The pathological wear of the tooth surface can be caused by bruxism, which is clenching and grinding of the teeth.
In the case below, attrition is severe, the enamel is completely worn away leaving underlying dentine and pulp exposed.
These results in an increased risk of dental caries.
There is yellow colour appearance of tooth surface and secondary dentin formation was visible.
CAUSE- The etiology of dental attrition is multifactorial. One of the most common causes of attrition is BRUXISM . Bruxism is the parafunctional movement of mandible, occurring during day or night. It can be associated with presence of audible sound when clenching or grinding teeth.
PREVENTION - When a diagnosis of bruxism has been confirmed, it is recommended that the patient buy a full coverage acrylic occlusal splint such as Michigan splint or Tanner appliance, to prevent further bruxism.
TREATMENT - Cosmetic or functional intervention may be required if tooth surface loss is pathological or if there has been advanced loss of tooth structure.
Densitising agents such as topical fluoride vanishes can be applied and at home desensitising toothpastes can be recommended.
Many restorative options have been proposed, such as direct composite restoration, bonded cast metal restorations , crown lengthening procedures.
The decision to restore the dentition depends on the wants and needs of the patients , the severity of tooth surface loss and whether tooth loss is active.
The use of adhesive materials to replace lost tooth structure can be performed as a conservative and cost effective approach before a more permanent solution of crowns or veneers is considered.