Tooth Attrition, Erosion, Abrasion

The term ‘tooth wear’ (TW) is a general term that can be used to describe the surface loss of dental hard tissues from causes other than dental caries, trauma or as a result of developmental disorders. It is a normal physiological process that is macroscopically irreversible and is cumulative with age. 

The process of tooth wear has a multi-factorial cause. Individual cause factors may be subdivided into:

  • Erosion
  • Abrasion
  • Abfraction 
  • Attrition 

Clinically however, it is difficult (if not at times impossible) to isolate a single causative factor when a patient presents with tooth wear. 

Where the process of tooth wear is considered to be excessive to the extent that it is associated with functional or aesthetic concerns by the dental patient, is disproportionate for the age of the patient, symptoms of discomfort are present or indeed if the rate of tooth wear is deemed to be so severe that it may be of grave concern to the dental patient or dentist, then immediate treatment is indicated to stop any further tooth wear. 

Your dentist may advice you change your diet if tooth wear is due to erosion and advice of any treatment that may help restore the affected teeth back to their normal shape or form. 

If your tooth wear is due to abrasion, your dentist may give you oral hygiene instructions to stop you from excessively brushing your teeth or stop any habit that may be causing tooth abrasion. 

Sometimes tooth wear may be due to excessive pressure on teeth, termed attrition. Your dentist can explain to you how your teeth may be getting damaged and what the best options to stop this are. 

In majority of cases patient may be grinding their teeth at night. Grinding teeth at night is called Bruxism

Some of the symptoms of bruxism (tooth grinding), such as facial pain, will often disappear when you stop grinding your teeth. Others, such as tooth damage, can be permanent and may need dental treatment.

Possible symptoms of teeth grinding include:

  • headaches
  • facial muscle pain (facial myalgia)
  • earache
  • tightness and stiffness in the shoulders
  • pain and stiffness in the jaw joint and surrounding muscles (known as the temporomandibular joint)
  • sleep disruption (both to you and your partner) 

Symptoms that affect the mouth include:

  • worn teeth, which can result in short teeth, increased tooth sensitivity and possible loss of teeth
  • fractured teeth or fillings
  • difficulty opening your mouth

It’s important to note tooth wear only occurs in severe cases of bruxism and not everyone who grinds their teeth will have it.

If your teeth become worn through grinding, you may need dental treatment to avoid developing further problems, such as infection or a dental abscess.

When to see a doctor or dentist

You should see your dentist if:

  • your teeth are worn, damaged or sensitive
  • you have pain in your jaw, face or ear
  • your partner complains that you make a grinding sound in your sleep

Tell your dentist if you think you’re grinding your teeth. They’ll check your teeth and jaw for signs of bruxism, help work out the possible causes, and suggest appropriate treatment.