Tooth surface loss: A review of literature

Abstract

Objectives: Tooth surface loss (TSL) or tooth wear (TW) is an irreversible loss of hard tooth structure caused by factors other than those responsible for dental caries. TSL is observed clinically as attrition, abrasion, abfraction, and erosion. It may be associated with symptoms such as tooth hypersensitivity and function impairment, and may lead to change in the morphology of the affected tooth. However, it may also be asymptomatic, meaning the patient may not be aware of it. In this instance, the dentist is encouraged to make the patient aware of this issue.The aim of this review is to provide an overview of the classification and management of TSL.

Material and methods: The PubMed (MEDLINE) search engine was used to gather the most recent information on TSL. The search was restricted to a five year period (1 September 2014-31 August 2019), and only English-language studies were included. A Boolean search of the PubMed dataset was implemented to combine a range of keywords: (Tooth surface loss OR tooth wear) AND (tooth attrition OR tooth Abrasion OR tooth erosion OR tooth abfraction OR non-carious cervical lesions) AND (humans). Studies were also obtained by manual searches and from Google Scholar.

Results: By this process, 560 articles and studies were obtained. More studies were also obtained by manual searches and from Google Scholar. The most relevant published studies were chosen and used in the current review. The selected articles are included in the reference list.

Conclusion: TSL is a clinical problem that dentists face on a daily basis. Therefore, a sound clinical approach by which TSL can be prevented and managed is essential. While this approach requires that dentists are knowledgeable about the issue, increasing public awareness of TSL is also vital.

Keywords: Carbonated drink; Gastro-oesophageal regurgitation; Non-carious cervical lesions; Tooth surface loss; Tooth wear.

Fig. 1

Cervical abrasion lesions caused by the aggressive use of the chewing stick (Miswak).

Fig. 2

Abrasion lesions are caused by the consumption of dried sunflower seeds and are a result of keeping the shell vertically and applying force in order to crack it.

Fig. 3

Different stages in the continuous erosion process (Modified from Lussi et al., 2011): 1. Softening of the enamel red area with no material loss, 2. Partial material loss (Black arrow) and softening of the underlying surface (subsurface) (Red area), 3. Significant loss of material (Black arrow) and softening of the underlying surface (Red area).