Dental Wear: How to Measure, Prevent and Treat

Abstract

The aim of this work is to have a complete picture of dental wear, defining it properly, understanding how it occurs and its consequences, as well as reviewing the different methods to measure it, the existing preventive measures and treatment options. The topic was considered relevant due to the high prevalence of the condition, especially increasing in children, and the lack of clear management protocol. For that purpose, a systematic literature review of scientific publications was carried out. Dental wear is divided in three types: attrition, erosion and abrasion. Abfraction can be added but is not recognized universally as a different type. Each one has different causes including parafunctional disorders for attrition, intrinsic or extrinsic acid exposure for erosion, and foreign bodies, such as abrasive toothpastes, for abrasion. The consequences on dentition are therefore different for each, leading to different recognizable patterns. It explains the complexity of defining a uniform way to measure wear: many indexes have been developed and employed through time until this day, with the BEWE being the easiest one to use and the TWES offering good perspectives for the future. The latter seems to be the most complete until now. As for the management, it seems all the preventive measures developed until now lack evidence about their efficiency even though they are the preferred option. For now, counselling and monitoring seem to be the key to handle wear. As for restorative treatments, they should be delayed as long as possible but in advanced cases, they are the best alternative. Ceramic ones remain the first option, but composite resin has known improvements in its manufacturing and technique which makes it more used today than it was before. Further studies are still needed regarding its durability.