Tooth Abrasion: Causes, Diagnosis, and Effective Treatments

What is dental abrasion?

Dental abrasion is a type of wear that occurs when external mechanical forces affect the surface of the teeth. It is characterized by the progressive loss of enamel and, in more advanced cases, dentin. This condition can affect both the aesthetics and functionality of the teeth, causing sensitivity and increasing the risk of cavities and fractures.

Unlike abfraction, which is due to biomechanical forces, or erosion, which is caused by acids, abrasion is the result of external physical factors that wear down the tooth structure.

Causes of dental abrasion

Dental abrasion occurs when mechanical agents progressively wear down the tooth surface. Its most frequent causes include:

• Aggressive brushing: Brushing with too much pressure, improper movements, or using hard bristles can cause enamel wear, especially in the cervical area of the tooth.
• Use of abrasive toothpastes: Some toothpastes contain abrasive particles that, if used excessively, can erode the enamel.
• Habit of holding objects with teeth: Holding pencils, needles, or nails with your teeth can cause premature wear.
• Bruxism: Although bruxism is more associated with dental attrition, it can also contribute to wear in the cervical area, increasing the risk of abrasion.
• Use of ill-fitting dental prosthetics: Removable prosthetics that do not fit correctly can generate friction and wear on adjacent teeth.
• Oral piercings: Piercings in the tongue or lips can repeatedly impact the teeth, causing wear.

Symptoms of dental abrasion

✅ Enamel loss: Visible wear on the tooth surface, especially near the gum line.
✅ Tooth sensitivity: Increased sensitivity to cold, heat, or acidic foods due to dentin exposure.
✅ Rough tooth surfaces: Sensation of irregularity or roughness when running the tongue over affected teeth.
✅ Loss of tooth height: In severe cases, excessive wear can make teeth appear shorter.
✅ Increased susceptibility to cavities: Dentin exposure facilitates the proliferation of bacteria and the development of cavities.

Diagnosis of dental abrasion

For an accurate diagnosis, the dentist will evaluate different factors:

🦷 Visual and tactile examination: Inspection of the teeth to detect areas of wear and dentin exposure.
🦷 Clinical history: Analysis of oral hygiene habits and possible contributing factors.
🦷 Dental X-rays: Help evaluate tooth structure loss and rule out other problems.
🦷 Dental wear indices: Some dentists use wear scales to assess the progression of damage.

Treatment of dental abrasion

Treatment will depend on the severity of the lesion and its impact on the patient's functionality and aesthetics.

🔹 Modification of oral hygiene habits: Use of soft-bristled brushes and appropriate brushing techniques to minimize wear.
🔹 Use of non-abrasive toothpastes: Opt for formulas designed for sensitive teeth with a low abrasivity index.
🔹 Fluoride application: To strengthen enamel and reduce sensitivity in teeth with mild abrasion.
🔹 Adhesive restorations: Use of composite resins to rebuild worn areas and protect exposed dentin.
🔹 Use of protective splints: In cases where bruxism aggravates abrasion, nocturnal splints are recommended.
🔹 Correction of ill-fitting prosthetics: If removable prosthetics are generating friction, they should be adjusted or replaced.

Prevention of dental abrasion

✔️ Use soft-bristled toothbrushes and avoid applying too much pressure when brushing.
✔️ Choose toothpastes with a low abrasivity index and avoid products with rough particles.
✔️ Do not use your teeth to hold, cut, or bite hard objects.
✔️ Avoid excessive consumption of acidic foods that can weaken enamel.
✔️ Use mouthguards if you clench your teeth or play contact sports.
✔️ Visit the dentist regularly to monitor any abnormal wear on your teeth.

Conclusion

Dental abrasion is a common condition that, if left untreated, can lead to sensitivity, fractures, and structural deterioration of the teeth. Identifying its causes and modifying habits is essential to prevent its progression. In advanced cases, restorative treatment with composite resins or crowns may be necessary.

Legal Notice and Disclaimer

This article is part of ONAK's Dictionary of Medical Terms and is for informational purposes only. It should not be considered a substitute for consultation with a dentist. The information provided herein does not guarantee the prevention, diagnosis, or treatment of any dental condition.

ONAK is not responsible for the misuse of the information contained in this article. It is recommended to consult a dental health professional for a personalized evaluation and determination of appropriate treatment.

Bibliography

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2. Lussi, A., Carvalho, T. S. "Erosive tooth wear: A multifactorial condition of growing concern and increasing knowledge." Monogr Oral Sci. 2014; 25:1-15. Available at: https://pubmed.ncbi.nlm.nih.gov/24993261/

3. Bartlett, D. W., Ricketts, D. N., Smith, B. G. "The relationship between oral hygiene and dental erosion." J Oral Rehabil. 1998; 25(11): 899-903. Available at: https://pubmed.ncbi.nlm.nih.gov/9879029/