily in the musculoskeletal and nervous systems human, as well as in the digestive, respiratory, cardiovascular and other.

According to various estimates, due to a violation of the functions and condition of the masticatory apparatus and the changes described above, a decrease in human life expectancy can occur by 15 years or more. Against this background, smoking becomes a harmless entertainment.

Causes of pathological abrasion of teeth

The causes of pathological abrasion of teeth are very diverse. All of them can be combined into the following groups.

1. Functional inferiority of hard tissues of teeth caused by a decrease in quality and quantitative characteristics enamel and dentin. In this case, the process can be:

• Hereditary (eg Capdepon-Stenton Syndrome);
• Congenital (violations of amelo- and dentinogenesis);
• Acquired (metabolic disorders of various etiologies, as well as dysfunctions of the endocrine, vascular, nervous and other systems)

Resistance to abrasion in teeth depends on the processes of calcification of hard tissues of the tooth in the pre- and posteruptive periods. The leading role in the processes of mineralization is occupied by the neurohumoral regulation of the body. The usefulness of the function of the parathyroid glands, responsible for the balance of calcium and potassium in the body, is especially important.

Capdepon-Stenton Syndrome

Amelo- and dentinogenesis disorders

1. Functional overload of teeth which can occur when:

• Partial loss of teeth;
• Parafunctions (eg bruxism);
• Hypertonic masticatory muscles of various origins;
• Chronic dental trauma;
• malocclusion;

Pathology can be caused or aggravated in cases where there are defects in the dentition and parafunction of the masticatory muscles. Missing teeth impose their functions on the remaining teeth, and, accordingly, on their periodontium, causing its functional overload. Due to this, the adaptive capabilities of the supporting apparatus of the tooth are reduced, which are not able to compensate for the decrease in the height of the lower third of the face. With pathological abrasion, secondary cement is deposited on the surface of the tooth root, restructuring in bone tissue alveoli and deformation of the periodontal gap.

Along with this, a decrease in height may be accompanied by parafunctions of the masticatory muscles, manifested in the form of bruxism, hypertonicity, etc. Reducing the height will certainly lead to dystrophic changes in the temporomandibular joint. Since these processes are interconnected, the so-called " vicious circle when each of its elements exacerbates the other and the whole process as a whole. In this case, the establishment of causal relationships and the creation of plans for prevention and treatment becomes very difficult.

1. Occupational hazards may occur in production with the release of acids, alkalis and other substances, taking certain medications, etc. For example, acids reduce quality characteristics enamel and dentine, and fine dust is the most common abrasive, which, in combination with adequate dental system becomes aggressive, accelerating the processes of physiological erasure.

Same reason increased erasure iatrogenic factors, such as the high hardness of some ceramic masses during prosthetics and poor-quality polishing of restorations, can become. Even in cases where the hardness of materials does not exceed the hardness of tooth tissues, their aggressive surface is incomparable with the endurance of enamel, and even more so of tooth dentin.

Classification of pathological abrasion of teeth

If distinguish physiological process From the pathological to the doctor is often not difficult, then the manifestations of pathological abrasion are very diverse and need to be classified and specified in each case. Therefore, the classification of pathological abrasion of teeth is as follows:

1. By stage(M.R. Bushan):

• Physiological - within the enamel;
• Transitional - within the enamel with partial involvement of dentin;
• Pathological - within the dentin.

Physiological abrasion always occurs within the dentin, however, in young age enhanced erasing of only the enamel together with etiological factor can be diagnosed by a doctor. Erasure of dentin is hallmark pathological wear. Dentinal involvement can cause hypersensitivity and pulpal changes such as replacement dentin deposits, narrowing of the root canal lumen to obstruction and pulp atrophy, and formation of calcifications (denticles) in the tooth cavity.

1. By degree(M.R. Bushan):

• I - wear on 1/3 of the length of the tooth crown;
• II - wear by 2/3 of the length of the tooth crown;
• III - wear of the tooth crown by more than 2/3.

In the absence of other factors contributing to periodontal disease, pathological abrasion is rarely accompanied by changes in the supporting apparatus of the tooth. This is due to a decrease in the extraosseous part of the tooth and a decrease in the length of the lever, which reduces the load on the periodontium when the load is on the teeth.

1. By shape(A.L. Grozovsky):

• horizontal;
• vertical;
• Mixed.

With the horizontal form of abrasion, there is a decrease in the hard tissues of the teeth in a horizontal plane with the formation of horizontal abrasion facets. The process most often occurs both on the lower and upper jaw. The vertical type of abrasion is most characteristic and obvious on the frontal group of teeth: on the palatal surface of the upper frontal teeth and the labial surface of the antagonists, which is determined by occlusal relationships. However, with, for example, a progenic ratio of the jaws and dentitions, wear facets on the upper frontal teeth are observed from the labial side and from the lingual side of the antagonists.

Forms of increased tooth wear: a - horizontal; b - vertical; c - mixed

1. By degree of compensation(E.I. Gavrilov):

• Compensated - without reducing the height of the lower third of the face;
• Decompensated - with a decrease in the height of the lower third of the face;

The dentoalveolar system has relatively high compensatory capabilities. Following the loss of hard tissues of the tooth, restructuring occurs alveolar process jaws and displacement of teeth in the area of ​​the defect or the area of ​​the absence of occlusal relationships. The so-called dento-alvelar elongation, or the Popov-Godon phenomenon. Depending on the degree of such restructuring, pathological tooth wear is differentiated into compensated, when the displacement of the teeth prevents a decrease in the height of the lower third of the face, and decompensated, when compensatory changes are not able to completely eliminate the defect or are completely absent.

1. By length(V.Yu. Kurlyandsky):

• Localized - increased abrasion of individual teeth or a group of teeth;
• Generalized.

Localized abrasion is more often observed in the frontal dentition, for example, with a deep bite. This type of abrasion is also locally compensated by the body due to local hypertrophy of the alveolar process. In this case, the fulcrum of the height of the lower third of the face attributable to chewing teeth, remain intact, without disturbing the occlusal relationship and the position of the elements of the temporomandibular joint.

In the generalized form of the process, the crowns of all teeth are captured, with a violation of the bite height. In this case, the degree of compensation depends on individual features organism.

The article was written by N.A. Sokolov. Please, when copying the material, do not forget to indicate the link to the current page.

Teeth Wear updated: February 25, 2018 by: Valeria Zelinskaya

We all know that teeth are a reflection of the body, however modern world cruel, and the environment affects the condition of the teeth not the most in 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 taken a step forward, and if 50 years ago the word “dentist” inspired quiet horror, now this doctor does not cause any concern, since the latest technology allow you to treat your 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, an unpleasant smell is not the only problem of our time, 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, if the 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.