When it comes to tooth wear and what damages the health of people’s teeth, the most commonly discussed topic is diet – sugar and foods high in saturated fat have become the most widely known factor for contributing towards a decline in oral health. There are, however, a variety of factors that can contribute to tooth wear. Many patients don’t know that things such as bruxism, malocclusion, eating disorders, and excessive brushing can also cause damage. Tooth wear can be something you see in your patients more often than expected, especially as a survey concluded that 15 per cent of UK adults presented moderate tooth wear and it was more common in men (19 per cent) than women (11 per cent).[i]
Commonly characterised by grinding the teeth and clenching the jaw, Bruxism can cause tooth wear, tooth breakage, TMJ dysfunction, and headaches.[ii] Supporting a patient who has, for example, suffered some kind of tooth wear due to their bruxism will likely be an ongoing process so it’s important to get to the cause of their bruxism and support them where you can.
One major cause of bruxism is stress and anxiety, especially as almost 70 per cent of bruxism occurs as a result of this.[iii] Further still, it was discovered that job related stress is one of the most significant factors associated with bruxism. The study revealed that shift workers who were unhappy with their schedule experienced more stress and therefore became more susceptible to bruxism. It’s also important to note that, in this study, men presented with higher levels of job stress, depressive symptoms, and bruxism compared to their female counterparts.
As the patients you could see whom suffer with bruxism are likely to have stress and anxiety too it would be good practice to be prepared to support your patients with stress management techniques. Here are some things you could do:
- Speak to your patient. Asking them how they are can get a person speaking about their problems and sometimes venting about stress can be the biggest reliever.
- Mindfulness, yoga, and meditation. Practising these methods have been known to reduce stress via two different pathways in the brain, changing the structures and activity in areas of the brain associated with attention and emotional regulation.[iv]
- Suggest that they plan ahead if future tasks cause them a lot of stress. Sometimes breaking larger tasks down into small chunks can help a person manage the situation with less stress.
- Whilst a lot of people who suffer with stress and anxiety can help themselves, some may need to see a professional. If you are genuinely concerned about the wellbeing of your patient, it may be a good idea to advise that they can get further support through their GP or a private therapist.
The effect of eating disorders
Eating disorders (ED) that include symptoms such as purging can play a role in causing tooth wear too. [v] In fact, changes in the mouth can often be the first signs of an eating disorder. The acidity levels of vomit that repeatedly flows over the teeth will affect the natural pH levels in the mouth. Over time, the tooth enamel can be lost and cause the teeth to change in colour, shape, and length. The teeth can also become brittle, translucent, and weak. When these symptoms start to show, most patients will grow concerned and seek treatment.
You might be wondering how you can treat a patient’s tooth wear when they have an ED that may take a long time to recover from. Of course, you can’t cure your patient’s eating disorder, but you can help them manage the cause of their tooth wear. Here are some strategies you can keep in mind for these patients:[vi]
- Ensure the environment they are in is non-judgemental and relaxed. Suggesting that any tooth wear visible could be caused by fizzy drinks, for instance, may lead to disclosure of an ED.
- If it’s already known that they suffer with an ED it’s important to be as positive as possible when speaking to them about their symptoms as this could motivate them to continue treatment.
- Using fluoride mouthwash after purging can help reduce acid attacks.
- Drinking water as much as possible will help to keep the mouth moisturised as a dry mouth can upset the natural oral balance and leave the teeth more vulnerable. This will help to reduce exposure to any acidity in the mouth too.
Recommend the best
One sure way to support your patients suffering with tooth wear problems in-house and after they leave your practice is with Curasept Biosmalto from J&S Davis. The impact action mousse can help to manage caries, abrasion, and erosion – with seven years of research behind it you can rest assured that your patients’ symptoms will improve with regular use. Not just that but the formula also works to quickly remineralise enamel and dentine. What’s more, Curasept Biosmalto impact action mousse from J&S Davis is vegan so you can include a variety of patients in this treatment option!
Overall, tooth wear is an issue that many patients will face at some point in their life. The most you can do is to be prepared to support your patients when they come to you for treatment. Of course, treating any uncomfortable symptoms with the most effective products is important but ensuring that you address the root cause should be a priority too.
[i] Steele, J. and O’Sullivan, I. (2011). Adult Dental Health Survey 2009. [online] GOV.UK. Available at: https://files.digital.nhs.uk/publicationimport/pub01xxx/pub01086/adul-dent-heal-surv-summ-them-exec-2009-rep2.pdf [Accessed 10 Jan. 2022].
[ii] The Bruxism Association (n.d.). What Is Bruxism? [online] Bruxism.org.uk. Available at: https://www.bruxism.org.uk/what-is-bruxism.php [Accessed 10 Jan. 2022].
[iii] The Bruxism Association (n.d.). Causes Of Bruxism. [online] Bruxism.org.uk. Available at: https://www.bruxism.org.uk/causes-of-bruxism.php [Accessed 10 Jan. 2022].
[iv] Apa.org. (2019). Mindfulness Meditation: a Research-Proven Way to Reduce Stress. [online] Available at: https://www.apa.org/topics/mindfulness/meditation#:~:text=By%20lowering%20the%20stress%20response [Accessed 10 Jan. 2022].
[v] Dental Complications of Eating Disorders (2018). Dental Complications of Eating Disorders. [online] National Eating Disorders Association. Available at: https://www.nationaleatingdisorders.org/dental-complications-eating-disorders [Accessed 10 Jan. 2022].
[vi] Douglas, L. (2015). Caring for Dental Patients. [online] Nature. Available at: https://www.nature.com/articles/bdjteam20159 [Accessed 10 Jan. 2022].