Umhlanga Dental
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• Teeth Grinding (Bruxism) and tooth enamel erosion
Tooth enamel is the strongest substance in the human body. This semi-translucent, hard, outer layer of the teeth has an important job: protecting teeth from the daily wear and tear of biting and chewing, as well as temperature extremes from hot or cold foods and drinks. Enamel also guards teeth against the erosive effects of acids and chemicals.

Enamel covers the dentin, a part of the tooth that is not as dense as enamel. When enamel erodes, the dentin loses some of its protection. Then microscopic tubes inside the dentin allow hot, cold, or sweet foods to stimulate nerves within the tooth. As a result, you may notice that your teeth have become painfully sensitive to hot or cold foods and drinks and sweets.

question What Causes Tooth Enamel Erosion?
answer Many factors can contribute to tooth enamel loss:
• Consumption of too many soft drinks or fruit drinks, along with poor dental hygiene. Bacteria thrive on sugar and produce high acid levels that can eat away at enamel.
• Eating lots of sour foods or candies. Acidic foods can erode tooth enamel.
• Dry mouth or low saliva volume. Saliva helps prevent decay by neutralizing acids and washing away leftover food in the mouth.
• Acid reflux disease (GERD), or heartburn. Acid reflux brings stomach acids up to the mouth, where the acids can erode enamel.
• Bulimia, alcoholism, or binge drinking, in which frequent vomiting exposes teeth to stomach acids.
• Certain drugs or supplements with high acid content, such as aspirin or vitamin C, can also erode enamel.
• Friction and wear and tear – from brushing teeth too vigorously or grinding teeth, can erode enamel.

question What Are the Symptoms of Tooth Enamel Erosion?
answer When tooth enamel erodes, you may have some of these symptoms:
• Sensitive teeth or tooth pain when eating with hot, cold, or sweet foods, or drinks.
• Rough or irregular edges on the teeth, which can become cracked or chipped when enamel is lost.
• Smooth, shiny surfaces on the teeth -- enamel erosion causes mineral loss on these areas.
• Yellowed teeth from thinned enamel.
• Cupping, or dents, that show up on the biting or chewing surfaces of the teeth.
• When tooth enamel erodes, teeth are more vulnerable to cavities and decay.

question How Can You Protect Tooth Enamel From Erosion?
answer Good dental care at home and at the dentist’s office can help prevent tooth enamel erosion. Here are 12 tips that can help:
• Cut down on acidic drinks and foods, such as carbonated drinks and citrus fruits and juices. If you do drink them, do so at mealtimes to minimize their effects on the enamel.
• Switch to modified products, such as low-acid orange juice.
• Rinse your mouth with water right after having acidic foods or drinks.
• Drink sodas and fruit juices with a straw, which helps acids to bypass the teeth. Don’t swish acidic drinks around in your mouth.
• Finish a meal with a glass of milk or piece of cheese to neutralize acids.
• Chew sugar-free gum with xylitol, which reduces acids from foods and drinks. Chewing gum also increases saliva flow, which helps prevent enamel erosion because saliva strengthens teeth with key minerals.
• Drink more water during the day if you have dry mouth or low saliva problems.
• Use a soft toothbrush and avoid brushing too aggressively.
• Wait for at least one hour to brush teeth after they have been exposed to acids in food or drinks. Acid leaves the enamel softened and more prone to erosion during brushing.
• Use fluoride toothpaste to strengthen your teeth.
• Ask your dentist about using commercial toothpastes to reduce tooth sensitivity or to protect against acid erosion.
• Get treatment for disorders that can bring acid into the mouth, such as bulimia, alcoholism or GERD.

question Can Damaged Tooth Enamel Be Repaired?
answer There are several ways to fix damaged tooth enamel. The right approach depends on your particular problem with enamel loss.
Tooth bonding can protect a tooth with enamel erosion and improve the appearance of teeth that are worn down, chipped, or discolored.
If enamel loss is significant, a dentist may cover the tooth with a crown to protect it from further damage.

Night guards
question What are night guards, and why are they important?
answer It has been well stated that a smile is one's greatest asset, yet it is not always safeguarded as such. Whether you have all natural teeth, or have just spent a small fortune restoring or cosmetically enhancing your smile, a night guard may be the best way to look after your investment. A night guard (also known as an occlusal splint, a bite guard, and a muscle relaxation appliance) is a device most often recommended as the first line of treatment for bruxism (teeth grinding) and TMD (dysfunction of the TMJ). It is usually worn while you sleep to prevent damaging your teeth by the clenching or grinding associated with either the psychological aspects of stress, one's abnormal bite, a sleep disorder, or a combination of the above. Nightly wear significantly reduces daytime bruxism, because the mouth becomes more sensitized, leading to a heightened awareness whenever the opposing teeth are in contact during abnormal function. A night guard can help reduce your grinding and TMJ troubles by:
(1) helping to relax your jaw muscles, which in turn reduces muscle spasms;
(2) alleviating your headaches;
(3) enabling your jaw to find its best position, since teeth are prevented from locking together; and
(4) substituting for your teeth when it comes to wear - it is better to grind the night guard than your own teeth. During the day you should be aware that the only time the teeth should meet is when you chew and when you swallow. All other times think lips together teeth apart.
Grinding can wear away the surfaces of your teeth causing them to become painful or loose. Although maxillary (upper arch) devices are recommended as the treatment of choice, a lower arch device is indicated when a patient have a severe gag reflex with the upper arch device. Quality night guards can prevent further wear of your natural dentition. They will also help to protect your investment after undergoing a smile makeover. With night guards, it is not enough to simply wear one; they must also be routinely checked and adjusted. Ill devised or poorly adjusted night guards often do not succeed in resolving the problem. Well adjusted night guards (and the acceptable restoration of affected teeth), will allow a patient with bruxism to live a normal life, without significant tooth wear or other dental-related traumas. Remember, we only get one set of adult teeth, so please protect your smile.

question What causes teeth grinding and clenching (bruxism) and what are its manifestations?
answer The main causes of teeth grinding and clenching (bruxism) are stress, and a poor bite. People often take out their worries, fears and stress subconsciously, while they sleep, causing the muscles and joints associated with the mouth to become strained and over-worked. These muscles can go into spasm, and the joints can become inflamed and result in pain of the TMJ (temporomandibular joint). Teeth clenching and grinding can also result in the loss of enamel, causing teeth to become more sensitive and causing the eventual need for root canal therapy and crowns. When tooth structure is lost, the bite collapses, resulting in the face developing an older appearance. Grinding can also cause teeth to fracture and can cause mobility of the teeth. When the bite is off, the muscles and joints can become strained, resulting in TMJ problems and jaw pain. When this happens, neck problems and headaches can arise, and one’s posture can become affected. Keep in mind that a lot of force can be exerted by the chewing muscles.

question What causes teeth to get shorter over time?
answer People don’t often notice the subtle wearing down of their tooth structure, which over time can amount to a huge change in the appearance of their smile. Just as you may not notice the sole of your shoe wearing down until you see the hole, your bite can collapse in much the same way. Severe wearing down of the teeth’s outer layer (enamel) is often the result of grinding or bruxing the teeth. Acidic conditions (such as acid reflux, bulimia, etc.) can also act to weaken the tooth structure accelerating this wear. Severe wear may become evident on the front teeth, the back teeth or on both, depending on the way one grinds. Excessive wear in the back of the mouth translates to even more wear in the front as the bite collapses. When the front teeth are affected, the teeth start to get more translucent at the top edges, and start to chip away. As these front teeth continue to wear down, and the teeth become shorter, the face begins to take on a much older appearance.

question Is it normal for a toddler to grind their teeth? What can be done about it?
answer It is not uncommon for toddlers to grind their teeth .There may be a variety of reasons responsible for their teeth grinding, including: teething pain, malocclusion (when teeth are not meeting properly), or simply adjusting to the new sensation of having teeth. The average age when grinding may start is at 3 years old, and usually ends by the time the child is 6 years of age. This grinding is not likely to result in any real damage to their teeth, but you should mention it to your child’s dentist to prevent any possible problems from arising.
Although the noise can become quite disturbing, you may just have to wait a period of time for your child to grow out of it. Older children may be fitted with a night guard appliance, although they will probably need to go through a few of them as their teeth and jaws continue to grow.


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