Dental Attrition- Aetiology, Diagnosis and Treatment Planning: A Review

Tooth wear and its rehabilitation is a much discussed and studied subject in dentistry. The increased life expectancy may be one of the factors that it has become more ubiquitous. Often patients with tooth wear report to the dental clinic requiring extensive restorative treatment. Wear can be the result of attrition, abrasion, erosion or abfraction. The clinical presentation may vary and can be quite confusing. A proper diagnosis of the aetiology is essential for management of worn dentition as these factors must be eliminated before initiating restorative treatment. Attrition is the result of tooth-tooth grinding due to functional and parafunctional habits. It appears as wear facets on the occlusal surfaces of teeth which in due course can lead to considerable loss of tooth structure and loss of vertical dimension. This review article focuses on dental attrition as the aetiology of tooth wear, the signs and symptoms which help in diagnosis of attrition and the guidelines for treatment planning. A literature search was done using PubMed and Google Scholar with the key words: ‘dental attrition’, ‘tooth loss’, ‘ occlusal wear’. The articles excluded were reviews, case reports and references in which wear had meaning other than loss of tooth tissue. Observer agreements were analysed and disputes were resolved with debate and discussion.