Dental Attrition

November 06, 2015

Dental attrition is the deterioration of the biting surface of the teeth due to unusual contact or friction. A close examination of the teeth shows flattened ridges where the opposing teeth have rubbed against each other. Though, it is quite normal for the teeth to wear with age, it becomes a matter of concern when there is accelerated wearing down and a change in the vertical dimension. This ultimately leads to sensitivity, tooth loss and expensive treatment in the form of dental restorations. Several factors contribute towards this process and it is always better to identify and treat the underlying cause.

Cause

1. The main reason for premature wear is bruxing wherein the forces created while grinding and clenching damage the enamel
2. Poor bite or malocclusion where the teeth are not aligned properly is another possible cause as it brings about an abnormal contact between opposing teeth
3. A very coarse diet can also be a contributing factor
4. Dental developmental disorders also predispose towards accelerated attrition as it affects the composition and consequently, enamel hardness
5. If the back teeth are missing, then most of the chewing forces are concentrated on the front teeth. This, in turn, leads to greater wearing down of the incisal edges of the anterior teeth
6. Porcelain restorations are particularly damaging for the opposing natural teeth

Impact

Ideally, teeth should be monitored for tooth wear on a regular basis. Early diagnosis is the best as extensive attrition brings its own set of problems requiring installation of crowns that proves to be quite expensive. Attrition leads to:

1. Enamel loss that eventually exposes dentin, leading to increased sensitivity, decay and pain
2. If it affects all the teeth, there may be bite collapse or loss of vertical dimension
3. This puts an increased strain on the TMJ leading to joint disorders
4. It also leads to a decrease in facial height giving it a more rounded look
5. Additionally it leads to problems in chewing food and change of the diet - such patients are not able to consume chewy and hard foods as well as chewing gum due to TMJ disorders 

Treatment

Dental attrition that occurs gradually with age may not require any intervention. But if it occurs at a young age it cannot be ignored. Though lost enamel cannot be regenerated, dental restorations are meant to restore functionality.

1. Where bruxing is the main culprit, occlusal splints that reduce grinding and protect the teeth and restorations are advisable
2. In the case of misalignment of teeth, orthodontic treatment may be required to improve the bite and reduce occlusal trauma
3. Where the molars and premolars have been worn down, partial dentures or restorations for the back teeth may become necessary, depending on the extent of damage
4. As far as baby teeth are concerned, fillings may be done if attrition has led to decay