Tooth wear is a common occurrence that can impact oral health over time. While teeth are durable and designed to withstand daily chewing and biting, they are susceptible to gradual changes. One prevalent form of this wear is dental attrition, a process that happens slowly and can often go unnoticed until it becomes more pronounced. Understanding attrition is important for maintaining the long-term health and function of your teeth.
What is Dental Attrition?
Dental attrition refers to the progressive loss of tooth structure resulting from direct tooth-to-tooth contact. This mechanical wear primarily affects the chewing surfaces of back teeth and the biting edges of front teeth. It is considered a physiological process that occurs naturally with aging, but excessive or accelerated attrition can indicate a problem.
Affected teeth often show characteristic signs, such as flattened chewing surfaces or shortened teeth. The cusps, which are the pointed parts of teeth, may appear worn down, and the tooth surfaces can look polished. It is important to distinguish attrition from other forms of tooth wear, like erosion, which is chemical wear from acids, or abrasion, which is wear from foreign objects like a toothbrush.
What Causes Attrition?
The primary cause of dental attrition is the mechanical force generated when teeth rub or grind against each other. One of the most common contributors to this process is bruxism, which involves the habitual grinding or clenching of teeth. This can occur both during the day and, more frequently, unconsciously during sleep, exerting significant force on the teeth.
Malocclusion, or an improper bite alignment, also plays a role in attrition. When teeth do not fit together correctly, certain teeth may experience excessive force and friction during chewing or grinding movements. This uneven distribution of force can accelerate the wearing away of tooth enamel and dentin in specific areas.
How to Identify Attrition
Recognizing the signs of dental attrition can help in seeking timely intervention. Visible indicators often include flattened chewing surfaces, a reduction in the overall length of teeth, and the appearance of sharp enamel edges. As the outer enamel layer wears away, the underlying dentin, which is softer and more yellowish, may become exposed, potentially leading to increased tooth sensitivity to hot, cold, or sweet stimuli.
Individuals might also notice changes in their bite or experience jaw pain, headaches, or discomfort in the temporomandibular joint, which are often associated with the underlying causes like bruxism. A dental professional diagnoses attrition through a thorough visual inspection and clinical examination, sometimes analyzing the patient’s bite to understand the patterns of wear. Early identification allows for strategies to prevent further damage.
Addressing Attrition
Managing dental attrition involves both preventing further wear and restoring damaged tooth structure. Prevention strategies focus on addressing the underlying causes, particularly bruxism. This may include stress reduction techniques, behavior modification, and the use of custom-made night guards or occlusal splints worn during sleep to protect teeth from grinding forces.
If malocclusion is a significant contributing factor, orthodontic treatment such as braces or clear aligners can help correct tooth alignment and reduce uneven forces. Once attrition has caused significant tooth loss, restorative options are available to rebuild the tooth structure and function. These treatments can include dental bonding for mild to moderate wear, or veneers, crowns, and onlays for more extensive damage. Early intervention helps prevent progression and more complex treatments.