TOOTH WEAR


What is the difference between ABRASION, ATTRITION, ABFRACTION AND EROSION ?

Tooth wear is a term used to describe the progressive loss of a tooth’s surface due to actions other than those which cause tooth decay or dental trauma. For that reason, this type of wear is also known as non-carious tooth substance loss.

This very common condition occurs in approximately 97% of the population and it is a normal physiological process occurring throughout life.

It has been demonstrated that the prevalence of tooth wear (where dentine is exposed on at least one tooth surface) among the dentate population reported in National Surveys was:

17.4% for 12-year-olds,
29.7% for 15-year olds,
38.1% for 16–24 year-olds,
76.2% for 35–44 year-olds
93.0% for 65+ year olds.

For all age groups, males had a higher prevalence of tooth wear than females. The amount of tooth wear seen currently is considerably greater than in the past due to the fact that more people are now retaining their natural teeth into old age. Also, depending on the country and type of diet the tooth wear statistics very from one location to another.

The majorly of tooth wear results from three main processes; Attrition, Abrasion and Erosion. These forms of tooth wear can further lead to a condition known as Abfraction, where by tooth tissue is ‘fractured’ due to stress lesions caused by extrinsic forces on the enamel.

Since tooth wear is a complex, multi-factorial problem, most of the time it is  difficult to identify a single causative factor. However, tooth wear is often a combination of the above mechanisms. E.g. attrition in bruxism sometimes occurs together with erosion. Many clinicians therefore make diagnoses such as “tooth wear with a major element of attrition”, or “tooth wear with a major element of erosion” to reflect this. This makes the diagnosis and management difficult. Therefore, it is important to distinguish between these various types of tooth wear, provide an insight into diagnosis, risk factors, and causative factors, in order to implement appropriate interventions.