MA'OR YESHIVA HIGH SCHOOL of the Jersey Shore Celebrating 10 Years of Educational Excellence

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By: Dr. Jacques Doueck

Teeth wear out, it’s a fact. For most of us this does not affect our daily lives, since the wear is not significant. For some of us, however, the enamel (the very hard outer layer of the tooth, which protects against tooth decay) may wear out on the back molars. This causes the teeth to become very sensitive to sweet, hot, and cold. When the enamel is worn out for many people it’s like having an open cavity, as the dentin, the softer layer of the tooth under the enamel, is exposed. If there are only a couple of teeth that are sensitive, we can cover the exposed areas, and this stops the sensitivity. When a patient reacts to my scratching the tooth surface with a probe, we can usually help the patient by putting in a bonded filling. Sometimes the wear to the tooth is so severe that a root canal is required.

When front teeth wear out this can cause sensitivity. But more importantly, severe wear of front teeth will lead to the rapid wear of the back teeth. This is because the front teeth are designed to protect the back teeth as we chew and move our jaws from side to side. 

Patients with worn out teeth (worn out enamel), come to our office not only due to sensitivity issues. Another main issue is concern about the patient’s smile. When teeth are severely worn out, the face takes on a collapsed appearance. For many people, it looks like they have no teeth at all!

I would like to cite two recent cases: In the first case, Anna came in complaining of severe sensitivity to sweet and cold in her front teeth. When she smiled you could hardly see her teeth. Examination showed that all her teeth were severely worn. We covered the sensitive teeth with bonding, and built up her collapsed bite. Her sensitive teeth improved and now when she smiles you can see her teeth. This vast improvement is a great cause for smiling.

In the second case, a prominent businessman came to us complaining, “My teeth don’t show when I smile.” In order to restore his collapsed bite, we had to build up twelve of his upper teeth. Then we were able to lengthen his upper front teeth to the desired size and shape, which significantly improved his smile and his ability to chew. He, too, left our office smiling. 

A word about prevention: Acidic foods and drinks, dry mouth and night-time grinding all contribute to melting away of your precious enamel, and rapid wear of the softer underlying dentin. One should avoid or limit acidic foods and drinks, or at least rinse your mouth afterwards. If you suffer from dry mouth, I recommend using Biotene™ rinse, paste, and gel, which my patients have found to be effective. Most importantly, a night guard will protect the teeth from further wear.