Dental attrition is a type of tooth wear caused by tooth-to-tooth contact, resulting in loss of tooth tissue, usually starting at the incisal or occlusal surfaces. Tooth wear is a physiological process and is commonly seen as a normal part of aging. Advanced and excessive wear and tooth surface loss can be defined as pathological in nature, requiring intervention by a dental practitioner. The pathological wear of the tooth surface can be caused by bruxism, which is clenching and grinding of the teeth. If the attrition is severe, the enamel can be completely worn away leaving underlying dentin exposed, resulting in an increased risk of dental caries and dentin hypersensitivity. It is best to identify pathological attrition at an early stage to prevent unnecessary loss of tooth structure as enamel does not regenerate.
Signa and symptoms : Attrition occurs as a result of opposing tooth surfaces contacting. The contact can affect cuspal, incisal and proximal surface areas.
Indications of attrition can include:
Cosmetic or functional intervention may be required if tooth surface loss is pathological in nature or if there has been advanced loss of tooth structure. The first stage of treatment involves the management of any associated conditions such as fractured teeth or sharp cusps or incisal edges. These can be resolved via restoration of and polishing of sharp cusps. At this stage desensitizing agents such as topical fluoride varnishes can be applied, and at home desensitising toothpastes recommended. There are many different restorative treatment options which have been proposed such as direct composite restorations, bonded cast metal restorations, removable partial dentures, orthodontic treatment, crown lengthening procedures and protective splints. The decision to restore the dentition depends on the wants and needs of the patient, the severity of tooth surface loss and whether tooth surface loss is active. 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.