Diagnosis and management of dental wear

Dental wear is loss of tooth structure resulting from erosion, attrition, abrasion and, possibly, abfraction. Clinical/experimental data suggest no single damaging mechanism, but rather simultaneous interaction of these destructive processes. The most important interaction is abrasion/attrition potentiated by dental erosion. Awareness of this pathosis is not well-appreciated by the public and dental professionals because the signs may be subtle. This article focuses on recognizing, diagnosing and managing dental wear. Dental wear is a challenging problem for clinicians because of the subtlety of early changes; confusion about the etiology of the problem; and the dilemma of when or how to manage the etiology. Unfortunately, failure to recognize and manage the process often results in inaction until the breakdown is severe. At that point, the structural breakdown is so advanced that major rehabilitative treatment often is needed. This introductory article discusses diagnosing and managing dental wear.