Types, clinical features, Causes prevention & treatment
Non-carious loss of tooth structure is a problem that is often found in senior citizens and is a cause of many complaints. It is not a new entity but has acquired more attention in recent time.
Types of tooth wear
It is loss of tooth substance by the friction with a foreign substance. These are smooth and usually C shaped, more wide than deeper.
These are usually facio-cervical concavities that are more broad than deep and can be associated with an abrasive diet. They are usually found on prominent teeth in the arch (i.e., canines, premolars, and mesio-buccal aspects of first molars). They may affect several teeth in a row with a “band” of abrasive damage. Sometime they may cause hypersensitivity.
Figure 1. Abrasion: note the concave smooth cavities in the cervical regions of upper and lower teeth.
Causes of AbrasionIt is mostly located in the cervical area of the teeth. The reason may be one or a combination of the following factors:
- o Excessive tooth brushing for longer period
- o Use of hard tooth brush
- o Use of tooth paste containing highly abrasive material
- o Use of locally prepared tooth cleaning powder or paste like Gul, Gulak or Lal Manjan
- o Repeatedly putting foreign objects in the mouth like pipe smoking, pen, bobby
- o pins and any other occupational material.
Prevention of Abrasion
Use of common sense is the best way of preventing the abrasion. If the cause is a hard tooth brush or brushing the teeth for a longer duration or use of an excessively abrasive tooth paste. Then correcting the hardness of the tooth brush, adjusting the time, and changing the tooth paste will be sufficient. If the cause is abrasive food or any occupational factor, this may be difficult to treat but not impossible.
Treatment of Abrasive Lesions
The treatment of the cavities created by abrasion is the restoration of teeth by Glass Ionomer or tooth coloured composite filling material. These types of fillings or restoration fall under the category of 'Cosmetic' or 'Aesthetic' 'Restorations'.
Sometimes, the depth of the abrasive lesion is so deep that it affects the pulp in an adverse way. In this stage, it is better to get the 'Root Canal Treatment' before going for aesthetic restoration. But, if the lesion had been there since long, the involved tooth may need extraction.
It is the loss of tooth material due to tooth to tooth contact. It usually occurs on occlusal and incisal surfaces.
They show matching occlusal wear between arches and shiny wear facets on restorations. There is an increased risk for fracture of teeth and restorations.
Figure 2. extreme attrition of teeth leading to loss of complete crown of mandibular teeth