Abrasions of the teeth – colloquially called tooth wear – (synonyms: Abrasio dentium; Ankylosis of teeth; Proximal tooth wear; Attrition of tooth structure; Attrition of teeth; Pronounced attrition of teeth; Decalcification of teeth; Dental ankylosis; Dental resorption; External tooth resorption; Habitual tooth abrasion; Hyperplasia cementi; Hyperplasia of tooth cementum; Dental abrasion; Dental abrasion from dentifrices; Dental buildup from materia alba; Dental buildup from materia alba; Dental erosion; Dental erosion from medications; Dental erosion from drugs; Dental erosion from food; Dental erosion from insatiable vomiting; Dental color change of hard tissue; Dental resorption; Cementosis; ICD-10: K03. – Other diseases of dental hard tissues) refers to any loss of dental hard tissues caused by friction. The rubbing of teeth against each other usually occurs unconsciously, often at night in the form of nocturnal teeth grinding.
Abrasions can occur both sporadically and in the entire dentition, which is then called an abrasion dentition.
Symptoms – complaints
The loss of tooth structure initially affects only the enamel. However, further abrasion can continue to damage the teeth to the point that the dentin (tooth bone) is also affected. If the dentin is exposed, the teeth often react sensitively because the dentin is very sensitive to pain. In addition, dentin is much softer than enamel, so it is lost much more quickly.
Consequential diseases
The consequences of abrasions are often sensitive teeth, because the pain-sensitive dentin is exposed.
The ongoing irritation can cause the pulp (tooth nerve) to retract further and further into the root of the tooth. If the stress is very severe, it can even lead to inflammation of the tooth nerve, which can sometimes lead to its death, making root canal treatment necessary.
Pathogenesis (disease development) – etiology (causes)
Often, the dentures of older people are heavily abraded, which can also be considered as a kind of wear. Here, the abrasions are usually caused by contact between the teeth, which is called attrition. The tooth crowns are then shorter, and usually the dentin is also already exposed.
In a young dentition, the abrasions are usually due to parafunctions such as grinding.
Another possible cause of tooth structure loss is incorrect tooth brushing. The “scrubbing” of teeth with highly abrasive toothpastes can lead to abrasions at an early stage. Therefore, there is a so-called RDA value (Radioactive Dentin Abrasion) for toothpastes. This is a guideline value that allows a statement to be made about how abrasive a toothpaste is. Different abrasion values of toothpastes are caused by the fact that each toothpaste contains different cleaning agents of different types, quantities and sizes. Values of an RDA up to 70 are considered low abrasive and are therefore recommended.
Diagnostics
Diagnosis is made on the basis of clinical appearance.
Therapy
Often, the teeth have become sensitive due to the abrasive changes. In these cases, it is recommended to use a toothpaste for sensitive teeth, if necessary in combination with a mouth rinse. A sealant for exposed dentin can be applied at the dentist.
If teeth grinding is the causative factor for the abrasions, a customized grinding splint made by the dentist should be worn at night to minimize further tooth structure loss.
