14 June 2023

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Dental wear: what are the risk factors?

Lara Figini

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Tooth wear (TW) is the loss of hard tooth tissue from the surface not due to caries, trauma or developmental disorders.

There are various causes of wear including friction, erosion, abrasion and abfraction, caused by tensile stress generated by non-axial cyclic occlusal forces.

In severe cases of TW, patients may suffer from severe pain and psychosocial issues due to compromised aesthetics, masticatory dysfunction, temporomandibular joint disorders, masticatory muscle disorders and orofacial pain. These issues can have a significant impact on a person’s quality of life.

TW is a multifactorial phenomenon which can be physiological or pathological. Knowing the risk factors is essential to promote the diagnosis, prevention strategies and timely interceptive treatment. In addition, knowledge of risk factors for TW and adequate clinical screening could detect associated pathologies.

Materials and methods

In a review published in May 2023 in the Journal of Oral Rehabilitation, the authors describe factors associated with TW in the permanent dentition based on quantitative measurements. Researchers conducted a search in October 2022 via Medline (PubMed interface) and Scopus. Two independent reviewers selected and analyzed the studies.

Results

The research team identified 2,702 articles for evaluation of titles and abstracts and included 273 studies in the review. The results show the need to standardize TW measurement indices and study design.

The studies included in the review highlighted numerous factors associated with dental wear: sociodemographic factors, systemic pathologies, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders (TMD), behavioral factors and stress.

Findings related to chemical wear (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, especially alcohol consumption and eating behaviors, supported the need to develop educational campaigns and public health interventions.

In addition to chemicals, this review identifies several mechanical risk factors for TW, such as toothbrushing and bruxism. The influence of the latter factor needs to be explored in future studies.

Conclusions

From the data of this review, researchers concluded that the management and prevention of TW requires a multidisciplinary approach. The authors said that practitioners’ information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.

For more information: "Risks factors of tooth wear in permanent dentition: a scoping review."