Shift Happens
written by Jimmy Kilimitzoglou, DDS of e.s.i. Healthy Dentistry for Creations Magazine
Do you ever find yourself wondering: “I never noticed these spaces around my teeth! Why do I now have spaces between my teeth and my gums that are trapping food? OMG, are my teeth getting longer and are my gums receding? Why are my teeth getting shorter? I swear, this tooth was not sticking out like that!”
Well, as we mature, there are some changes in our teeth. This can be normal wear and tear. Some of us are grinders. We may grind side to side, wearing away our enamel, resulting in shorter teeth. We may do this because of stress or because of genetics. Sometimes the wearing away of the enamel is due to a gritty diet. Abrasive foods can cause a premature deterioration of the enamel. As this attrition continues, teeth now touch together differently and the forces can result in shifting of teeth. This translates into spaces between the teeth, gum recession and crooked teeth. Hey, shift happens!
So a gritty diet can wear away teeth. What about an acidic diet? Many people drink lemon infused water because of gastrointestinal benefits. Others drink coffee, tea or seltzer. The acid wears away the enamel and when the enamel wears away completely, it exposes the inner layer of the tooth called dentin. Exposed dentin means tooth sensitivity to hot and cold. This phenomenon is called erosion. Sometimes people brush too hard or use a hard bristle toothbrush that can harm teeth and gums. Teeth can develop notches at the gum line called abrasions and gums can wear away resulting in recession, more exposed dentin and sensitivity.
OK, enough with the problems and their cause. What can we do about them? First of all we have to look at nutrition and make some modifications. It all starts with a well balanced nutritious diet, adequate water intake and, of course, good oral hygiene. It is also important to have a balanced pH (not too acidic). There are anti-sensitivity tooth pastes, low abrasive tooth pastes, professionally dispensed mineral anti sensitivity creams and mouth rinses that can buffer the pH and re-mineralize tooth structure to restore health and manage the sensitivity. Obviously there are other professional anti-sensitivity treatments that we have available to us like varnishes, sealants, bonding and gum grafting. The key is to be minimally invasive.
For grinders, we recommend oral appliances to protect teeth from further attrition. These appliances are usually made from a soft resilient material and are worn at night. However, for severe grinders, they are worn for a few hours during the day. For clenchers and TMJ patients, or more accurately called temporomandibular disorders (TMD), we recommend a hard night guard that is specifically made with certain dimensions. It acts as a deprogramming device which trains the muscles to relax and reverse their hyperactivity. Oftentimes the grinding or clenching is caused by a sleep disorder and those patients are referred for a sleep study.
When significant shifting of teeth has occurred we have options for getting them aligned. One option is clear aligner therapy like Invisalign. By carefully aligning the teeth to support each other we can ensure that they touch togethe appropriately, they wear more evenly, are easier to keep healthy and prevent recession, TMD and gum disease.
Let’s face it. As the years go by there are some aging effects. In my eyes we can see it one of two ways: people getting older or people maturing gracefully. Which one are you?
