Dental attrition

Advanced and excessive wear and tooth surface loss can be defined as pathological in nature, requiring intervention by a dental practitioner.

It is best to identify pathological attrition at an early stage to prevent unnecessary loss of tooth structure as enamel does not regenerate.

This can be caused by several factors, including parafunctional habits such as bruxism or clenching, developmental defects, hard or rough-textured diet, and absence of posterior teeth support.

Dental erosion is tooth surface loss caused by extrinsic or intrinsic forms of acid.

[7] The different physiological processes of tooth wear (abrasion, attrition and erosion) usually occur simultaneously and rarely work individually.

Attrition, abrasion, erosion or a combination of these factors are the main reasons for tooth wear in elderly people who retain their natural teeth.

To manage the condition, it is important to first diagnose it, describing the type of tooth surface loss, its severity and location.

Patients must be monitored closely, with clinical photographs 6–12 monthly to evaluate if the tooth surface loss is being prevented.

[18] The first stage of treatment involves managing any associated conditions, such as fractured teeth or sharp cusps or incisal edges.

[16] The use of adhesive materials to replace lost tooth structure can be performed as a conservative and cost-effective approach before a more permanent solution of crowns or veneers is considered.