erosion

Saw this 20 years-"young" shy gentleman, always soft spoken and smiling. Quiet kid, very polite. I like him. Moderate to severe wear on his teeth considering his age. All first molars have flat cusps. #20 had a chipped DO composite. I scheduled him for #20-DO and #19-O.

All I did on #19 was to sandblast the exposed dentin. On MB cusp, there was food trapped, so I also used caries detector to see if there was any decay, since the dentin did not have the shiny appearance that it normally does. I was asked by someone in the office isn't this caused by wear, would it come off easily? I disagree strongly. I believe it is cause by erosion, since there is no contact on those pitted dentinal area. I also believe that if we do nothing, the erosion will continue, and the unsupported enamel will be worn down. teeth will erupt. Can't just tell this nice young man to wear nightguard and just wish him good luck on the remaining awaken hours! I think too often we prescribe nightguard and do nothing for the patient while their teeth deteriorate. We blame them for not wearing it because it is bulky, and awkward. Really, who likes to wear it? Can there be even a slight possibility of romance if you are wearing nightguard to bed?