Tooth wear is an extremely common phenomenon (it occurs in the clear majority of the population) encountered in the human dentition. The term tooth wear refers to reduction in tooth mass due to reasons other than trauma or cavities. It can occur due to a variety of causes. Types of tooth wear are known as attrition, abrasion, erosion and abfraction.

ATTRITION is mechanical wear due to tooth-to-tooth contact. It appears as flattened occlusal (chewing) surfaces displaying wear facets. Attrition is worsened by tooth grinding (bruxism) and a poor bite.

ABRASION is also a type of mechanical wear, but is caused by contact with items other than teeth. It appears as smooth wear along the sides of the teeth (especially along the gum line) or fractured chewing surfaces. It can be due to use of a hard tooth brush or using a scrubbing motion to brush the teeth, use of toothpicks, nail biting, or biting on objects. Abrasion is worsened by aggressive tooth brushing or use of abrasive toothpastes.

EROSION is chemical wear of the teeth. It occurs from frequent exposure of the teeth to acidic foods and beverages, chronic vomiting, and gastric reflux. It is more commonly seen on the inner surfaces of the teeth (when due to vomiting or reflux) or a scooped-out appearance on the tips of the molars (when due to food or beverage consumption).

ABFRACTION is mechanical wear due to flexing of the teeth during use. It appears as missing tooth material at the gum line that is triangular in shape. It can be due to excessive force placed on the teeth due to tooth grinding or an uneven bite.

What can one do to avoid tooth wear? Some preventive measures are use of a nightguard for those individuals who grind their teeth, use of toothpastes other than abrasive ones, proper tooth brushing technique, avoiding “using the teeth as tools” by biting on objects, limiting intake of acidic foods and beverages or rinsing with water afterwards, addressing bulimia, fluoride application, treatment for gastric reflux, and correction of an unhealthy bite through orthodontic treatment.