Will Excessive Use of Molars Cause Them to Wear Down Over Time?

Do molars wear down over time?

My daughter is 18 years old and has misaligned teeth with a slight overbite (not severe in appearance).
Currently, her speech and eating are fine, and we can accept her appearance since she previously underwent a painful two years of palatal expansion.
Later, due to her jaw becoming misaligned, all the appliances were removed to allow for recovery.
The doctor mentioned that if we want to pursue further treatment, the only option would be orthognathic surgery, which is a major procedure that we would prefer to avoid.

I would like to ask the doctor about her current situation.
My daughter is currently relying on her two back molars for chewing (her wisdom teeth have already been extracted).
Will the excessive use of these two molars cause them to wear down and become shorter over time? Since teeth are living structures (excluding cavities), will they maintain their height? We are concerned that if the molars continue to wear down over time, she may eventually have no teeth left to use.
We would greatly appreciate your insights on this matter.
Thank you very much!

Jing Miao, 60~69 year old female. Ask Date: 2020/05/14

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Jing Miao,
Hello! As mentioned, your daughter has a severe malocclusion, resulting in only her molars making contact.
Over time, this will inevitably cause the posterior aspect of the molars to wear down and become shorter.
Additionally, this may lead to sensitivity or the need for root canal treatment.
Although the malocclusion appears to be mild in appearance, it can have long-term effects on the digestive system.
I recommend that surgical intervention may be more appropriate.
Please take care, and I wish you all the best!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/05/14

More Info

Excessive use of molars, particularly in the context of chewing, can indeed lead to wear over time. The molars are designed to withstand significant forces during chewing, but they are not impervious to wear. The primary concern with relying heavily on a limited number of teeth, such as the back molars, is that they may experience accelerated wear due to the increased load placed on them.

When a person has an uneven bite or misaligned teeth, certain teeth may bear more pressure than others. In your daughter's case, since she is primarily using her two back molars for chewing, these teeth may be subjected to more stress than they are designed to handle. Over time, this can lead to several issues, including:
1. Wear and Tear: The enamel, which is the hard outer layer of the teeth, can wear down due to constant friction from chewing. This wear can lead to a decrease in the height of the molars, making them shorter and potentially affecting their ability to function properly.

2. Sensitivity: As the enamel wears down, the underlying dentin becomes exposed. This can lead to increased sensitivity to hot, cold, or sweet foods, which can be uncomfortable for your daughter.

3. Increased Risk of Cavities: Worn-down teeth may have irregular surfaces that can trap food particles and bacteria, increasing the risk of cavities.

4. Jaw and Muscle Strain: Over-reliance on specific teeth can lead to uneven wear on the jaw and surrounding muscles, potentially causing discomfort or pain in the jaw joint (TMJ disorders).

5. Potential for Tooth Loss: If the molars wear down significantly, they may become less effective at chewing, which can lead to further reliance on them and a vicious cycle of wear. In severe cases, this could lead to tooth loss.

To address your concerns, it is essential to maintain regular dental check-ups. A dentist can monitor the wear on your daughter's molars and provide guidance on how to manage her dental health effectively. They may recommend:
- Orthodontic Evaluation: Although you mentioned that previous orthodontic treatments were challenging, consulting with an orthodontist could provide insights into whether any less invasive options are available to improve her bite alignment without resorting to surgery.

- Protective Dental Appliances: If grinding or excessive wear is a concern, a dentist may suggest a night guard or other protective appliance to help distribute the chewing forces more evenly across all teeth.

- Dietary Adjustments: Encouraging a balanced diet that does not overly rely on hard or chewy foods can help reduce the strain on her molars.

- Regular Dental Care: Maintaining good oral hygiene practices, including brushing and flossing, can help prevent cavities and other dental issues that may arise from excessive wear.

In summary, while molars can wear down over time with excessive use, proactive dental care and regular check-ups can help manage this issue. It is crucial to address any concerns about your daughter's dental health with a qualified dentist who can provide personalized advice and treatment options.

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