Occlusal Wear


What is Occlusal Wear:

Occlusal Wear is the loss of tooth structure due to the rubbing of tooth against tooth.

Causes of Worn Teeth:

  • Parafunctional habits: bruxism (grinding), clenching, or object biting (ice, nails, pens). These can occur for a number of reasons, including:
    • Stress
    • Medications: levodopa, fluoxetine, lithium, citalopram, etc.
    • Habits
  • Bite interference due to:
    • Natural tooth position
    • Restorations that are “high” or unpolished porcelain rubbing against natural tooth structure.
    • Shifting tooth position from periodontal disease
  • Missing teeth – spaces in your dentition will put more pressure than normal on the remaining teeth. This is most noticeable with your molars and other posterior teeth.
  • Diet
    • Nuts, ice
    • Excessive gum chewing
  • Systemic/Neurological
    • Sleep apnea
    • Huntington’s disease, Parkinson’s disease
    • Down syndrome
    • Autism
  • Developmental dental defects –enamel is thin or weak

Symptoms of Tooth Wear:

  • Flattening of chewing surfaces
  • Trismus (restricted mouth opening)
  • Tenderness in the muscles used for chewing
  • Headaches, usually near the temples
  • Clicking of the temporomandibular joint (TMJ) – where your jaw attaches to the rest of your skull
  • Bite doesn’t “feel right”
  • Loose teeth

Risks of Attrition:

  • Teeth: Tooth sensitivity, fracture of teeth, exposure of tooth nerve, poor esthetics, toothaches
  • Functional: Decreased chewing efficiency, pain on chewing
  • Temporomandibular joint disorders, or chronic headaches

Treatment Options:

  • Bite equilibration – a procedure done in office where the dentist reduces the area causing the interference, allowing the teeth to come together more naturally
  • Occlusal guard to prevent grinding and clenching
  • Restorative procedures – fillings or crowns to prevent further wear, decrease sensitivity, or improve aesthetics of worn dentition.
  • Orthodontic movement to fix issues with a misaligned bite
  • For severe cases, the only treatment is a “full mouth rehab” – necessitating crowns for nearly every tooth.


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