Dental Diseases
Attrition
aka Occlusal Wear · Tooth Wear
Physiological or pathological loss of tooth structure from tooth-to-tooth contact.
§ figuresFigures (2)
Fig. 1Typical Presentation of Dental Attrition
“Typical Presentation of Attrition” · Itdent · CC BY-SA 4.0 · Wikimedia Commons
Fig. 2Typical Appearance of Attrition
“Typical Appearance of Attrition” · Itdent · CC BY-SA 4.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Attrition figures pending faculty review.
§ overviewOverview
Mechanical wear of incisal/occlusal surfaces due to functional or parafunctional masticatory contact.
§ icdICD Classification
K03.0
§ etiologyEtiology
- 01Normal ageing
- 02Bruxism
- 03Coarse diet
- 04Loss of posterior support
- 05Malocclusion
§ epidemiologyEpidemiology
Increases with age; severe in bruxers.
§ pathogenesisPathogenesis
Repetitive enamel-to-enamel/dentin contact → progressive surface loss.
§ clinicalClinical Features
- 01Flat, shiny wear facets
- 02Exposed dentin (yellow)
- 03Cupping of cusp tips
- 04Shortening of clinical crown
- 05Matching facets on opposing teeth
§ differentialDifferential Diagnosis
- 01Erosion (smooth, concave)
- 02Abrasion (V-shaped notches)
- 03Abfraction
§ investigationsInvestigations
- 01Clinical examination
- 02Study models / photographs for monitoring
§ treatmentTreatment
- 01Manage bruxism: occlusal splint
- 02Restore lost structure: composite, crowns
- 03Rehabilitate VDO if severe
§ complicationsComplications
- 01Pulp exposure
- 02Sensitivity
- 03Loss of vertical dimension
§ prognosisPrognosis
Good if aetiology addressed and VDO restored.
§ examKey Examination Points
- 01Matching wear facets = attrition
- 02Bruxism = primary cause in young adults
- 03Distinguish from erosion (acid) by facet pattern
§ revisionQuick Revision Summary
- 01Shiny, flat facets
- 02Matching opposing wear
- 03Occlusal guard for bruxism
§ vivaBDS Viva Questions
- 01How does attrition differ from erosion?
- 02What is the role of occlusal splints?
- 03When is restorative intervention required?
§ mcqsMCQs — Assessment (3)
Question 1
Attrition is caused by:
Question 2
Characteristic feature of attrition:
Question 3
Primary management of bruxism-related attrition:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Tumours Online — Head and Neck
IARC / WHO · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 1
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Additional sources cited on this page
- Neville BW. Oral & Maxillofacial Pathology, 4e
- Tyas MJ. Tooth Wear and Sensitivity. 2000
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.