In addition, or in parallel with this, we consume a lot of acidic drinks which attack our teeth. The most common and undoubtedly the most destructive of these products is an internationally-known soft drink. “But lemon juice or other citrus fruits, products high in sugar and even wine have a corrosive effect on our teeth”, explains Prof. Vanheusden. In short, we create problems for ourselves and our teeth which among other things can be caused by dental misalignment leading to premature tooth wear.
The influence of stress and the impact of soft drinks
On a theoretical level, tooth wear falls broadly into three categories. Abrasion lesions indicate mechanical wear and tear caused by friction between an abrasive agent and one or more teeth. Attrition-type lesions result from inappropriate contact or friction between teeth. Finally, what is referred to as dental erosion covers dental tissue loss of enamel by acid dissolution without the involvement of microorganisms.
“Attrition and erosion are the most common and the most aggressive problems”, explains Prof. Vanheusden. “These are linked to two social problems: stress and excessive consumption of soft-drinks whose corrosive properties have been amply illustrated. These two factors can go hand in hand and become potentially dangerous. In any case, erosion and tooth wear sometimes lead to real situations of dental ill health, even among those who otherwise have good oral hygiene or who are still quite young”.
Tissue loss will vary according to the degree of advancement and the duration of the underlying causes of tooth wear and erosion. "In addition to sensitivity, more often than not it is generally for esthetic reasons that the patient in question consults his or her dentist", continues Prof. Vanheusden.
On the prevention trail
Phenomena of dental wear and its causes are probably not yet sufficiently well-known by the public. Traditionally, in Belgium, prevention is the poor relation of dentistry. It must be said that, in his practice, the dentist also manages care, treatment and follow-up care too. The importance attached to awareness or education that could lead to saving teeth is often reduced or limited. In addition, dental practitioners have been poorly trained in prevention and the difficulties associated with it. Finally, “in contrast with some countries, we do not have a large number of dental hygienists specialised in the important work of prevention”, states Prof. Vanheusden.
Another difficulty for dentists is the fact that tooth wear and erosion are complex phenomena. Once they are identified, treating them involves discovering the underlying causes in order to make the patients aware of them and to encourage them to make behavioral changes. This process takes time and is far from simple.
Given the challenges for the population, certain changes in diet are achievable without the need for a personal revolution. On the other hand, the possible solutions to the problem of bruxism are more difficult to deal with. It is not enough for a dentist to tell a patient that he grinds his teeth during the night and that this is causing tooth wear in order for him to change his behaviour. A person can take care not to grind his teeth during the day but during the night is another matter entirely.
“Consultations with a psychologist could help to modify the patient’s stress levels and to help change the behavior that this stress causes. However, it is not always easy to advise a patient to adopt such an approach”, says Prof. Vanheusden with a smile. Apart from dealing with stress levels, no other therapy is known that could help to deal with the problem of bruxism. “On the other hand, we know how to limit its consequences”, he continues.
This solution involves the wearing of what is called a splint. This is made of resin and is made from an imprint of the mouth of the patient and is therefore adapted to the patient’s mouth. The splint must be worn during sleep: it prevents the teeth from rubbing against each other by placing an obstacle between them. Nonetheless, this preventive measure, which is undoubtedly an important one, does not really solve the problem when tooth wear or erosion are too advanced or when they are caused by sources other than bruxism.
