Tooth abrasion is a type of dental wear resulting from mechanical factors acting on the teeth. It is a common condition where the hard structure of the tooth, the enamel and dentin, is worn away by friction from external objects. This wear is distinct from dental erosion (chemical dissolution from acids) and attrition (wear from tooth-on-tooth contact, like grinding). Understanding abrasion is crucial for preventing further damage and preserving oral health.
Identifying Tooth Abrasion
Abrasion is the mechanical wearing away of tooth structure due to repeated interaction with foreign objects. This process causes a gradual loss of the outer enamel layer and the softer dentin beneath it. The characteristic physical appearance is a V-shaped or wedge-shaped notch that forms near the gumline, also known as the cervical area of the tooth.
These lesions typically have a hard, smooth, and shiny surface, distinguishing them from the rougher texture of decay. As the abrasion progresses, the underlying dentin may become exposed, which can lead to a yellowing appearance in the affected area. The most common symptom is increased tooth sensitivity to hot, cold, or sweet stimuli, because the protective enamel barrier is compromised.
Common Sources of Mechanical Wear
Aggressive or improper toothbrushing technique is the primary cause of tooth abrasion. Using a hard-bristled toothbrush or applying excessive force, especially in a horizontal or “sawing” motion, causes significant friction against the enamel near the gums. This action physically scrapes away the tooth structure over time, leading to wedge-shaped defects.
The use of highly abrasive toothpastes is another contributor. Some whitening or charcoal-based formulas contain abrasive particles that increase frictional wear, especially when combined with aggressive brushing. The abrasiveness of toothpaste is measured by its Relative Dentin Abrasion (RDA) value, and high RDA products can exacerbate the damage.
Abrasion also results from habits involving objects repeatedly contacting the teeth. These include habitual chewing on hard items like pen caps, pencils, or fingernails. Other sources involve the improper use of dental aids, such as excessive force when flossing or using toothpicks, or holding items like pipe stems or hairpins between the teeth.
Stopping Progression and Restoring Teeth
The most important step in managing abrasion is identifying and eliminating the source of mechanical wear. This often involves switching to a soft-bristled or electric toothbrush to reduce physical trauma. Individuals should adopt a modified brushing technique, such as the modified Bass method, which uses small, gentle, circular or vertical motions instead of horizontal scrubbing.
Selecting a low-abrasive toothpaste is also recommended to minimize surface wear. For teeth experiencing sensitivity, dentists may apply professional fluoride treatments or recommend desensitizing agents to strengthen the remaining tooth structure. Since lost tooth enamel cannot regenerate, existing structural damage often requires restorative treatment.
Dental professionals commonly use composite resin bonding, a tooth-colored filling material, to repair the lost tooth structure. This restoration rebuilds the affected area, restoring the tooth’s integrity and reducing sensitivity by covering the exposed dentin. For more extensive wear, options like glass ionomer cements or porcelain veneers may be used to protect the tooth and improve its appearance.