Definition of Occlusal Wear
- The loss of tooth structure due to the rubbing of tooth against the tooth.
Causes of Worn Teeth
- Parafunctional habits: bruxism (grinding), clenching, or object biting (ice, nails, pens). These can occur for a number of reasons, including:
- Medications: levodopa, fluoxetine, lithium, citalopram, etc.
- Bite interference due to:
- Natural tooth position
- Restorations that are “high” or unpolished porcelain rubbing against natural tooth structure.
- Shifting tooth position from periodontal disease
- Missing teeth – spaces in your dentition will put more pressure than normal on the remaining teeth. This is most noticeable with your molars and other posterior teeth.
- Nuts, ice
- Excessive gum chewing
- Sleep apnea
- Huntington’s disease, Parkinson’s disease
- Down syndrome
- Developmental dental defects –enamel is thin or weak
Symptoms of Tooth Wear
- Flattening of chewing surfaces
- Trismus (restricted mouth opening)
- Tenderness in the muscles used for chewing
- Headaches, usually near the temples
- The clicking of the temporomandibular joint (TMJ) – where your jaw attaches to the rest of your skull
- The bite doesn’t “feel right”
- Loose teeth
Risks of Attrition
- Teeth: Tooth sensitivity, fracture of teeth, exposure of tooth nerve, poor esthetics, toothaches
- Functional: Decreased chewing efficiency, pain on chewing
- Temporomandibular joint disorders, or chronic headaches
- Bite equilibration: A procedure done in the office where the dentist reduces the area causing the interference, allowing the teeth to come together more naturally
- Occlusal guard to prevent grinding and clenching
- Restorative procedures: Fillings or crowns to prevent further wear, decrease sensitivity, or improve aesthetics of worn dentition.
- Orthodontic movement to fix issues with a misaligned bite
- For severe cases, the only treatment is a “full mouth rehab” – necessitating crowns for nearly every tooth.