Tooth Wear Mechanisms and Etiology

Video 1. Which elements of tooth wear are most common today?

Tooth wear is a problem, in the sense that, as we age there are wear forces on the teeth. Those wear forces can lead to what most of us will have as we age, which is physiological tooth wear. There’s some natural wearing away of the tooth. The problem is when that process gets accelerated. And that process gets accelerated because of exposure to food acids, excessive consumption of soft drinks, excessive consumption of juices that are acidic. The acid then softens the enamel and that accelerates the wear of the biting surface of the tooth, as well as the wear of the smooth surfaces, especially if they’re brushed with a toothbrush too soon after the acid exposure.

The mineral in enamel is a calcium-deficient carbonated hydroxyapatite, with the carbonate rendering the tooth more acid-soluble than true hydroxapatite.2 During a lifetime, one’s teeth are subjected to a number of physical and chemical insults that damage this more soluble hydroxyapatite of enamel, as well as the other hard dental tissues, including the dentin and cementum. This chronic destruction of hard dental tissues due to physical or chemical wear, or a combination of both, has been defined as tooth wear.2 While enamel is the most at risk for dental erosion, as teeth are lasting longer in more recent times, dentists have had to pay more attention to the coronal and root dentin, because their exposure is becoming more common as a result of growing issues related to tooth wear and gum recession.