Hi, hello and welcome to another blog! If any of you guys have seen me recently we will have had a discussion about tooth wear, so I thought I would put together a bit of an explanation about what tooth wear is, how we get tooth wear, how we can prevent tooth wear and what to do once we have tooth wear - which lets face it most adults have some form of or another. Could I SAY tooth wear any more??? Lets see….

So over time our teeth will change a little bit, the colour might be different, we might pick up a filling or two and inevitably there will be some form of tooth wear. Tooth wear is a bit of an umbrella term and some of the most common forms that I see day to day are:

Recession
Tooth Brush Abrasion - I usually refer to this as Overbrushing
Acid Erosion
Attrition

So we’ll have a chat about each one of these in this series of blog posts and I’ll pop in some pictures so you can have a look at home and see if you’re starting to get any wear on your teeth. Having a conversation about tooth wear with your Dentist or Dental Hygienist is really important and if they don’t bring it up and you think you could have some tooth wear you really should. The main problems we usually encounter with tooth wear are

a) How it looks - teeth will either appear longer, shorter, bumpy or thinner depending on the type of tooth wear you have

b) SENSITIVITY - and my goodness this is a huge dental problem so by preventing or reducing tooth wear, particularly recession based tooth wear will in turn help prevent or reduce sensitivity which will make you all a lot happier when you come to see me :)

Now in dentistry there is a scoring system for tooth wear developed at Kings College London called a B.E.W.E. (Basic Erosive toothWear Exam), I’ve stopped calling it this because people don’t know what the hell I’m talking about, and in surgery I’m just calling it a tooth wear score. By now my patients (hi) should be well used to a bleeding score which we use at your appointment to help determine how healthy, or unhealthy your gums are, we want this score to be less than 10% this score can fluctuate, yadda yadda yadda. I don’t expect a tooth wear score to change that much once we’ve had a look at it during our appointment, particularly for adults that I see who have mostly historic tooth wear and who are already practising good preventative techniques, but it’s a good way to know where your teeth are in terms of tooth wear and give you advice based on your score.

The exam gives you a score out of 18, your score then puts you into a band and you are given advice based upon that band which I’ll list here if you’re having a look back over this after your appointment

Band 1 - Score 2 or less/18 - Your Dental Hygienist or Dentist will just have a look at tooth wear at your next appointment

Band 2 - Score 3-8/18 - Your Dental Hygienist or Dentist will give you oral hygiene and dietary advice, recommend a low abrasive toothpaste and have a look at tooth wear on your next visit

Band 3 - Score 9-13/18 - Everything we have discussed above plus your Dental Hygienist or Dentist will identify the main cause of your tooth wear, possibly recommend a plan to get some additional fluoride onto the surface of your teeth, continue to monitor possibly with digital photographs or study models and look at again at your next visit

Band 4 - Score 14 and over/18 - Everything we have discussed above plus your Dental Hygienist or Dentist may consider placing some tooth coloured filling material on your teeth to help protect them from further wear and possibly consider sending you to see a specialist

If you would like some more information on this scoring system you can visit the excellent website www.erosivetoothwear.com which has lots more information.

But what does it all mean Basil?? I feel that this system has been created - rightly so - for young adults who have just got their full set of permanent teeth and are taking responsibility for their own oral hygiene routine and diet choices to help us nip tooth wear in the bud or prevent it entirely in a new generation of patients.

Unfortunately the average score I’m getting at the moment for most of my adult patients is 12/18 and they’re featuring in band 3, sounds high doesn’t it and it is high which is why we have to reactively treat tooth wear for patients on a daily basis. To add insult to injury, most adults have a couple if not all of the types of tooth wear we have listed above so I’ll discuss all of this in more detail now in the next few blog posts about the different kinds of tooth wear and let you know how we can prevent each type progressing further or ideally starting altogether and how I would manage each type of tooth wear if you’ve already got some. Just read what applies to you, or read them all the more the merrier!

Hopefully with the introduction of the Basic Erosive Tooth Wear Exam we can become more preventative rather than reactive to tooth wear but this is 100% a two way street, lots of the tooth wear we see in dentistry is due to lifestyle rather than teeth so we really need to look after our whole selves to try and prevent tooth wear, I’m not perfect, unfortunately I’m one of those adults who have tooth wear but with these tips and tricks in the next couple of blogs hopefully we can prevent things getting worse.

Acid erosion is the cornerstone of most types of tooth wear so a really fast and easy way to help treat this is with a toothpaste, usually I would recommend something like a Sensodyne Pro Enamel* or at the moment I am really loving the Toothpaste for Rebuilding Teeth by Spotlight Oral Care.

Thanks so much for reading, I’ve linked each type of tooth wear blog above and here, so if you suffer from recession, overbrushing, attrition (flattening edges of top and bottom teeth) or acid erosion or a combo of the four have a little read and any questions please let me know and you can read more about tooth wear at www.erosivetoothwear.com.

*gifted products