1. Dr. Shahzadi Tayyaba Hashmi
DNT 243
TOOTH WEAR
Dr. Shahzadi Tayyaba Hashmi

2. TOOTH WEAR Definition:
‘Tooth wear is defined as loss of tooth tissue due to causes other than caries’
Types:
Physiological ( occurs with age)
Pathological ( excessive tooth wear)
Three types have been described,
Attrition
Abrasion
Erosion

3. Causes of tooth wear

4. ATTRITION Definition:
Attrition is tooth wear caused by tooth-to-tooth contact
Occurs as a normal part of aging and it is usually the incisal edges which wear away first, followed by the occlusal surfaces of molar teeth
Excessive occlusal wear may occur in the following situations:
Patients with Bruxism ( excessive grinding of teeth by patients)
Patients who have lost several posterior teeth may show excessive attrition of the anterior teeth, especially if these are used for chewing
Patients who suffer from developmental disturbances of tooth structure, such as Amelogenesis and Dentinogenesis Imperfecta

5. Examples of attrition

6. ABRASION Definition: Causes: It is always pathological
Abrasion is frictional tooth loss caused by extrinsic agents
Causes:
It is always pathological
and may be caused by
Tooth brushing
Biting on a pipe or a pencil
Tooth brush abrasion is caused by poor tooth brushing technique

7. Characteristics of abrasion
It has following characteristics:
Particularly affects the labial and buccal surfaces of the maxillary incisor, canine and premolar teeth
Resulting cavity is wedge-shaped
The problem is often compounded by the use of hard tooth brushes and abrasive toothpaste

8. Tooth brush abrasion

9. EROSION
Erosion is the loss of tooth substance caused by chemical agents and is non-bacterial and therefore does not include loss by caries
Most erosion is caused by acids and is seen in following groups:
Those with gastric reflux and with bulimia and anorexia. Regurgitation of acid from the stomach particularly affects the palatal surfaces of the maxillary teeth

10. EROSION 2. As an occupational hazard:
Those who work in an acidic environment e.g in factories making batteries
Erosion in these groups is relatively rare but because the acid is in the environment the erosion is particularly seen on the labial surfaces of both upper and lower incisor teeth
3. Those who consume excessive amounts of carbonated soft drinks or fruit juices. The teeth which are most commonly affected are the palatal surfaces of the upper anterior teeth. Teeth may appear yellow due to reduction in the thickness of enamel. Typically cavities are shallow and broad

11. Acid erosion by bulimia

12. Erosion

13. TREATMENT Diagnose the most likely cause
In many cases the causes may be multiple
Abrasion caused by tooth brushing may be reduced by improving brushing technique
A careful history and detailed notes on the position of erosion are important in order to determine the exact cause
Dietary analysis and advice are essential for those suffering from erosion due to dietary causes