Tooth Wear
 

What is Abrasion?

Abrasion is a term we use to describe mechanical wear that comes from something other than teeth.

It come from a frequent rubbing or scraping against the tooth surface, that over time results in the loss of some tooth tissue.

This is caused in most cases by our trusted friend the tooth brush being used over zealously.

Toothbrush abrasion is by far the most common cause; so much so that 'abrasion' and '

How does Toothbrush Abrasion Occur?

Toothbrush abrasion is a result of brushing:
  • For too long
  • Too hard or with too much pressure
  • With the wrong technique- most often this is due to a long fast horizontal scrubbing motion
  • Or a combination of all three.

Selecting a toothbrush that is too hard will also contribute.

Tooth brush abrasion is something I see every single day!

It is in my opinion the least significant of the types of tooth wear in terms of the damage it does and how easy it is to treat and rectify! However, that being said, if it is left and allowed to continue, it can severely affect the look and strength of your teeth- giving rise to sensitivity; it can even compromise the nerve of the tooth- so you need to be aware of it.

Personally, I see no need to brush your teeth more than twice a day (three at the very maximum) for two minutes whether using a manual or electric toothbrush. That is, of course, assuming you do it the right way.

Brushing a third time incorrectly will either just increase the damage being done, or miss the same places you did the last time you brushed.

So brushing your teeth correctly is the key; the proper tooth brushing technique and advice on brushes can be found in our care section.

What Other Types of Abrasion are There?

In developing countries some of the diets are a lot more coarse and tough than a typical western diet. Chewing meat on the bone for example is a common practice in certain places; leading to more significant wear of the teeth by essentially 'normal processes'.

Toothbrushes in these countries are often not the soft manufactured bristles that westerners use today. In India twigs of the neem or banyan tree have been used for centuries as a bushing device because of the medicinal properties. It is chewed until it becomes soft and splayed and then used as a regular tooth brush. Muslims similarly chew the twigs of the arak tree.

This exercise itself and the roughness of the resulting DIY toothbrushes are likely to contribute further to tooth abrasion.

What does Toothbrush Abrasion Look Like?

Toothbrush abrasion is pretty easy to spot in its later stages, but you can detect it as soon as it starts, if you know what you are looking for.

Your teeth are surrounded by a thin cuff of gum at their base. In a young healthy adult with no gum disease this totally covers the root of the tooth and bone supporting it, so the only thing visible in the mouth is the crown of the tooth.

The ability of the gum to resist wear from toothbrushing depends on its thickness. The very prominent bony anatomy in the mouth, or teeth that have been orthodontically moved forward in the bone to bring them in line, often have particularly thin areas of gum over them; these are prone to much more rapid wear.

  • Exposed root surface
The first sign is some exposed root surface.This becomes visible because of gum recession; more specifically the wearing away of the cuff of gum by incorrect and over enthusiastic toothbrushing.

The first visible evidence of toothbrush abrasion is the junction between the crown (top of your tooth) and the slightly yellower root surface.

  • Eaten out (notched) tooth appearance

This root surface is much softer and doesn't have the strong enamel layer to protect it. Because of this, it wears much more easily and more quickly; over time characteristic scooped out notches begin appearing on your teeth at the gum line. It can look like something has taken a bite out of your teeth.


Unlike gum recession associated with gum disease, the gums tend to be very healthy- firm, pink and hard with no evidence of gingivitis. Also the area of gum in between the teeth is rarely affected, which makes logical sense since this is harder to get to when brushing.

Toothbrush abrasion causes gum recession in the most prominent and accessible areas to the toothbrush bristles. Once the covering of gum disappears, the root surfaces then take the brunt of the force and begin to wear down.

Which Teeth are Most Commonly Affected?

The teeth most commonly affected are the outsides of the premolars and first molars.

In general, the top teeth tend to be more affected than the bottom, but there is quite a bit of variation from person to person; it depends on the amount, direction, angle and location of the force you are exerting.
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We can often tell the 'lefties' (left handed brushers) simply by the patterns of wear on their teeth.' But how did you know/?' they often say!



Canine teeth are the next most common to be affected, then upper incisors and sometimes the inside (palatal) surfaces of the top teeth (rarely the bottom- people don't spend long enough brushing here!).

Any teeth that stick out of the arch and have very thin surrounding gums are particularly vulnerable. If you have one tooth positioned out of line from all the rest towards the cheek- this tooth is obviously going to end up being brushed more than those that are set back and as such, is more likely to exhibit toothbrush abrasion.

The 'wearing away' of the gum, is usually necessary for toothbrush abrasion to occur. However, if you have exposed root surfaces for any other reason, such as periodontitis or a nearby surgical extraction, you are one step closer to this kind of tooth wear. Just something to bear in mind.