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St Peters Dental Clinic Blog

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: https://www.erosivetoothwear.com/

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.

Dental decay explained

 

 

 Tooth decay, or 'dental caries' begins as a local chalky spot or loss of minerals on the outside enamel of a tooth. Bacteria living in your mouth eat a portion of the sugars and simple carbohydrates you consume and metabolise them to acids which start eating holes in your teeth. You can interrupt the process at many stages:

1. Starve the bacteria. Avoid sucrose (white sugar) and sweet foods - these are bacterial favourites and easiest for them to digest. But don't be 'conned' into thinking that honey or raw sugar are healthier - the bacteria love them too.

2. Minimise the frequency of sugar intake. After you eat something sweet it takes 2 hours for your salive to clear the acids produced. Mouth bacteria are like little babies - they need frequent feeds. Don't feed them regularly and they will go away, or at least be kept in check by less harmful bacteria. This means regular meals are less harmful than many snacks or grazing throughout the day.

3. Consistency / texture is important. Sweet sticky food such as cakes, toffees, lollies, dried fruit, jams etc are more harmful or cariogenic (decay promoting) than sugar in liquid form eg soft drinks, mixers or cordials, which again are more problematic than solids, eg chocolate, a dry biscuit or eating desert with your meal. 

Fresh fruit, although sweet, contains plenty of water and fibre, so it tends to end up in your stomach, not on your teeth. So, diet is very important, but not just what you eat, but how often and in what form. In general, the less processed the food is the better, and most savoury foods are 'tooth neutral' in terms of decay potential. Some dairy products eg cheese or joghurt even have a protective effect due to the protein casein.

Another way to interrupt the decay process is by physically removing the dental plaque (bacterial film) from your teeth on a regular basis. Tooth brushing does this quite well, but a toothbrush cannot get to all surfaces of the teeth (especially where they touch each other), so flossing or removing plaque from between your teeth eg with interdental brushes, flossettes, or toothpicks is also recommended at least once a day.

Decay causing bacteria are quite 'clever' - they use some of the sugar you consume to create a 'glue' which helps attach them to your teeth so they cannot be easily removed by rinsing for example. This is called a 'biofilm', and becomes a complex community of different bacterial colonies, their food stores and protective devices living on your teeth. The longer it stays undisturbed the harder it is to remove, and the more 'dangerous' and selfsustaining it becomes. Brushing and flossing (or equivalent) disrupt the plaque biofilm, so remember to brush and floss at least once a day. Twice a day brushing is recommended as most people are not as perfect as we would like to be.

Early dental decay is a reversable process. Minerals lost from the surface of the enamel can go back into the enamel. Your saliva does this automatically. You can help the process by supplying the required minerals from toothpaste, fluoride gels, tooth mouse or other reminerizing solutions.

Decay takes time - up to a year in many cases from a small chalky spot to an actual cavity forming in a tooth. Once a cavity has formed and the enamel structure has been lost, the bacteria move into their new home and continue eating away at your tooth. At this stage remineralisation is no longer sufficient. The bacteria must be physically removed and replaced with a filling material to compensate for the lost tooth structure. Sometimes the amout of tooth structure eaten away is significant, and more complex restorative techniques are needed, such as a crown. In addition, the decay process may progress towards the 'pulp'(living core or 'nerve') of the tooth and cause sensitivity, or even pain and infection if ignored. Complex treatment or even removal of the tooth may be needed, so clearly it is best not to allow decay to progress to this stage.

Se my blog:"Prevention is better than cure" for further ideas

Merry Christmas

Merry Christmas, happy holidays and a safe start to 2021! 

 

We are open again!

The Level 5 restrictions placed on Dental Practices have been lifted and it is business as usual from Monday 23 November 2020. We will be in touch with anyone whose appointments were moved or cancelled due to the lockdown very soon.

St Peters Dental Clinic closed

I am sorry to advise that South Australian dental practices have just been placed on Level 5 restrictions, and we are unable to provide any routine or emergency dental care at all as of tomorrow, Thursday 19th November 2020. Therefore St Peters Dental Clinic is closed. We apologise to all our loyal patients, and hope you will understand this is a COVID-19 government decision, and out of our control.

If you have facial swelling, bleeding or trauma in the next 6 days, please ring 0414272926 for advice. You can also ring this number for general advice or email us on info@stpetersdentalclinic.com.au. This phone number and email contact will be monitored regularly. 

Keep safe everyone! We will get through this.

We are open and available for routine dental appointments!

COVID-19 update

Level 1 restrictions apply in in South Australia from midnight Wednesday 13th May 2020 and we will be able to offer you the full scope of routine dental treatment including scaling and cleaning from Thursday 14th May with some additional precautions. Excellent news, and we welcome your phone calls or online bookings!

COVID_19 update Monday 27th April 2020

This picture is what rubber dam looks like. It is a way of isolating one tooth from the rest of your mouth while we work on it.


From Monday 27 April 2020 we are back on Level 2 restrictions for Dental Practice. This means we can do permanent fillings with rubber dam to stop aerosols from your saliva getting in the air. We can also do checkups, extractions and denture adjustments, but only minimal cleaning, no polishing and no surgery.
We hope this will ease soon. In the meantime if you need a follow up appointment from Level 3 restrictions we will be in contact soon.

Level 3 restrictions to ease next week

Hi everyone, 

It looks like some routine dentistry will be allowed from next week, with maintenance of appropriate infection control precautions which we already have in place. 

For the safety of staff and patients we have reconfigured our waiting room to comply with social distancing. Forms and updates will be completed either online or verbally without the need to handle paper casenotes. You will be asked to wash or sanitise your hands on entry, and to use an antiviral mouthwash before treatment. 

 Appointments may be longer to accommodate aerosol minimisation processes including high speed suction and the use of rubber dam, and there will be gaps to avoid overlap of patients coming and going. Existing rigorous surgery cleaning between patients will remain, and we have extended this to the waiting room, bathroom and reception area. Contactless payment is available, but we can accommodate all current payment methods.

 More news soon!

Current opening hours

Due to COVID_19 we are restricted to emergency and urgent dental appointments only. Our current working hours are Monday and Thursday 10am to 1pm. Please ring on 83627650 or book online. We may be able to accommodate other times - just ask!

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