Tooth wear at the gum-line

Have you noticed that your gum is receding and your getting a notch in the tooth at the gum-line? You may be worried because it looks bad, or it may even be making the tooth sensitive. What is causing this and what can you do about it. These are the questions this article will answer.

Tooth Wear at the gum-line causes

Dental erosion is a condition that is caused by excessive exposure to erosive acids and causes tooth softening and wear without bacteria from plaque.  Although erosion is grouped under a larger umbrella called erosive tooth wear including toothbrush abrasion and abfraction and attrition from excessive teeth grinding may also contribute to this wear, the acid speeds any wear caused by abrasion, the net result is the loss of valuable enamel from the teeth. 

Tooth pellicle

One suggestion is that brushing shortly after consuming acid containing food or beverage speeds this erosion, because the acid softens the enamel and tooth brushing then would brush the softened enamel away. Another suggestion is that eating or drink acid containing food or beverage too soon after tooth brushing can also contribute, because there is a protein pellicle that protects the enamel from erosion that is brushed away when brushing and takes time to rebuild. if acid comes in contact with the tooth structure when the pellicle is not in place erosion occurs. Dentists now suggest waiting 1-2 hours after brushing before eating anything. 

Saliva

Saliva is a critical component that helps buffer the pH in your mouth it is also responsible for making the pellicle that protects the teeth. With a low salivary flow, the it takes longer for the normal pH of the mouth to return after eating and it takes longer to build the pellicle after brushing. Low saliva flow from medications, dehydration and salivary gland dysfunction can inhibits the ability to properly buffer acid attacks. Also the contents of the saliva can make it more or less helpful in buffering. Saliva that contains bicarbinate is more effective at buffering acids.

Frictional Forces

Tooth brushing is a frictional force that if done too harshly or too soon after consuming high acid contents will brush the softened enamel right away. Teeth grinding also abrades enamel once it has been softened. Night time grinding is the perfect time to catch the mouth without its protective saliva too. Don't eat or drink anything right before going to be unless its water.

Diet

Increasing erosion parallels increases in the serving sizes throughout the years. In the 1950's the everage service size was about 7oz., in the 60's it went to 12oz. and by the 90's it was up to 20oz, now with the big gulp, some servings are 40 oz and you can get a free refill. reports show up to 85% of children reporting at least one soft drink per day with 20% reporting at least 4 servings per day. Not all acids are equal in their erosive potentials either. It was shown that citric acid, commonly used as a preservative.

pH of common drinks

equally challenging to the enamel surface is acid containing fruits such as citrus fruits and vegetables such as tomatoes and wine.

Risk factors

The risk factors for erosive tooth wear include: dietary habits including the amounts and frequency of consuming acidic foods, gastric reflux, GERD or bulemia, reduced salivary flow, and mechanical insults from teeth grinding or improper tooth-brushing. 

Treatment

As far as erosive tooth wear goes, nothing can replace early intervention. Once the enamel has been worn away, the restoration is extensive and costly. Fluoride can help prevent enamel wear, but not all fluoride is equal. Stannous fluoride has been proven to be more effective at preventing tooth wear and curbing sensitivity because it deposits a protective layer on the tooth surface.