Tooth attrition is the gradual wear of tooth surfaces due to functional or parafunctional occlusion, affecting areas such as occlusal surfaces and incisal edges. It can be categorized into physiological attrition, occurring with normal aging, and pathological attrition, resulting from abnormal chewing habits or structural defects, which may cause pain and sensitivity. Factors influencing attrition include bruxism and exposure to abrasive substances, both of which can also increase the risk of dental caries.

1. TOOTH ATTRITION
MUK
BDS 3

2. Attrition is the progressive wearing off of tooth
surfaces or restorations as a result of functional or
parafunctional occlusion of the teeth.
•Attrition majorly affects surfaces that come in contact on
occlusion which are : occlusal surfaces, proximal areas
and incisal edges.
Usually characterized by well defined shiny facets and
parallel striations within facet border of the attrited teeth
or tooth

4. Types of attrition
Physiological attrition: Attrition which occurs
progressively during normal aging process as a result of
masticatory occlusion. Usually a slow process through out
life .
This form of attrition plays an important role in maintaining
an advantageous crown to root ratio and gains intercoronal
space of 1cm which facilitates third molar eruption

5. Normal occlusion with physiological
attrition

7.  Pathological attrition: This is a severe form of
attrition that occurs as a result of abnormalities in
occlusion ,chewing pattern and structural defects in
teeth .
Examples are bruxism or clenching
Attrition is considered pathological when it causes
functional, aesthetic and dental sensitivity problems

8. AETIOLOGY
Abnormal chewing habits: Parafunctional chewing habits like
Bruxism and chronic persistent chewing of coarse foods or other
substances like tobacco.
In other occupations workers are exposed to an atmosphere of
abrasive dusts e.g. silica
Odontogenesis imperfecta and dentinogenesis imperfecta in
which the hardness of enamel and dentine is reduced and such
teeth become more prone to attrition.

9. Clinical presentation of attrition
 Loss of tooth anatomy: rounding and sharpening of incisal ages, loss of
cusps and fracturing of teeth.
 Sensitivity and pain : attrition may be entirely asymptomatic or there may
be dentine hypersensitivity.
 Tooth discoloration : attrition and erosion of the enamel exposes inner and
darker dentine giving a yellower appearance
 Compromised periodontal support leading to drifting of teeth
 Altered occlusion due to decreasing occlusal vertical dimension

12. BRUXISM
• This is excessive teeth grinding and clenching which is an oral
parafunctional activity .it presents with many symptoms and signs of
which among is excessive attrited teeth
• Bruxism is of two types a classification based on times of occurrence
which are: Sleep bruxism and awake bruxism.
• However dental damage may be similar in both cases though sleep
bruxism presents with worse symptoms on waking and improves
during the course of the day .

14. ATTRITION AND DENTAL CARIES
• The effect of attrition on dental caries development is multifactorial
involving tooth erosion and abrasion
• Physiological Attrition wears out the protective enamel increasing
seeding of acid into the enamel matrix therefore increasing
demineralization and the chance of developing carious lesions.
• In pathological attrition which involves severe enamel wear, the
dentine is exposed and this predisposes the tooth to bacterial
invasion by S. mutans which consequently leads to development and
rapid progression of dental caries .
• Bruxism can result in reduced salivary flow rate from the parotid
gland which predisposes the individual to dental caries.

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