Wear & Tear of Teeth? What’s That?


Tooth wear, also known as non-bacterial loss of tooth substances, is defined as the process of loss of tooth structures that does not involve dental caries (tooth decay) or any bacterial activity.

According to one of the recent studies, it has shown that over 95% of the human population is having some extent of tooth wear, whether it is mild or severe. This shows that tooth wear is a very common condition among the human population globally.

What Are The Different Types Of Tooth Wear?

In general, there are 3 different types of tooth wear that are commonly seen, namely:

  1. Abrasion

  2. Attrition

  3. Erosion

In most of the people, tooth wear involves all the 3 elements (abrasion, attrition and erosion). However, in most of the cases, one of the components of tooth wear dominates over the other elements. For example, if abrasion is the major element of tooth wear in certain patient, it is clinically known as tooth wear with major component of abrasion.

What Is Abrasion?

Abrasion is defined as the non-carious loss of tooth structure. It is due to the frictional wear of teeth by extrinsic/foreign agents. When there is constant or consistent friction between certain foreign substances and the teeth, this results in abrasion of the teeth. In abrasion, the tooth wear is not caused by the abnormal occlusion (biting condition) of the teeth.

According to types of foreign objects that cause the abrasion, the abrasion patterns can be further divided into different types:

  1. Toothbrush abrasion

  2. Ritual abrasion of the teeth

  3. Habitual abrasion

  4. Occupational abrasion

The most common abrasion pattern among the human population is the toothbrush abrasion. Toothbrush abrasion is most commonly seen on the exposed root portion of the teeth. This pattern of abrasion is usually associated with the daily practice of incorrect toothbrushing technique. Horizontal brushing strokes could result in toothbrush abrasion pattern. Besides that, the use of abrasive toothpastes could worsen the abrasion condition.

Toothbrush abrasion pattern commonly involves upper teeth more than lower teeth. The most commonly involved teeth are premolars, canines and incisors teeth. This type of abrasion pattern shows wedge-shaped cavities on the teeth. If these teeth (with toothbrush abrasion pattern) experience excessive biting force, micro-cracks of the teeth might happen.

Occupational type of abrasion is less commonly seen among the human population. This pattern of abrasion is only commonly seen in people with certain occupations such as tailors and factory workers. These people develop occupational abrasion pattern on their teeth due to the habit of holding/biting foreign suctances (such as needles, pencils or pen) between their teeth during work.

Habitual abrasion can be seen in people with certain parafunctional habits such as chewing pencils, biting fingernails, pipe smoking and etc. This type of abrasion can be prevented from progressing simply by breaking the causative habits.

Ritual abrasions of teeth are uncommon amont the human population. This type of abrasion is only seen in certain tribes who practise certain rituals that involve the biting of foreign objects.

What is Attrition?

Attrition of teeth is defined as the non-bacterial loss of tooth tissues that is caused by frictional tooth-to-tooth contact. Attrition can be further classified into 2 types, namely physiological attrition and pathological attirtion.

In physiological attrition, the pattern of tooth wear is constant and predictable. This type of attrition progress slowly. When the dentine (the second layer of tooth structure) is exposed, the tooth shows areas of yellow/brown colour on the biting surfaces. According to some of the studies, it states that the extent of physiological attrition is more severe in men as compared to women. The rate/extent of physiological attrition is largely dependent on the biting forces and the degree of abrasiveness of daily food.

On the other hand, pathological attrition is not considered as part of the normal human development. Some of the causes of pathological attrition include tooth grinding (bruxism), malocclusion, habits (such as chewing of betel quid) and abnormal tooth structures (such as dentinogenesis imperfecta). This type of attrition progresses faster than physiological type, thus, patient might complain of tooth hypersensitivity when the dentine (second layer of tooth structure) is exposed.

What is Erosion?

Erosion is defined as the non-carious loss of tooth structures due to the chemical action of certain chemical agents. Dental erosion does not involve any bacterial/carious activity. Dental erosions can be further classified into few types. Dietary erosion is caused by certain dietary habits. In this type of erosion, the excessive intake of acids is the most common cause. The sources of acids from food include citrus fruits, vinegars, soft drinks and etc. To reduce dietary erosion, it is important for the patient to reduce the amount and frequency of acids intake.

Besides that, dental erosion can be commonly observed in patients with gastrointestinal disorders (such as anorexia nervosa, gastro-esophageal reflux and bulimia) as well. These types of gastrointestinal diseases are associated with the regurtitation of the acidic contents from stomach &/or vomiting. These acidic content could result in the dental erosion of teeth. In these cases, it is important for the patients to seek medical consultations to treat the underlying gastrointestinal diseases.

What Are The Treatment Options Available For Tooth Wear?

The treatment options for tooth wear vary with the types and extent of tooth wear. The dental treatment options available for tooth wear include Dental Restoration (Dental Fillings), Dental Veneer, Dental Crown, Mouth Guard (For Buxism Patients), Orthodontic Treatment (If Tooth Wear Is Due To Malocclusion) and etc.

Treatment planning can only be decided after proper clinical examination and diagnosis being done by a qualified dentist. It is important to consult your dentist to determine the most suitable treatment of choice based on your oral conditions.

Tommy Wong

by Tommy Wong

A full-time Dental Student passionate to make a dent in the World of Dentistry. All through my dentistry journey, I have realised that there is still a lack of Oral Health Education to the public globally. This leads to high prevalence of Oral Diseases among the human population. With this mission, we have established GlobalDentalPro – Your Oral Health Educator with the mission to promote Oral Health globally to enable people to increase control over, and to improve their Oral Health & thus General Health. View all articles by Tommy Wong.


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