You know the saying, “Long in the tooth”? It refers to being able to tell a horse’s age by the length of their tooth. The longer the tooth, the older the horse. In humans, tooth attrition can reverse that formula, adding years to your look as your teeth wear away. Here’s what you should know about this condition.

What is tooth attrition?

Tooth attrition is dental wear caused by one tooth’s contact with another. While our teeth wear naturally over time, tooth attrition is natural wear times three. In extreme cases, tooth attrition reaches through the enamel, exposing the inner dentin of the tooth.

There are some obvious physical signs of tooth attrition. These include:

  • Teeth that are flat or thin
  • Fillings or other dental restorations that fail or fall out
  • Discolored or mottled teeth due to loss of enamel

Physically, patients experience pain because of the exposed dentin along with sore, red, and tender gums. Teeth can become increasingly sensitive to hot and cold foods, and the risk of cavities increases.

Abfraction is a type of dental attrition that occurs next to the gum line. The causes of this rare and puzzling dental condition are shared by dental attrition (see below).

Tooth abrasion

Tooth abrasion shares symptoms with tooth attrition but does not have the same causes. If tooth attrition is caused by tooth-on-tooth contact, tooth abrasion occurs as a result of outside forces acting on the teeth.

The most common of these forces is vigorous and aggressive tooth brushing, often with a hard-bristled brush. Tooth abrasion is also caused by overuse of abrasive toothpaste and toothpicks, both of which can create ridges in the teeth.

Tooth erosion

Unlike soil erosion, which is caused by the natural forces of wind, water, and time, the erosion of teeth is caused almost completely from “unnatural” forces acting on your teeth.

Biologically speaking, teeth are designed to bite and chew. They are not meant to be used as bottle openers, nut crackers, tool holders, string cutters, or nail trimmers. These common uses of teeth cause far more wear-and-tear per occurrence than do natural uses like eating, yet people often discount the damage they are doing.

For all types of dental attrition (including tooth abrasion and tooth erosion), wear may be excessive if it causes cosmetic concerns or causes pain or discomfort.

What causes dental attrition?

The main culprit of dental attrition is a condition that causes widespread destruction across all areas of oral health. Bruxism, that chronic action of tooth grinding and jaw clenching, is the primary cause of dental attrition. Teeth are just not meant to withstand the constant pressure and grinding of this chronic dental condition.

Other common causes of dental attrition (including tooth attrition, abrasion, and erosion) include:

  • Workplace factors: If you work in an industry that has dust and grit present (e.g., in construction or a manufacturing plant with dust), this fine grit can make its way into your mouth. You may not notice it, but over time, this grit works with your regular action of chewing to increase wear.
  • Diet: A diet high in acidic food and drink softens the tooth’s enamel and makes it vulnerable to excessive wear.
  • Health conditions: Dry mouth (xerostomia), anorexia, gastro-esophageal reflex disease (GERD), and bulimia all make conditions for excessive tooth wear and dental attrition to occur.
  • Enamel thickness: People with genetically thinner enamel will see more dental attrition over time.

With the exception of bruxism, which is capable of doing excessive damage all on its own, many cases of dental attrition are caused by a combination of factors. All of these factors must be addressed when it comes to treatment.

How to manage and treat tooth attrition

Tooth attrition treatment is imperative, as it can quickly lead to a number of more challenging oral health conditions. It can lead to periodontal disease, cracked teeth, cavities, and abscessed teeth.

As with many challenges to our oral health, tooth attrition treatment begins with prevention. If you are using a hard-bristled brush to clean your teeth, swap it out for a soft brush. Put away the abrasive toothpaste, and ask your dentist which paste is best for you. They may recommend a sensitive-teeth toothpaste.

Learn how to brush your teeth properl