Pathological dental abrasion: treatment
Pathological dental abrasion is characterised by rapid decay of enamel and dentin (much faster than under normal physiological deletion), which leads to disruption of chewing function and aesthetics. More often this disease is diagnosed in men than in women. Increased dental abrasion in varying degrees, have 12% of the population. As a rule, this pathology manifests itself in 40-45 years. Pathological abrasion are more commonly found on the front teeth and the fissures of molars and premolars. Over time, the gradual grinding of the teeth tissues. This is a natural process which is slow and is of a compensatory character. With proper bite the upper teeth are changed on the inside, and the bottom exposed. For forty years the crown is reduced to a quarter of its original height. And increased dental abrasion is quick and noticeable loss of enamel and dentin significantly higher than normal, and entails anatomical and physiological changes in the gums, the muscles involved in chewing, and temporomandibular joint.
What causes abnormal abrasion
Pathological tooth wear provoked by the following factors:
- dental or systemic diseases;
- the increased load on the masticatory organs;
- external influences.
Changes in the structure of the enamel as a result of disease
Pathological dental abrasion caused by the disease is divided into congenital or acquired. The first often occur on the background of the development of hereditary diseases, for example, the syndrome of Stenton-Capdepon, osteogenesis imperfecta, marble disease. These pathologies cause anomalies in the structure of bone tissue, and a person born with thin enamel and inadequate dentin. The pathological Erasure of such teeth is diagnosed at an early age.
Increased abrasion of the teeth develops in cases when there is a disturbance of calcium and phosphorus and protein metabolism, what happens with rickets, colitis, nutritional deficiency, profuse diarrhea, hypoparathyroidism. Thinner enamel and in the following dental disorders:
- wedge-shaped defect;
- the fluorosis.
Appear the problem may due to diseases of the thyroid gland, causing the body partially loses the ability to absorb calcium.
Unnecessary chewing load on the teeth
Unbalanced load on the masticatory organs occurs in the following cases:
- if you removed the teeth and the load, which they accepted, no offset. So, if you removed the large molars, the man begins to grind food, canines and incisors, but they can not withstand such loads and erased;
- if the prosthetics mistakes were made and the prosthesis prevents anatomically correct closure of the jaw while chewing;
- if the occlusion. Abnormal closure of the dentition, some teeth are forced to «work for two» or did not receive the necessary load. For example, if a direct bite, then quickly erased the edges of the anterior teeth;
- there are habits affecting the integrity of the tooth. These include snacking hard objects, cracking sunflower seeds the Central incisors or a tight closure of the jaw by excitement, lifting weights;
- the tone of the masticatory muscles (bruxism). About this disease, a person learns from their loved ones, as it manifests itself in a dream. The man’s teeth grinding, which leads to abrasion of the height of the crown;
Aggressive influence of external factors on hard tissue of teeth
The rate of acid-alkaline balance in the mouth is influenced not only by internal factors but also external. If the mouth environment is acidic, it has a negative impact on the ratio of pathogenic and useful bacteria and hardness of enamel. To aggressive external influences include:
- taking certain medicines. Medications can directly affect the enamel during swallowing (for example, if they are based on hydrochloric acid), or to change the quality characteristics of saliva;
- teeth cleaning means having a high index of abrasion. It can be a brightening or substances recommended by the national «experts», for example, charcoal or soda. The larger the diameter of the particles, the more they scratch the surface of the enamel, is how to sandpaper on glass. The longer used a similar tool, the thinner and more vulnerable enamel. The recommended rate of abrasion for pasta should not exceed 75 RDA;
- the use of abrasive brushes. If used for cleaning hard brush, it harms enamel and gums. Therefore, it is important to choose hygiene means individually depending on the condition of the oral cavity;
- professional pathology. The people working on the production of alkalis or acids, often complain of blurred teeth. Particles of the substances flying in the air, are deposited on the skin, inhaled, one feels their taste in his mouth. This has a negative impact on health. The distinctive feature of this factor is that the wear of the crown is uniform;
- the use of permanent metal-ceramic or porcelain prosthesis with a not-glazed surface.
Classification of natural and pathological abrasion of teeth
Considered normal if there is a gradual decline of teeth on 0,034–0,042 mm per year. Physiological tooth wear occurs in three stages:
- aged 25 to 35 years worn down teeth edges and fissures large and small molars;
- 45-50 years there has been decline in the upper layer of tooth enamel;
- after 50 years, the teeth are erased in the area of the enamel-dentinal border, and partially destroyed the dentine layer.
So, physiological attrition of the human remains unnoticed until thirty years of age. Prior to this period is the blurring of the fissures of the molars, that is, the upper surface of the masticatory organs is deprived of the natural bumps and becomes completely smooth. And worn down teeth edges. To fifty years of age the process of grinding of the teeth is accelerated, but only affects the top layer, while the dentin remains intact. In the fifties the enamel is already worn off and begins to decrease dentin. The second layer of the tooth wears much faster than enamel.
Pathological dental abrasion is divided by the depth, plane, and distribution process.
Depending on the depth of Erasure is isolated:
- I degree. The loss of tissue has occurred on the cutting edges of the incisors or canines, or molars become smooth as a result of fading the fissure. Erased only the enamel layer, dentin is not affected;
- II. The crown declined by a third from its initial height, exposed dentinal layer;
- III degree. From crowns it remains only one third. X-rayed the tooth cavity;
- IV degree. The crown of the tooth is reduced by more than 2/3.
Classification depending on the area loosens:
- vertical — erased the external part of the tooth. This type of characteristic of people with malocclusion;
- horizontal — decreases the length of the crown;
- mixed — body is reduced in height and in thickness.
Also pathology can be local (involves only one area) or generalized when suffering the entire dentition.
The process can involve one organ, a few, or all. Deformed teeth with one hand or both, one jaw or two. The surface is worn down tooth may be smooth, wire mesh, patterned or stepped.
Signs of pathological attrition
Increased blurring of teeth is changing the look of the smile and the disproportionate load on the masticatory organs. Quick decline tissue causes reduced crown, degrades the aesthetics of the dentition, change the proportions of the face.
This pathology affects a smile, because seriously top row of teeth visible. The source believes that all the teeth of the speaker are absent. That is why, when pathological abrasion of teeth patients trying not to smile and to talk with as close lips.
When pathology affects not only the aesthetics of the smile, but also there is a malocclusion, which leads to a decrease of the lower third of the face, drooping corners of the lips, rapid formation of nasolabial and chin wrinkles. The patient becomes more difficult to chew food, there is a problem with pronunciation.
In this pathology there is increased sensitivity to mechanical, thermal or chemical stimuli (hyperesthesia), after the protective layer is absent. The pain occurs while brushing teeth, eating hot, cold or acidic foods. Often the sharp edges injure the crowns of the cheeks and lips that can provoke an inflammatory process in the oral cavity.
The dysfunction of temporomandibular joint leads to pain in the muscles of the face, neck, back and head, there is a crunching and clicking in the joint, can disturb vision and hearing.
What to do when this disease decides the doctor determine the cause and conduct the necessary tests. At the reception, he examines the teeth, determines the firmness of the tissues, the degree of grinding of the masticatory organs. Visually evaluated facial symmetry and degree of occlusion. After a survey of the patient is established, what was the attrition, and to the extent possible, is to eliminate the root causes.
Before treatment is required to assess the condition of canals and the pulp. This is done using electroodontodiagnosis, x-ray, dental panoramic x-ray.
Computer programs help the physician to examine the model of the jaw, to determine the degree and depth of deformation, the ratio of the upper and lower jaw in chewing movements. If the disease is neglected, you will need to learn how to work the jaw joint and chewing muscles. This can be verified by x-ray, computed tomography of the temporomandibular joint, electromyography, and other necessary research.
How to treat pathological erasing
Depending on the severity of the pathology therapy performed by a physician or podiatrist. Treatment of pathological abrasion of teeth involves the elimination of the factors contributing to the pathology, the restoration of the crowns and the return of facial symmetry. When the abrasion of the teeth treatment is rather expensive and time-consuming, requires a weekly visit of the doctor.
The first stage of treatment involves eliminating the underlying cause. May be the normalization of mineral and protein metabolism, getting rid of hormonal abnormalities, consulting or change of defective. To reduce tooth sensitivity, the doctor will prescribe vitamin therapy, electrophoresis, processing of dental preparations containing fluoride. Sharp edges are sanded, so they do not injure the mucosa. This is followed by a prosthetic bridge or removable dentures. When the tonus of the masticatory muscles, the patient needs to wear a protective mouth guard.
When the first and second stages of the disease the treatment involves stopping the pathological process and the restoration of the crown. In the initial phase establishes the temporary denture so that the patient could re-learn how to chew. After the bridges are replaced by permanent ones. If the patient delayed treatment to the doctor, and teeth Stoch more than 60% of the height of the crown, then you must increase the bite razumnymi or periodontal splints.
The reconstruction of the height of the crown may be performed using restoration, kulevich inlays, artificial crowns, Lumineers or veneers.
When choosing a prosthesis plays an important role its material. If the teeth is enamel, it is possible to supply artificial teeth from porcelain fused to metal or ceramics. In the treatment of the disease at the initial stage of reliable and are plastic dentures made of precious metals. If the disease is the result of increased load or bruxism, then you want to install the most durable materials, which are metalloplastmass or metal. In any case, to avoid repeated abrasion should be used only one material.
When pathological abrasion treatment plan is made individually, taking into account the extent, predisposing factors and distribution loss of hard tissues. Pathological dental abrasion, regardless of severity, are successfully treated thanks to the methods of orthopedics and orthodontics.
In order to prevent the occurrence of disease, the person needs to correct the bite in a timely manner to treat bruxism, to prevent «gaps» in the tooth row, and seek dental care only to highly qualified specialists.