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There are two common reasons tooth wear occurs: acid erosion and attrition. In this blog, I’ll be exploring what happens in both cases, and what you can do to protect your healthy and beautiful smile.
The primary cause of worn teeth is acid erosion. Acid from drinks and our stomachs slowly dissolves the enamel (the outer surface of the tooth) until it reaches the dentine (the yellow inner surface of the tooth).
The speed of the erosion depends on the frequency of acid contact with enamel. Enamel is the hardest substance in the human body, so it can take a long time for acid to wear it away. When it finally reaches the inner surface of the tooth, however, the rate of erosion progresses rapidly because the dentine is so soft.
Let’s explore the two main suspects culpable for acid erosion:
Up to 80 per cent of adults are at risk of enamel loss as a result of what they eat according to the American Dental Association,
In fact, a study on the relationship between food habits and tooth erosion was conducted on Malaysian University students. It was found that 68 per cent of participants had tooth erosion. Those subjects who had received information about healthy eating were less likely to have tooth erosion.
Some foods in our diets can be incredibly acidic. The pH scale measures acidity or alkalinity levels in a range from zero to 14. Substances that fall below a pH of seven are considered acidic, and those above seven are alkaline.
When we’re not eating and drinking, our saliva should be in the neutral range of 6.5 to 7.5 pH. This range is perfect for preventing enamel erosion and tooth decay.
There are certain foods that are common in our diets that can become a problem when consumed in excess.
The most popular offenders are:
These substances range from two to five on the pH scale. I know lemon water is quite trendy these days, but when consumed in excess it will cause issues over time!
When consuming foods with high levels of acidity, you should rinse your mouth with water and wait at least an hour before brushing your teeth. This gives your saliva a chance to wash away the acid and reharden your enamel.
Dental erosion as a result of stomach acid generally progresses more rapidly and can be more severe. This is because our stomach acid has a pH between one and two, which is incredibly acidic – much more so than the foods in our diet.
Stomach acids can enter the mouth for a multitude of reasons, most obviously vomiting, but also as a result of gastroesophageal reflux disease (otherwise known as acid reflux). This is when acid from the stomach leaks up the oesophagus due to weakened oesophageal muscles.
Patients with these conditions should be especially mindful of staying hydrated. Saliva is an excellent natural defence against tooth wear as it helps to clean the teeth of acid and allow the enamel to reharden. Many acid reflux medications can cause an incredibly dry mouth, so chewing sugar-free gum and drinking lots of water should help.
These include:
Acid erosion is difficult to identify before it becomes a problem unless you are being regularly monitored at a dental practice. This is yet another reason it is so important to visit your dentist on a regular basis – even if you don’t think there are any issues in your mouth.
Your dentist and hygienist will take digital scans of your teeth and compare them over time. This is the only real way of identifying tooth wear before it requires treatment.
With regards to stomach-related acid erosion, take note of regular heartburn which could be a sign of acid reflux. In these cases, I recommend visiting not only a GP, but also your dentist or hygienist to keep a close eye on your teeth. You may have heard stories from women who have experienced loss of tooth structure during pregnancies where they suffered with regular heartburn.
Dental attrition is caused by “tooth to tooth contact”, such as grinding or clenching teeth. The resulting friction causes enamel to wear down.
Many times, teeth grinding and jaw clenching are stress and anxiety induced. If you’re experiencing stress and anxiety to such an extent that your teeth are being affected, I recommend you consult a professional. After all, the healthiest and most beautiful smiles come from happy and confident people, and we all deserve to feel this way.
A 2011 study on the prevalence of dental attrition found that 80 per cent of participants (400 subjects out of a total of 500) showed signs of dental attrition up to the dentine.
If you’re struggling with attrition as a result of grinding your teeth or clenching your jaw and can’t seem to stop, I recommend investing in a hard acrylic mouth guard to protect your teeth during your sleep.
The rate of wear as a result of acid erosion is much faster than erosion by attrition.
The long-term consequences of tooth wear depend on a multitude of factors, including but not limited to a patient's genetics and the source of erosion. If no tooth wear protective measures are put in place, you might be putting yourself at risk of tooth ache, sensitivity, and even tooth loss. Once the erosion reaches the inner tooth, it could cause an infection in the nerve, which might require root canal treatments.
A consequence of tooth erosion that many patients fear the most, however, is simply an uneven smile. Teeth become shorter very gradually – over time you might not notice, but looking back at pictures might make you gasp at the difference!
Whilst this consequence is cosmetic, it can be a huge knock to your confidence. Confidence is a key ingredient in a healthy and beautiful smile, and that’s why I so often stress the importance of regular check ups with your dentist.
Reduction of stress, being mindful about your diet, and consulting a professional are great ways to protect your teeth.
Remember – simple is best! The best way to look after your teeth is simply to brush them for two minutes twice a day with a fluoride toothpaste. Enamel that has fluoride in it is stronger than enamel without fluoride.
No matter where your tooth wear comes from, a good dental practice should be completely non-judgemental. At London Dental Specialists, we are always here to help. Irrespective of the cause of your tooth erosion, there will be a solution and we can show you. Complete the form below so we can restore your smile to its former glory.
Dental implants are made up of a titanium screw that goes into the bone. Sounds scary, but they are the strongest and most convenient option available to fix missing, broken, or dead teeth.
At London Dental Specialists, we specialise in offering high-quality dental implants to successfully rebuild your healthy and beautiful smile. But there are other options out there, and in order to feel confident about your choices, you should be aware of what they are and how they compare.
Your specialist dentist will place a titanium implant into the jawbone beneath the missing tooth. We can imagine that the screw replaces the root of the missing tooth. After a healing period of three months, a custom moulded crown can be screwed on top of the titanium implant, fixing it in place. Cosmetically, dental implants look great – in fact, no one will even be able to tell you’ve got one!
Your dentist should consider how much bone you have at the implant site. Some patients might require a bone graft ahead of fitting a dental implant. A bone graft usually takes bone from the chin, the back of the mouth, or the hip.
This bone doesn’t always have to come from you, either! Interestingly, the bone used in your bone graft might come from a patient who has recently had hip surgery! The head of the femur, which is removed during this type of surgery, is often donated to dentists to be used in bone grafts. Of course, this will always be clearly communicated to the patient!
Whilst a bone graft is beneficial, if one cannot be carried out, or one you’ve previously had is no longer working, a longer dental implant can be screwed into the cheekbones, underneath the nose or behind the upper jaw.
There are two main options for replacing missing teeth outside of a dental implant:
There are several types of dental bridges and the most common is the traditional fixed bridge. The traditional fixed bridge is usually made from metal, porcelain, or ceramic teeth joined together. Fitting this type of bridge involves drilling the tooth down to a stump to get an impression of it, and then fitting the bridge on top.
Whilst this is more secure than other forms of dental bridge, the destruction of the natural tooth could lead to the need for root canal treatment. This is where we can enter what is called a restorative cycle: the more the tooth is “restored” and “repaired”, the more damaged it becomes until eventually this process will lead to the failure of our teeth.
Another common bridge is a Maryland bridge, also known as a resin-retained or “sticky” bridge. This is where a replacement tooth is glued into a gap, fixed in place by a wing-like structure which also supports the neighbouring teeth.
Dental bridges can last for many years, especially with good oral hygiene. Over time, the cement can deteriorate, or patients to fall short of good oral hygiene. Both of these will lead to tooth decay and collapse of the bridge. In situations where there are multiple missing teeth, bridges are not recommended.
One of the great advantages of dental implants is that the process never goes down this restorative spiral. And the more missing teeth you have, the more important it is to choose a treatment option that is strong and doesn’t cause further damage.
The most important consideration about dentures is that they require more extensive hygiene care to keep them healthy because dentures trap plaque.
A clinical trial conducted in Newcastle which compared patients who had fixed teeth with those who had removable teeth found that patients with removable teeth had higher rates of gum disease. Other studies have supported this, finding that “subjects wearing removable dentures were significantly at risk for periodontal disease progression”.
This is not to say that patients who have dentures are doomed! Of course not. However, if you do choose to have a denture, your oral hygiene must be pristine in order to protect your teeth. It is much harder to keep dentures clean than it would be an implant. This is because dentures might cover other teeth and cause a buildup of plaque.
I cannot stress enough the importance of taking our oral hygiene seriously, both from a gum disease perspective and a decay perspective.
The only patients for whom a dental implant might not be appropriate are those patients who have had radiotherapy in the area of the mouth that requires the implants. For example, some salivary gland tumours require radiotherapy to treat, and will have been targeted extensively. Radiotherapy will kill the blood supply to the bone, and in these situations a dental implant would not be ideal.
Whatever your situation or issue, we want to equip you with the knowledge you need to feel confident and reassured, before you even visit a specialist. If you’d like to chat more about concerns surrounding the best treatment option for you please complete the form below.
Dental implants are an exceptional solution for those seeking to replace missing or severely damaged teeth. They involve the surgical placement of a titanium post into the jawbone, which acts as an artificial root. This post then supports a custom-made crown, bridge, or denture, mimicking the appearance and functionality of natural teeth (read more here).
To help you visualise the process, here's a handy diagram:
Dental implants boast a plethora of benefits, from improved appearance and speech to enhanced comfort and convenience. Moreover, they're renowned for their durability and success rates, making them a top choice for those seeking a long-term solution to missing or damaged teeth.
The earlier you address tooth loss or damage, the better. Prompt action can prevent complications, such as shifting teeth, bone loss, and infection. So, don't delay—consult your dentist to determine whether dental implants are the right choice for you.
Are Dental Implants in Your Future? Don't Delay, Act Today!
Feeling enlightened and ready to embark on your journey towards a dazzling new smile? Don't hesitate! Fill out the form below to schedule your appointment.
There are 3 causes of tooth wear - attrition, abrasion, and erosion.
Attrition is caused by the constant grinding of teeth against each other, wearing down the enamel. It's particularly prevalent in those who suffer from bruxism, a condition that compels one to clench or grind their teeth (usually during sleep). Clenching and grinding is extremely common these days due to our stressful lives.
Abrasion is the result of excessive tooth brushing or using a toothbrush with hard bristles. It can also be caused by biting on hard objects, like pens or fingernails.
Erosion is the dissolution of tooth enamel due to the presence of acids. These acids can come from external sources like fizzy drinks, citrus fruits, and even wine (I know, gasp). They can also be a result of internal factors like acid reflux or frequent vomiting.
If you suffer from bruxism, a custom-made mouth guard will protect your teeth from grinding and clenching, giving your enamel a well-deserved break.
Choose a toothbrush with medium bristles and adopt a gentle brushing technique. Better still, but an electric toothbrush with a pressure sensor so that you can be confident about knowing when you are brushing too hard. Also, avoid biting on hard objects or using them to open packages (yes, I'm talking to you, pen chewers).
To combat erosion, try these simple yet effective strategies:
Now, for the Grand Finale!
There you have it, folks - the causes and solutions for tooth wear, all in one nifty package. And remember, prevention is always better than cure, so start implementing these solutions today to keep tooth wear at bay (read about treatments options for situations where there are cosmetic issues due to tooth wear).
Want to know how to take your dental health to the next level? Fill out the form below and the team will contact you within 24 hours.
Tooth sensitivity is that electrifying jolt that shoots through your teeth when you bite into a frosty ice cream cone or sip a steaming cup of tea. In this article, we'll uncover the shocking truth behind tooth sensitivity and how you can put an end to it.
The primary culprit behind tooth sensitivity is the erosion of tooth enamel. Enamel, the hardest substance in the human body, serves as the protective layer for the softer, more sensitive tissue beneath it. In an unfortunate turn of events, your enamel can wear down, exposing the dentin layer and its tubules that lead directly to the tooth's nerve centre. No wonder you're experiencing such a shocking sensation!
Here are some helpful tips to alleviate tooth sensitivity and protect your precious enamel:
Feeling inspired to take action? Give your teeth the TLC they deserve by filling out the form below, and let's schedule a check-up.
Invisalign is the most widely known and used aligner brand in the world today. More and more adults are considering and taking up on the teeth straightening journey since these almost invisible options are available on the market. Click here to read about all the options.
Are you one of them?
Have you seen a dentist for assessments or scans to determine if you would be eligible?
Were you told that Invisalign is not a good option for you but you are still keen on having it because of its discrete nature?
Don`t give up, here at London Dental Specialists, we work with complex cases other dentists don't have the experience of treating. We are here to help you to find out how you can still achieve your desired smile.
Please complete the form below and one of the team will contact you within 24 hours (on a weekday).
With so many different toothbrushes on the market, it can be confusing choosing one that is right for you. As a dental hygienist for London Dental Specialists, I can alleviate your tooth brushing worries and save you a heap of time researching (read more here).
The important thing to consider when purchasing an electric toothbrush is head movement. An oscillating and rotating head is the perfect combination of requirements for efficient plaque removal. The Oral-B brushes have both of these features, so I tend to recommend this brand of electric toothbrush to all of my patients. It is also important to purchase a brush which is rechargeable as a battery powered brush will begin to deplete in power after the first use. This is compared to a rechargeable brush which will generally maintain its level of power when re-charged.
The Oral-B pro series onwards are the best type of brush to go for. This includes the genius and smart range. These brushes are best as they tend to have more power which will remove plaque efficiently. These brushes also have a built in timer and pressure sensor to prevent you from over brushing your teeth and gums. These electric toothbrushes tend to retail at £35+ and can be purchased from Amazon or Boots for the best prices. Any Oral-B brush that is below a pro series will not be adequate for plaque removal.
If you have the budget to allow, the Oral-B iO series is currently the best brush on the market and retails at approx. £100+. These brushes have 2 pressure sensors opposed to 1 (which you’ll be getting with the Pro series). This ensures that you are not underbrushing as well as over brushing. Underbrushing can be just as detrimental to your oral hygiene as brushing too gently will not remove a sufficient amount of plaque.
Electric toothbrushes will generally live for many years, however, it is a good idea to change your electric brush every few years. This is because like most rechargeable electronics, the battery will reduce over time and will either not maintain its level of power or will not charge completely. This will result in a compromised toothbrush efficiency and therefore, sub-optimal plaque removal.
Ready to take the first step towards a brighter, healthier smile? Fill out the form below and let's get started! Trust us, your teeth will thank you (and so will we!).
There can be some confusion when it comes to dental appointments and we hope that this blog will clear up any uncertainty (Read about the different dental roles here). Your hygienists’ main priority are your gums and helping to prevent and treat gum disease. This involves providing you with tailored oral hygiene advice and recommendations.
Your dentist is there to check your teeth for any decay and take any x-rays that may be indicated. This task can also be carried out by your hygienist, if he/she is a qualified dental therapist but this is usually made clear to you at the time of booking your appointment.
There are certain things that a dental therapist or hygienist cannot diagnose that will be in your best interests and you will need to see a dentist for these (read about the importance of regular check ups).
One of the most important checks all dental clinicians (dentists, hygienists and therapists) carry out is a mouth cancer screening, this is done at every appointment and can be life saving. Regular appointments with your dental hygienist/therapist or dentist is crucial to spot the signs of mouth cancer early. A common misconception is that patients with full dentures (top and bottom) do not need to visit the dentist. Mouth cancer can still affect these patients, therefore it is paramount to have regular check ups. They could save your life or a loved one's life.
If you are concerned about gum disease, oral cancer or would simply like more information on any dental concerns, please complete the form below.
Have you ever worried that you had bad breath? This blog will give you some tips on what causes this and how to prevent any embarrassing moments.
Halitosis can be caused by bacteria that are not removed efficiently when brushing with your toothbrush. It is important to angle your toothbrush towards the gumline and spend at least 2 minutes brushing. To make bruising your teeth easier and more efficient you can consider an electric toothbrush.
Brushing your teeth efficiently but still experiencing bad breath?
If you are not cleaning in between your teeth, 40% of tooth surfaces are being missed. These are areas where your toothbrush bristles cannot reach, therefore, bacterial plaque will continue to accumulate and cause bad breath. Not all tools are made equally when it comes to cleaning in between your teeth. Interdental brushes are far superior when it comes to removing these harmful bacteria when compared to conventional string floss (read more here).
This diagnosis is usually made when the gingival cause has been eliminated i.e. when halitosis is present with perfect oral hygiene, the problem is coming from the stomach. A consultation with a gastroenterologist It could also be that there are some digestive issues occurring in which your GP can help get to the root cause of the problem.
Ready to kick bad breath to the curb? Don't let halitosis hold you back any longer! Fill out the form below to get expert tips and personalised advice on how to achieve fresh breath for good. Your social life (and everyone around you) will thank you!
It may shock you to know that 90 per cent of people will have gum disease at some point in their lifetime.
But before that statistic scares you, dear reader, it’s important to know that when caught early enough, periodontitis and gingivitis are highly predictable if you take on board all the advice given.
Gingivitis is a totally reversible form of gum disease and periodontitis (which 90% of us will get at some point) is an irreversible gum disease. In this blog I’ll be exploring the differences and sharing everything you need to know to protect your healthy and beautiful smile.
In short, gum disease is caused by an immune reaction to bacteria in your mouth. But dependent on the type of gum disease, the way in which this occurs is very different.
Let’s dive in.
Gingivitis is a reversible gum disease. In this case, the immune system reacts to bacteria around the teeth; however, this reaction is restricted to the gums alone and does not affect the bone. There is no loss of supporting structures of the teeth, rather issues are restricted to the soft tissue. Resultant inflammation in the gums causes redness, swelling, and bleeding. Left untreated, gingivitis may – but not always – become periodontitis over a number of years.
Periodontitis is irreversible. In this case, the supporting structures of the teeth are destroyed. The rate of this destruction varies wildly between patients due to factors such as genetic makeup, smoking history, oral hygiene and other medical issues – for example, diabetes. Periodontitis occurs when the immune system tries to fight off bacteria in the mouth. As the body tries to defend itself, toxic by-products are released that destroy the connection between the gums and the teeth and can stimulate loss of bone structure.
90% of human beings get periodontitis at some point in their life!!! Nobody knows why there is so much variation about when gingivitis becomes periodontitis. It is, however, important to point out that periodontitis is a more extreme version of gingivitis. It is always a result of untreated gingivitis.
In fact, a study conducted in the 1970s to the mid-80s aimed to understand the initiation and rate of progression of periodontal disease and subsequent tooth loss. The study was conducted on a group of 480 male labourers at two Sri Lankan tea plantations. The participants were between 14 and 46 years old, and did not practise any form of oral hygiene.
Interestingly, despite the fact that all participants lived very similar lifestyles and did not use any oral hygiene techniques at all, the results varied massively. They all had gingivitis, but some had more aggressive gum disease too.
If all participants didn’t brush their teeth and lived very similar lifestyles, why were the results so varied? This study goes some way towards proving the importance of brushing your teeth, but it’s also important to remember that there are other factors at play that increase your risk of contracting gum disease.
Whilst there’s no hard evidence that gives us an exact list of what these other factors are, we can make some reasonable assumptions, such as:
Let’s explore in more detail what you need to be aware of regarding the two forms of gum disease, and what you should do about it if you’re worried you’re showing symptoms.
Bleeding gums must never be ignored. We’ve all seen the scary Cordodyl mouthwash or toothpaste adverts that claim a small sign of blood when you’re brushing your teeth could be a sign of gum disease. Unfortunately, whilst those adverts do tend towards hyperbole, they aren’t all scaremongering. If you’re seeing blood when you brush your teeth, you should absolutely see your hygienist or periodontist. Treating gum disease early increases your chances of protecting your healthy and beautiful smile.
The shocking statistic I shared at the start of this blog shouldn’t be taken lightly. Gum disease is serious, but in my blog series I’m aiming to reassure patients and make them feel confident, not make them more scared of dental professionals!
A dental professional can help you to figure out whether you’re experiencing gingivitis or periodontitis, and get started on a treatment plan that will minimise the negative symptoms. Think of it this way: you wouldn’t ignore it if your eye was bleeding! You certainly shouldn’t be ignoring bleeding from your mouth, either – assuming you’re planning on keeping your teeth for the rest of your life, that is!
Statistics for the prevalence of periodontitis in adults vary from 19 per cent in adults over 30 to more than 70 per cent in adults over 65. Unfortunately, it is incredibly difficult to predict when periodontitis is going to occur. Periodontitis can only be diagnosed after destruction has occurred. This is why it’s so important to see an appropriately trained dental hygienist regularly, especially if you’re experiencing symptoms of gum disease, so that treatment can begin before it gets worse.
Even though periodontitis is irreversible, it is extremely beneficial to identify the disease before it causes looseness or movement of the teeth. This happens because the gaps between the teeth and the gums get too big. These are called periodontal pockets, and ideally they should measure four millimetres or less so that the immune system isn’t triggered to cause destruction.
In basic terms, this happens because if the pocket measures five millimetres or above, the good bacteria found in these spaces changes into bad bacteria. But fear not! There are steps that can be taken to minimise the negative effects of these bad bacteria.
The first thing to do in this case is to clean the periodontal pocket. Our job as dental professionals is to keep underneath the gum clean, and your job as the patient is to keep above the gum clean so that nothing gets back in!
If cleaning the periodontal pockets isn’t enough to reverse the immune response, there are more advanced surgical gum treatments to regenerate the bone that has been lost and cut away excess soft tissue.
However, this does not mean periodontitis has been cured. It cannot be cured because a cure would involve the suppression of the immune system (which is akin to using a sledge-hammer to crack a nut). Periodontitis is a chronic condition and maintenance is still required, but it can be controlled with regular cleaning of the gum pockets and practising good oral hygiene.
Keeping the plan simple is always best namely:
Have a read of my previous blog where I explore in more detail how to maintain a good oral hygiene routine, and don’t forget to subscribe to my mailing list so you can be notified every time a new informative blog post goes out. If you’re worried about early signs of gum disease or are just seeking some reassurance please complete the form below and we will contact you promptly.
