Types of Dental Wear Challenges: Attrition, Abrasion and Abfraction

Abfraction aura dental

Just as our body ages and suffers from wear and tear, our teeth too have to put up with all sorts of erosive experiences that result in tooth problems. For instance, a lot of pressure on teeth can lead to dental damage such as dental abrasion or attrition. Your teeth’s enamel will wear down eventually and make your teeth weak and loose. Ultimately, if you don’t take timely measures, it results in tooth loss.

Dental Attrition

Dental Attrition is a common type of dental wear that results from tooth to tooth contact. When teeth rub against each other, it causes friction and slowly eat away the biting surfaces of the teeth. While attrition is typically considered a normal part of the ageing process, for many people attrition is quite rapid and advanced due to underlying causes and eating patterns.

Teeth grinding also known as bruxism is one of the leading pathological causes for attrition. It leads to severe and untimely dental wear/damage, if not checked in time. In some serious cases of bruxism, the protective layer of the teeth(enamel) is worn out to such an extent that you can see the inner dentin of the teeth. This leads to faster tooth decay and high dental sensitivity.

How can one tell if there is dental attrition?

Apart from tooth decay and high sensitivity, there are other signs of dental attrition such as:

  •         Tender gums
  •         Loss of teeth structure
  •         Flattening or thinning of the teeth
  •         Dental pain due to loss of enamel
  •         Failure of dental treatments
  •         Exposure of dentin layer and tooth discolouration

Erosion is also caused in patients who suffer from gastro oesophageal reflux disease. Additionally, if people have a low salivary flow rate, erosion is higher.

Dental Abfraction

 On the other hand, dental abfraction is loss of the natural tooth structure where the tooth and gum are aligned. The damage is typically V-shaped or wedge-shaped and is not caused by bacteria, infection or cavities.

It is caused by long-term stress on the teeth. The reasons could be bruxism or teeth grinding, misaligned teeth(malocclusion) or mineral loss owing to acidic or abrasive factors in the mouth.

Often, there are multiple reasons that lead to abfraction. A dentist is the right person to tell you why abfraction is caused.

The difference between attrition and abfraction is that the abnormal load impacts the teeth at a different location causing tooth flexure. This leads to tooth flexure which results in flaking of the enamel around the neck of the tooth instead of the biting surface.  The lesion caused by abfraction are V-shaped and the ones by abrasion and attrition are flat.

Symptoms of Abfraction

Patients typically come to know of abfraction when there is food stuck in the wedge of the lesion or when the smile is wider. One might even be able to feel it on the tongue.

Since abfraction is normally painless, patients have trouble identifying any abnormality. But there is tooth sensitivity especially with hot and cold are concerned.

If the symptoms are not checked in time, it may lead to

  •         worn and shiny facets of tooth (translucency)
  •         exposed dentin
  •         chipping of the tooth surface

Eventually, the loss of tooth enamel can make your teeth more susceptible to bacteria and tooth decay. It can also impact the structural integrity of the tooth.

This is a fairly common problem and patients tend to neglect it at this stage because there is no pain or discomfort. However, once the enamel starts chipping off, the second layer or dentin is exposed. This layer is very sensitive and gets damaged very quickly compared to the enamel causing a number of oral health issues.

Dental Abrasion

Abrasion is when the tooth structure disintegrates due to mechanical forces from a foreign element. It mainly impacts canines and premolars. Often abrasion is caused by using a hard toothbrush or abrasive toothpaste. Many times, it is external objects to blame such as cracking nuts, chewing pencils, lip piercings, tobacco etc.

Abrasion occurs on the outer or buccal part of the tooth where the external object comes into contact.

While each of these dental wear processes might impact the tooth structure differently, they ultimately lead to other teeth problems and complications. If you observe any abnormality or deviation in your teeth structure or surface, then it is best to consult the dentist at the earliest to prevent further damage to your teeth.


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