Q: My dentist has told me that I have severe wear on my teeth. What are my options?

A: Most people believe that they can lose teeth only because of cavities or gum disease. But the fact is more and more adults are losing teeth due to advanced attrition or tooth wear than ever before.

Not only does the tooth itself wear down but even face shape changes as the height of the teeth reduces, which might show on the lips and cheeks causing premature ageing.

One of the main reasons for severe attrition is bruxism or grinding. If there is some chemical factor such as acid reflux, gastroesophageal reflux disease (GERD) or intake of acidic drinks such as fruit juices, lemon and fizzy drinks, the breakdown is accelerated. Once the tough enamel layer breaks down, the softer layer called the dentin is exposed. This could potentially cause sensitivity.

As the dentin layer breaks down, the underlying nerve might eventually get exposed which might lead to more complicated treatment.

The treatment depends on the underlying factors that have caused the wear in the first place and then the process of rebuilding the lost tooth structure.

The process of rebuilding is now a lot easier than ever before thanks to Digital Smile Design Technology, where the patient can see how the rebuilt teeth will look before even starting the treatment. A mock-up can also be made with waxed teeth models to get more details if required.

Once the patient and dentist agree on what might look and work best the teeth preparation can start, impressions are made, and temporary teeth are fabricated. Once the patient and dentist are happy with the way the new smile looks, the final teeth can be made with either zirconia or porcelain or combinations of the two. The entire process from start to finish can take about a week to 10 days.

It’s a good idea to address tooth wear earlier rather than later as it gets more complicated and expensive as the damage increases. Best of luck with your full mouth rehabilitation.

Tanveer Ahmed is an implantologist, dental surgeon and medical director at New Ivory Dental and Implant Clinic. Got a problem? Our fantastic panel of renowned experts is available to 
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