Tooth wear is one of the most serious problems in dentistry. To some extent, tooth wear is an inevitable consequence of eating and chewing with teeth, especially when eating tough, hard, or coarse foods.
But tooth wear can also be a sign of major, correctable problems in oral healthcare. Excessive wear on occlusal surfaces (where teeth come together) may be a sign of bite problems such as bruxism or TMJ. Tooth erosion, caused by acidic foods, stomach acids, and other damaging chemicals can often be addressed with diet changes or medical treatments. Good diagnostic tools help us identify the proper approach to treating tooth wear including when reconstructive dentistry is appropriate. And early diagnosis helps us provide treatment when we have the best options.
Unfortunately, some people say, current methods for diagnosing tooth wear are inadequate, and we need a new standard.
Evaluating the Old Standards
For this paper, published in BioMed Central’s Oral Health imprint, researchers proposed four characteristics of a desirable tooth wear standard. It should:
- Assess mechanical wear and chemical erosion
- Be applicable for use in assessing patients and conducting research
- Have criteria that are well-defined
- Be easy to use
They then evaluated the four most commonly cited tooth wear standards. They selected the Eccles index, the tooth wear index, the Lussi index, and the basic erosive wear examination.
None of the tested tooth wear evaluations actually met the four basic criteria. In addition, researchers felt they couldn’t combine two or more of the standards together to create an ideal tooth wear method. Therefore, they proposed a new tooth wear standard.
A Modular Design
Many of the current evaluation systems is that they fail to evaluate wear in all different parts of the tooth. Researchers proposed that a modular system could help overcome this weakness. In the proposed modular system, a 5-point scale, there are separate terms for different types of wear, but the system designates a single number for the degree of wear.
For example, a wear rating of 2 might mean wear with dentin exposure for less than 50% of the horizontal area or the vertical loss of less than one third of the clinical crown height for occlusal or incisal wear. For other wear surfaces, a rating of 2 would indicate dentin exposure of 50% or less.
It seems that there is some potential for confusion with the potential number of different meanings attached to each numerical rating. Perhaps in practice distinctions will be clearer.
Assessing Tooth Wear Is an Art and Science
Despite the fact that these standards don’t achieve everything researchers might hope for, in our office we are able to comprehensively diagnose tooth wear to determine the proper cause of wear and recommend appropriate treatment. A combination of extensive education and long experience have allowed us to develop our own approach for analyzing tooth wear. We offer many solutions for cracked, chipped, and worn teeth.
If your teeth are worn and you are looking for reconstructive dentistry to restore the health, beauty, and function of your smile, we can help. Please call (914) 526-2144 today for an appointment with a Westchester County dentist at Advanced Dentistry of Mohegan Lake.
