According to a 2006 Q & A article in the New York Times, it is estimated that chewing exerts a force of about 70 pounds per square inch on the molars and tapers off some towards the front of the mouth. However, more force than this can be exerted on the teeth during parafunctional behaviors such as teeth grinding or clenching. In fact, bruxism is said to exert at least two times the force of chewing.
When you consider that 70 pounds per square inch is being exerted on your teeth every time you chew, it comes as no surprise that this will eventually cause your tooth enamel to wear down over time. In cases where the force of chewing is compounded by the additional force of bruxism, it is also no surprise that this can cause the enamel to wear down faster. Although worn enamel is a naturally occurring phenomenon, destructive behaviors like teeth grinding or clenching can increase the rate of enamel erosion.
As the tooth enamel wears down, it will become thinner and less protective. This can result in tooth sensitivity and it can also increase the risk of developing tooth decay. Additionally, thinning enamel also allows the underlying dentin layer to show. Since dentin is a yellowish color, this ultimately gives your teeth a yellowish tint.
Tooth sensitivity and yellowing teeth are two main reasons that encourage people to seek treatment for worn enamel. Luckily, there are some cosmetic dental treatments that can be used to address both the look and function of teeth affected by worn enamel. These treatments include:
Cosmetic bonding, also sometimes known as dental bonding or composite bonding, is the process of applying layers of composite resin to the tooth and then hardening these layers in place. This method is ideal because composite resin is able to create a strong bond with existing enamel without the need for extensive modifications to the natural tooth structure. This means that the majority of the natural tooth is preserved while an additional protective layer can be placed over areas that have worn enamel. The composite resin used for bonding can also be customized in terms of color to make the teeth appear brighter. However, the main downside of cosmetic bonding is that results only last about 5-7 years because composite resin is not the most durable dental material.
Like cosmetic bonding, porcelain veneers can also be used to create a protective layer over worn enamel that also improves their color. However, porcelain veneers are thin shells that must be cemented onto the front side of the teeth after minor modifications to the natural tooth structure. Veneers will also take a minimum of two dental appointments to complete because of the fact that they are custom fabricated by a dental laboratory. Since porcelain is much stronger than composite resin, however, veneers are expected to last about 10-15 years when cared for properly.
Dental crowns are tooth-shaped caps made from various dental materials that are designed to completely encapsulate the affected tooth. However, since extensive modification to the natural tooth structure is needed to place a dental crown, your cosmetic dentist will likely only recommend one if your tooth already has extensive enamel wear in multiple places or if there are other reasons to justify the placement of a dental crown. Dental crowns, like veneers, will also need two appointments in order to be completed. Although the exact lifespan of your dental crown can vary depending on the type of material used, most crowns last about 10-15 years.
Dr. Sadati possesses extensive experience in all aspects of advanced restorative dentistry, with an emphasis in cosmetic and implant dentistry. He has attained Accredited Fellow status in the American Academy of Cosmetic Dentistry (AACD), the most rigorous, demanding credentialing process in the world. He is the only AACD Accredited Fellow in South Florida.