Tooth Wear and TMJ Disorders
Tooth Wear and TMJ Disorders
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
FAQ
01. What is tooth wear?
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
02. What causes tooth wear?
Tooth wear can be caused by any of the following:
- Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough.
- Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time.
- Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices.
- Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.
03. How is it treated?
The first step in treating any type of tooth wear is to determine the cause during a simple oral examination right here at the dental office. Once the cause has been identified, we can work together to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, we can make you a nightguard that will protect your teeth during sleep or periods of high stress. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.
04. WHAT IS BRUXISM?
Bruxism is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously grind your teeth at night or clench your teeth together during the day.
05. WHAT IS TMJ DISORDER?
When teeth grinding is allowed to progress, much of the teeth surface is lost so that the bite collapses, and the temporomandibular joint is left to endure the damage. Bruxism can be a symptom of, cause, or ever worsen TMJ.
06. DOES TMJ LEAD TO BRUXISM?
TMJ is often caused by misaligned teeth, which can also be a cause Bruxism.
07. What can be done for TMJ symptoms?
TMJ disorders have many and various causes, some of which will decrease over time on their own.
It is useful to know what is causing the TMJ symptoms and especially to make sure that they are not signs of other (more treatable or more serious) conditions.
Often the symptoms will be temporary and/or can be treated and prevented by following simple advice including:
- Taking only a soft diet that doesn’t require too much chewing (at least until the symptoms have passed).
- Avoiding opening your mouth too wide.
- For example, when yawning try putting your hand under your chin to stop yourself opening too wide. Try cutting up fruit (eg apples) into pieces rather than biting off big chunks.
- Avoid habits that can stress your TMJ such as chewing gum, biting pen/ or pencil tops or biting your nails.
- Use simple pain killers as required.
- Your dentist, doctor or oral and maxillofacial surgeon might prescribe some pain control for you. Ibuprofen (eg NeurofenTM) is one of the best types of analgesic for TMJ symptoms – but, as for all pain control, do not take it if you have been advised against it (eg by your doctor).
- Jaw exercises can be helpful.
- Your dentist or oral and maxillofacial surgeon might have shown you some – practise them regularly to train your joints and muscles.
- Placing a warm towel over the painful area often helps relieve the pain.
- Using a special splint on your upper or lower teeth to prevent grinding and clenching.
- Your dentist can make this for you to wear (usually at night).
- Treating the cause of your anxiety.
- Some doctors will prescribe a type of anti-depressant for TMJ pain – these can reduce muscular tension and therefore TMJ pain.
- Physiotherapists, as advised by your oral and maxillofacial surgeon can help some types of TMJ symptoms.
- In a very small number cases, surgery on the joint by an oral and maxillofacial surgeon is a treatment of TMJ symptoms. This is usually only after trying the other measures.
- As with other joint problems, TMJ disorders can be chronic in spite of treatment and taking steps to prevent it.
Sometimes, the patient will need to learn to live with some limitation of function – often this will only be from time to time.