Dental wear in questions. Keys to understand etiological factors, define the various clinical aspects of wear lesions and make the related diagnosis. - ROS - 2014 - Tome 43 - N°1

Odontologie conservatrice et restauratrice

Pages 36 to 55

Tooth wear is now an issue in daily practice, because of the evolution of food habits and dental hygiene. Three main mechanisms are identified: attrition (dento-dental contacts), abrasion (friction with non dental bodies), erosion (non bacterial acid attack). Tooth wear results from their various actions. The etiological diagnosis is particularly important to check the evolution of the pathological wear and prevent its recurrence. An interview with the patient allows to reveal life habits and possible digestive pathologies. A dentin hypersensitivity, due to the primary exposure of the dentin, is the warning sign of the wear. Each mechanism alters each affected tooth with specific lesional aspects in terms of shape and distribution; it is easier to make the etiological diagnosis when we are able to interpret them. An advanced wear can blur the diagnosis by the complexity of the wear aspects; a global decision tree, based on the analysis of the dental arches, facilitates the diagnosis.