Tooth wear is initially noticeable because the teeth becoming smaller and darker. This ages the patient but usually only becomes a functional problem when it affects your bite, contributing to temperomandibular joint disorder (TMD), leading to headaches, earache and neck or back aches. There are two main causes. One is uncontrolled grinding or clenching (bruxism) due to stress. The other is acid erosion, which is from either food or drink in the diet, or acid reflux commonly seen in patients who have suffered from bulimia or years of heartburn.
At six monthly check ups we can measure if the teeth are being worn down. This allows conservative treatment if the tooth wear is diagnoses early. In most cases, cessation advice is given, but a customised bite splint may be provided. For patients who do not want to wear an appliance, then a small injection of Botox in the clenching muscles will stop the damage caused by grinding.
For patients who present for examination after many years of tooth grinding, then treatment is required. Patients with erosion or tooth wear/bruxism in Harley Street would be treated by Dr Sherif to restore the teeth to their original dimensions, using composite bonding or crowns. This may require collaboration with a periodontist or endodontist to lengthen the teeth to provide the longest lasting result.