Let’s discuss the various forms of wear on teeth, particularly erosion, attrition abrasion and abfraction.
Erosion is the increasing loss of tooth structure that is dissolved by acid attack on teeth with no bacterial involvement. Common causes for tooth erosion are soft drinks, energy drinks and juices due to the high amount of acid (this includes sparkling water). To add to this, frequent consumption increases the amount of wear and speeds up the process of erosion. Another point to consider is those who suffer from reflux or gastroesophageal reflux disease (GORD) or from certain eating disorders (e.g., anorexia, bulimia).
In addition, the risk of erosion is high in individuals with a low salivary flow rate or dry mouth.
Attrition is the wearing down of the biting surfaces of teeth as a result of tooth-to-tooth contact or grinding between opposing teeth. The rate of attrition will increase in people who habitually clench or grind their teeth (a condition known as bruxism), e.g., during sleep. The teeth tend to appear flatter over time with increasing sensitivity and usually jaw joint pain. The vertical dimension of the face can change as well.
Abrasion is the progressive loss of the tooth surface caused by mechanical actions commonly associated with vigorous incorrect toothbrushing techniques and or using a hard toothbrush. For example, brushing in a horizontal backward and forward motion. Usually it appears at the necks of the teeth where the enamel is thin.
In other words, it is caused by harmful habits and is not a naturally occurring process.
Abfraction is the loss of tooth structure from flexure of the teeth from grinding and bruxism habits.
Bruxism leads to flaking of the enamel at the neck of the teeth where the enamel is the weakest and appears as v-shaped grooves.
It is unlike attrition, which affects the biting surfaces of the teeth.
With all of these in mind, it is important to know that all of these types of wear can occur at the same time at different stages. For example, a tooth surface that has been softened by erosion or an acid attack is more susceptible to abrasion and abfraction.
Signs and symptoms
- Worn teeth.
- Sensitivity to hot, cold and chewing.
- High caries risk.
- Restoration failure.
- Pain in the jaw joint.
Prevention
- Reduce foods and drinks hat are high in acid.
- Manage reflux conditions.
- Use a straw.
- Use the correct toothbrushing technique and always a soft toothbrush.
- For bruxism, grinding, and clenching get a customised night guard or splint to protect your teeth.
- Have regular dental checkups and cleans to assess wear before you notice.
Tooth wear increases with age. For all age groups, males had a higher prevalence of tooth wear than females.
