Worn teeth in Istanbul: causes and treatment options

Teeth that are getting shorter, flattening, cracking or becoming sensitive are usually showing wear. This loss of tissue is not decay, and it generally combines several mechanisms: friction between the teeth, exposure to acid, mechanical habits, or the failure of old restorations. Before considering veneers or crowns in Istanbul, the cause has to be identified and the wear checked to see whether it is still active.

What tooth wear is

It is a progressive loss of enamel, and then sometimes of dentine. It changes the length of the teeth, the shape of the edges, the bite and the appearance of the smile. It may stay confined to a few teeth or affect much of the mouth. Because several causes usually overlap, a photograph alone cannot establish the treatment.

The causes

Grinding and clenching

Bruxism means grinding, clenching or other repeated jaw activity, during sleep or while awake. It produces flattened, chipped or cracked teeth, sensitivity, muscle fatigue and jaw pain. A night guard protects the teeth in some situations, but it does not correct the cause of the bruxism.

Acid erosion

Erosion is chemical dissolution of dental tissue by acids that do not come from the bacteria of decay. Acidic food and drink, gastro-oesophageal reflux and repeated vomiting all contribute. Enamel loses its texture, becomes smoother, hollows out, and exposes more sensitive dentine underneath.

Abrasion and mechanical habits

Brushing too hard, highly abrasive products, and holding or cutting objects with the teeth all accelerate tissue loss. These are distinct from the wear produced by contact between the teeth themselves.

Signs that warrant an examination

- Teeth that are shorter, flattened, chipped, or have irregular edges.

- Sensitivity to cold, heat, acidic food or brushing.

- Repeated fractures of teeth, composites, veneers or crowns.

- Jaw pain or fatigue, headaches, a sense of clenching on waking.

- A gradual change in the height of the smile, or in how the teeth meet.

The assessment before treatment in Istanbul

Treatment depends on the mechanism, on how fast it is progressing, and on how much tissue is left. The assessment covers medical and dental history, dietary habits, digestive symptoms, bruxism, examination of the gums, the bite, photographs and whatever radiographs are indicated. Successive models or scans help to follow the progression.

- Map the areas of wear, and separate sound tissue from failing restorations.

- Identify dietary or digestive acid exposure, and refer to a doctor where needed.

- Assess bruxism, the muscles, the joints and the load being placed on the teeth.

- Check vitality, cracks, decay, root canal treatments, and the enamel available.

Treat the cause before restoring

A cosmetic restoration placed without controlling the cause wears, debonds or fractures. The first step therefore reduces the active factors: adjusting dietary habits, treating reflux or repeated vomiting, correcting traumatic brushing, managing awake clenching, night protection where indicated. The plan also has to set out maintenance and check-ups after you return home.

The treatment options

Prevention and sensitivity

Where wear is limited and stable, monitoring, dietary advice, a fluoride or desensitising toothpaste and professional applications are sometimes enough. The aim is to slow the progression and keep as much natural tissue as possible.

Additive composites

Composites rebuild certain worn areas with little or no additional preparation. They can be repaired, but they may stain, wear or fracture and need touching up. Whether they are indicated depends on the bite, the extent of the wear, and whether the causal factors can be controlled.

Onlays and partial restorations

Where back teeth have lost more structure, a partial restoration rebuilds the chewing surface while keeping more tissue than a full crown. The choice of material and of bonding depends on the tooth, the space and the loads involved.

Veneers and crowns

A veneer suits certain front teeth, where the enamel and the remaining structure allow it. A full crown is necessary on a heavily broken-down, heavily restored or fractured tooth — but it is not the automatic answer for every worn tooth. Each tooth gets the least invasive solution compatible with its health and its function.

Full-mouth rehabilitation

Where wear affects many teeth and substantially changes the bite, treatment requires overall planning, provisional try-ins and several phases. A digital simulation helps everyone understand each other, but it does not guarantee that the final result will be identical, nor that a large increase in bite height will suit everyone.

How long to stay in Istanbul

There is no universal stay for treating worn teeth. The number of appointments depends on the diagnosis, on stabilising the cause, on the number of teeth, on the temporaries, the try-ins, the corrections and the bite checks. Extensive rehabilitation needs several stages and a period of adaptation before the definitive work.

As a guide, at Nobel Dent, treatment with crowns on prepared teeth occupies a stay of seven to eight days, and veneers alone seven days. Extensive rehabilitation may need more: the timetable is set after the examination.

Risks and limits

- Sensitivity, pain or pulpal damage in a prepared tooth.

- Fracture, wear or debonding of a restoration if the loads persist.

- Difficulty chewing or speaking, or muscle fatigue, requiring adjustment.

- A difference between the cosmetic simulation, the temporaries and the real result.

- Future need to repair or replace composites, veneers, onlays or crowns.

Questions to ask before you agree

- What is the likely cause of the wear, and how will it be controlled?

- Is the wear still active, or stable?

- Which teeth can be treated by adding material, without significant preparation?

- Why is a veneer, an onlay or a crown proposed on each particular tooth?

- How will the bite and my tolerance be tested before the definitive work?

- Who handles adjustments, repairs and check-ups after I return home?

Sources

The American Dental Association describes erosion as a progressive, irreversible chemical loss of dental tissue, linked in particular to dietary or gastric acids. The National Institute of Dental and Craniofacial Research notes that bruxism produces flattened, cracked or sensitive teeth, and that guards mainly serve to protect the teeth.

Further reading

Our page on composite dental restoration covers the additive route, and dental crowns the case where a tooth is too broken down to keep. Our article on dental prosthetics explains how fixed and removable solutions compare, and the free quote page lists the documents to send.

This article is general information and does not replace an examination. Only a dentist can make a diagnosis and propose a treatment plan suited to you. Results vary from one person to another.