[2] Based on clinical surveys, studies have shown that abrasion is the most common but not the sole aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.

[3] Abrasion frequently presents at the cemento-enamel junction and can be caused by many contributing factors, all with the ability to affect the tooth surface in varying degrees.

Once this has occurred, subsequent treatment may involve the changes in oral hygiene, application of fluoride to reduce sensitivity, or the placement of a restoration to help prevent further loss of tooth structure and aid plaque control.

[4] Cause of abrasion may arise from interaction of teeth with other objects such as toothbrushes, toothpicks, floss, and ill-fitting dental appliance like retainers and dentures.

Apart from that, people with habits such as nail biting, chewing tobacco, lip or tongue piercing,[5] and having occupation such as joiner, are subjected to higher risks of abrasion.

[9] Further, brushing for extended periods of time (exceeding 2-3 min) in some cases, when combined with medium/hard bristled toothbrushes can cause abrasive lesions.

The bristles combined with forceful brushing techniques applied can roughen the tooth surface and cause abrasion as well as aggravating the gums.

[14] Specific ingredients are used in toothpaste to target removal of the bio-film and extrinsic staining however in some cases can contribute to the pastes being abrasive.

[10] The RDA scale was developed by the American Dental Association (ADA), government bodies and other stakeholders to quantify the abrasivity of a toothpaste.

[24] Currently, the claim on products such as toothpaste are not regulated by law, however a dentifrice is required to have a level lower than 250 to be considered safe and before being given the ADA seal of approval.

[32] Toothpastes containing stannous fluoride have been shown to inhibit acid erosion of tooth structure, thereby reducing its susceptibility to abrasive wear.

If the lesion is small and confined to enamel or cementum, a restoration is not warranted, instead the eradication of rough edges should occur to reduce plaque retentive properties.

[37] The surface of such lesions should be roughened prior to its restoration[38][39][40][41][42] - whether material is GI-based or resin-based[37] - with no need for bevelling of the coronal aspect of the cavity.