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Learn About Tooth Abrasion and Overbrushing

Recently, the issue of over brushing and its direct link to tooth abrasion has been a topic in many journal and news articles. A story in The Wall Street Journal (dated February 4, 2000) stated that in many cases, "the culprit in toothbrush abrasion is the toothbrush itself." This issue is particularly important because people can damage healthy teeth and gums by brushing too hard, oftentimes with a medium- or hard-bristled toothbrush. In fact, dentists and representatives of the American Dental Association have recommended for years that people use a soft-bristled toothbrush for their dental care.

Our teeth and gums are susceptible to wear and tear like all other parts of our bodies. In cases of improper brushing, such as brushing too vigorously, gum tissue can be worn away. Receding gums then lead to other significant dental problems such as sensitive teeth, periodontal disease, cavities, root canals, and potentially removal of teeth.

Solutions to brushing too hard and causing tooth abrasion include adjusting the angle of your toothbrush (it should be at a 45-degree angle), lessening the amount of pressure you use, monitoring the length of time, as well as making sure that you are using a soft-bristled toothbrush. In addition, always ask your dentist for specific recommendations related to your oral health care.

While the potential harm to teeth and gums through over brushing is significant, an even greater percentage of the population suffers damage to their teeth from occlusion (bad bite), genetic factors, and poor overall dental hygiene. It is critical to carefully maintain and monitor your oral health. The best approach to maintaining good oral health is to brush your teeth twice a day with a soft-bristled toothbrush to prevent tooth abrasion with fluoride toothpaste, floss or clean between the teeth using an interdental cleaner (special brushes, picks or sticks), and visit your dentist every six months. Follow your dentist's advice with regard to any changes to this regimen.

By Brian J. Gray, DDS, MAGD, FICO

How Malocclusion or Bad Bite Relates To Different Dental Problems

It is ironic that one of the most common dental disorders is also the most neglected, malocclusion, bad bite. The way the teeth fit together when the jaw closes and chews is of profound importance to the long-term health of your teeth.

If surfaces of the teeth interfere with how the jaw moves, the teeth can be worked loose or the enamel can be worn away this is know an malocclusion, bad bite. The muscles that move the jaw are very powerful and can do major damage to the teeth when the biting surfaces don't fit together properly.

The problem can be compounded if teeth interfere with functional muscle patterns, the jaw muscles will attempt to "erase" the part of the tooth that interferes by grinding against it all the more. This can lead to even more severe wear or it may crack off a cusp or split the tooth. Or it may loosen the tooth or cause it to move out of alignment. The excessive muscle activity often results in pain in the muscle itself. All of the jaw muscles can become sore including the temporal muscles that are the source of many so-called tension headaches.

Some excessive muscle activity may be caused by emotional stress. But with some special exceptions, damage done by stress induced grinding and clenching can be minimized to a manageable level by equalizing the biting surfaces that are in conflict with jaw movements.

The power of the jaw muscles may surprise you. Some people can exert over 900 pounds of compressive force with their jaw muscles so you can imagine how much damage such force can do when you close into a single tooth and then work it from side to side. The effect is very much like working a fence post loose as the bone around the root breaks down. If you can put your finger on any tooth in your mouth, and then squeezing your teeth together causes the tooth to move, you can be sure that it is just a matter of time before there will be a problem with that tooth.

Sometimes in malocclusion, bad bite the muscle forces that work the tooth sideways stimulates bone around the root to build up and become stronger. When that happens, the tooth actually bends in its socket and this creates a microscopic chipping away close to the gum line to form a deep groove in the tooth. This is called an abfraction. These deep grooves at the gum line are often mistaken for toothbrush abrasion, but scientists have shown us that the grooves are actually the results of bending of the tooth in its socket. These grooves can lead to much sensitivity in those teeth because the opening into the tooth exposes nerves that can be exquisitely sensitive. Correction of the bite to remove excessive lateral forces on the teeth in most instances either eliminates the sensitivity completely or reduces it to a much more acceptable level.

Patients should be aware that much confusion surrounds the importance of a harmonious bite, including many misconceptions that have been fostered by flawed research that has failed to properly relate the bite interferences to the position and condition of the temporomandibular joints. Knowledgeable clinicians, however, are very much aware of this relationship and can achieve excellent results in making both your teeth and your jaw muscles more comfortable by bringing your whole biting into harmony and avoiding malocclusion, bad bite.

By Peter E. Dawson, DDS