Interaction of different tooth wear processes

Although there are known situations where only one single process causes tooth wear (e.g. nocturnal teeth grinding produces wear by attrition alone), the clinical presentation often results from a combination of tooth wear processes.

When different tooth wear mechanisms act contemporaneously, diagnosis of dental erosion can be difficult (O’Sullivan & Milosevic 2007). In order to determine the dominant mechanism, thorough clinical observation is essential. It is also important to examine the patient’s general health, diet and habits.

Current evidence suggests that most tooth wear lesions are a combination of tooth wear processes, among which the combination of erosion and abrasion appears to play a dominant role (Addy & Shellis 2006).
Combination of erosion, abrasion and attrition

Wedge-shaped defect

Wedge-shaped defects may also be the result of multicausal tooth wear processes. Aetiology is most likely abrasion; however, in this case, early signs of erosion are also present (e.g. shiny surface and loss of perikymata).

Abrasion, abfraction and erosion