Tooth wear: The difference between Abrasion, Erosion, Attrition and Abfraction

Author: Dr. Nhan Tam View: 2,243
The distinctions between these are not absolute or clear cut. Opinions vary in what the correct definitions should be. There is also overlap in clinical appearance or diagnosis.


Loss of tooth structure due to mechanical action of a foreign element, such as a hard bristle toothbrush or a lip piercing.

This can occur anywhere that the foreign object rubs on the teeth.


Loss of tooth structure due to chemicals.

Chemicals involved in dental erosion are usually acidic, such as carbonated beverages, citrus fruits, tart candy, or stomach acid (bulimia; gastric reflux).

Erosion lesions are sharply defined, wedge-shaped depressions, usually in the facial and cervical areas.


Loss of tooth structure by mechanical forces from opposing teeth.

Limited to the contacting surfaces of the teeth.

Bruxism can cause attrition of the occlusal/incisal surfaces.


Loss of tooth structure caused by occlusal forces such as bruxing.

This structural loss occurs on the sides of the teeth, usually at the gumline level; not on the occlusal surfaces.

Causes notches in the tooth along the gumline.

Think of holding a bunch of uncooked spaghetti in your two hands. If you flex the spaghetti back and forth, some of them will start to crack. This is what happens to the tooth. The top is held together by the hard enamel crown. The bottom is held together by the bone. The part by the gumline is the part that starts to break away.

Nhan Tam Dental Clinic