Four Ways You Can Lose Your Teeth
One of the first questions patients ask is: “do I have any cavities?” But did you know there are actually four ways your teeth can be damaged? Cavities are a major source of tooth loss but gum disease, a bad bite and erosion are culprits that must be carefully monitored as well. Let’s briefly look at each:
Cavities
A cavity (also called caries) is a bacterial infection that causes tooth decay. Cavities occur when the outer layer of your tooth is sufficiently weakened that bad bacteria can infect its inner layers 1 . The outer layer of your tooth is temporarily weakened (demineralized) any time you expose it to a pH level lower than 5.5 -- this occurs every time you consume carbohydrates2. Your teeth remain in this weakened, demineralized state for about twenty minutes after eating. If you snack on foods, or sip on beverages throughout the day (even if they are systemically “healthy”), you are extending that weakened state and putting your teeth at a higher risk for cavities.
Periodontal (Gum) Disease
Periodontal disease is a progressive, inflammatory condition that destroys the bone and surrounding tissues that keep your teeth in place 3 . Its initial phase is called gingivitis – this is when your gums become inflamed, sensitive, and easily bleed. If the infection is not controlled with exceptional home care and professional assistance, it will progress into its secondary phase of periodontitis – this is when your bone will begin to dissolve, leading to mobility and eventual tooth loss. Periodontal disease is an inflammatory condition that is linked to multiple other systemic illnesses including: diabetes, heart disease, rheumatoid arthritis, Parkinson’s disease, Alzheimer's disease, forms of cancer and pregnancy complications 3,4 . Leaving gum disease unchecked places not only your teeth, but your systemic health at risk.
Bad Bite (Occlusal Disease)
Some wear (or attrition) on your teeth is normal but can be exacerbated by tooth positioning, jaw misalignment, clenching or grinding. Some professionals refer to this as “occlusal disease” or a “bad bite”. Signs of a bad bite include flattened teeth, chipping, cracking and recession (exposed root surfaces) 5,6. Symptoms may include clicking or popping in the temporal mandibular joint (TMJ), jaw pain, earaches and tinnitus5,6. Correcting your bite with orthodontic treatment like braces or Invisalign may help minimize damage but often an appliance (like a night guard or orthotic) will be advised to cushion excessive muscular forces.
Erosion
Erosion is different from a bad bite or cavities but is often missed in oral evaluations. Erosion is the chemical destruction of the outer layer of your tooth through excessive exposure to acid. This can stem from simple acid reflux, Gerd, Bulimia, alcohol, or carbonated beverages and is made worse by aggressive manual brushing. 7 . Classic signs of erosion are smooth, yellowed teeth with fewer lobes and grooves found on healthy dentition 7 .
Prevention is Everything
Bringing up evidence of these conditions is never meant to make you feel bad, but to inspire better habits and life-style choices that will keep your teeth healthy. Remember, an ounce of prevention is worth a pound of cure 8 -- especially when it comes to oral health.
References:
Rathee M, Sapra A. Dental Caries. StatPearls Publishing; 2021 Jan. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK551699/. Accessed December 12, 2021.
Kianoush N, Adler CJ, Nguyen KA, Browne GV, Simonian M, Hunter N. Bacterial profile of dentine caries and the impact of pH on bacterial population diversity. PLoS One. 2014;9(3):e92940. doi:10.1371/journal.pone.0092940
Bui FQ, Almeida-da-Silva CLC, Huynh B, et al. Association between periodontal pathogens and systemic disease. Biomed J. 2019;42(1):27-35. doi:10.1016/j.bj.2018.12.001
Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000. 2020;83(1):213-233. doi:10.1111/prd.12329
Torii K. Occlusal disease. J Den Health Res. 2018;1:1-0. Retrieved from: https://www.researchgate.net/profile/Kengo-Torii/publication/328438849. Accessed December 12, 2021.
Fan J, Caton JG. Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018;89 Suppl 1:S214-S222. doi:10.1002/JPER.16-0581
Donovan T, Nguyen-Ngoc C, Abd Alraheam I, Irusa K. Contemporary diagnosis and management of dental erosion. J Esthet Restor Dent. 2021;33(1):78-87. doi:10.1111/jerd.12706
National Archives. Benjamin Franklin; On Protection of Towns from Fire, 4 February 1735. Retrieved from: https://founders.archives.gov/documents/Franklin. Accessed December 12, 2021.
