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What can I do about my worn down teeth?

1. Erosion

Tooth wear can happen from erosion, that is chemical disolving of tooth structure. The most common causes are food acids, esp those in sports drinks and carbonated soft drinks. But other sources include sparking wines, white wine, soda water, chewable vitamin C tablets, citrus fruits, apples, strawberries, pineapple, pickles, salad dressing etc. Erosion can also result from outside sources eg swimming pool water in the case of competitive swimmers or stomach acid from reflux or some eating disorders.

In all these cases it is really important not to make the erosion worse. Drink plenty of water, rinse your mouth with water after erosive foods or drinks and don't brush your teeth for at least an hour after the erosion incident, whether it is vomiting or erosive drinks. In addition you can protect your teeth ahead of time with fluoride gels, or remineralising solutions eg tooth mousseTM. Another really useful strategy is to chew sugar free chewing gum. This helps your saliva neutralise acids very much faster than just waiting for nature - 20 min compared to 2 hours. Erosion cavities can be filled with tooth coloured filling materials especially if they become sensitive or deep enough to turn into a food trap. Check out this website for more information:

2. Abrasion

This is tooth wear that happens from an outside source eg a hard toothbrush or toothpick, or even hard food. It is most obvious on the necks of teeth near the gum line. The tooth enamel is thin in this area and easily worn down, and the root surface dentine is even softer and more easily abraded.

What you can do is avoid hard toothbrushes and toothpicks, abrasive toothpaste and other abrasives eg charcoal, salt and bicarb soda for cleaning your teeth. These can be extremely dangerous when mixed with vinegar or similar as this adds tooth erosion to the damage. Changing to an electric toothbrush can help as these have an oscillating rotating movement rather than scrubbing. Some also stall or change colour when you press too hard.
Abrasion weakens teeth at the narrowest part of the tooth. Sometimes teeth can also become quite sensitive and a lot of people do not like the yellow look of abraded root dentine. Your dentist can fill abrasion cavities that become sensitive or look 'ugly', but the main aim is to break the habit of wearing the teeth in the first place. Otherwise you will just wear away the new filling!

3. Attrition

This is tooth to tooth wear without food inbetween. It can happen at night when people grind their teeth without consciously being aware of the habit, or during the day when concentrating or focussing on small fiddly details. Stress is considered a factor, but in most cases your mind is just busy with something else and the grinding is a repetitive movement at an unconscious level.

It is very difficult to stop a habit. But you do have control over the process during the day. Awareness of factors that start the clenching or grinding allow to you intercept the process. For example you can learn to relax your lower jaw and  put the tip of your tongue between your front teeth.  When you start to close your mouth your teeth automatically touch your tongue and your jaw opens again. Remember: Your teeth should only be touching when you are eating food. At all other times there should be a small space - about 3mm - between them.

Night time grinding is much more difficult to prevent. Winding down before bed may help eg a herbal tea or hot chocolate, avoiding scary movies or complex online games, reelaxing music etc - whatever works for you. A reminder before you drift off to sleep to wake up if you grind too hard is extremely effective. This already happens in many cases when people wake up partially and realise their teeth are tightly together, their jaw hurts or their muscles are tight, and there may be a repetitive thought going through their head. Relax the jaw, roll over and go back to sleep. 

If this is still not effective, or the tooth wear is severe, a nightguard may be the answer. This is a custom made U-shaped piece of plastic which is usualy worn on the upper teeth during sleep and prevents the teeth from grinding against each other. It also 'jacks' your bite open slightly which makes it more difficult for the muscles to grind hard. Finally it acts as a 'foreign' object reminding us not to continue grinding.

A final note:
Restoring worn teeth to their original state, or even a reasonable state can be complex and quite expensive. It is far better to prevent the problem in the first place. Talk to your dentist for more information.

Also see my Blog: "What is a restorative dentist?"

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