Attrition, also known as dental attrition or occlusal wear, is a type of tooth wear[1] that is the loss of tooth structure by mechanical forces from opposing teeth[2]. Attrition initially affects the enamel and, if unchecked, may proceed to the underlying dentin. Once past the enamel, attrition quickly destroys the softer dentin.
The most common cause of attrition is bruxism. Functional habits are those such as chewing and swallowing, which usually puts very little force on opposing teeth. Parafunctional habits, such as clenching and clicking the teeth together nervously, place greater amounts of forces on opposing teeth and begin to wear the teeth. As expected, wear usually begins on the incisal or occlusal surfaces.
Treatment options have been systematically reviewed.[4][5]Clinical practice guidelines recommend less invasive options, usually direct, for initial treatment.[6]
Approaches include:
Direct options are fabricated directly in the mouth, while indirect options are fabricated outside the mouth and then cemented. Crowns, laminates, and veneers are typically considered indirect restorations
Direct (fabricated directly in the mouth, easier). Direct options are preferred for initial therapy.[6]
Indirect fabricated outside the mouth and then cemented. The indirect approach involves tooth preparation by removing dental tissue. Materials include "Porcelain veneers, ceramic crowns and onlays, indirect resin composite, indirect ceramic/composite, metal onlays, metal palatal veneers and polymer-infiltrated ceramic network"[4]
↑ 4.04.1Alani A, Mehta S, Koning I, Loomans B, Pereira-Cenci T (May 2025). "Restorative options for moderate and severe tooth wear: A systematic review". J Dent. 156: 105711. doi:10.1016/j.jdent.2025.105711. PMID40127753Check |pmid= value (help).
↑ 6.06.1Loomans B, Opdam N, Attin T, Bartlett D, Edelhoff D, Frankenberger R, Benic G, Ramseyer S, Wetselaar P, Sterenborg B, Hickel R, Pallesen U, Mehta S, Banerji S, Lussi A, Wilson N (2017). "Severe Tooth Wear: European Consensus Statement on Management Guidelines". J Adhes Dent. 19 (2): 111–119. doi:10.3290/j.jad.a38102. PMID28439579.
↑Milosevic A (August 2016). "Direct Placement Composite: the Treatment Modality of Choice to Restore the Worn or Eroded Dentition in Primary Dental Care". Prim Dent J. 5 (3): 25–29. doi:10.1177/205016841600500301. PMID28826460.
Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 56. ISBN 0-7216-9003-3.