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Tooth surface loss (TSL), the non-carious loss of tooth tissue, is considered pathological if the teeth involved experience sensitivity and pain, are functionally compromised or they detract from the patient's appearance. TSL is a common clinical finding in many patient groups, although differences between the primary and permanent dentition contribute to TSL occurring at a faster rate and with worse outcomes in the primary dentition. This case report presents localized abrasion and associated apical periodontitis affecting a single primary tooth in a 2-year-old infant following the misuse of a babies' dummy clip whilst teething. Abrasion is rare in the primary dentition.
CPD/Clinical Relevance: This article highlights an unusual presentation of dental abrasion affecting the primary dentition caused by a previously unreported foreign object; abrasion in this case was a side-effect of soothing the discomfort of teething.
Article
Tooth surface loss (TSL) is the non-carious loss of tooth tissue that occurs throughout life1 that is generally multifactorial in nature. Factors causing TSL include:
TSL is generally regarded as pathological if teeth become so worn that they do not function effectively, become a source of pain or seriously compromise appearance.3 It has been suggested that the term TSL be used when it is not possible to identify a single aetiological factor responsible for the wear.3Attrition is a physiological phenomenon where tooth substance is removed following contact between opposing dental surfaces.3Erosion is a chemical process involving the loss of tooth substance, usually following contact with acid of either intrinsic or extrinsic origin.3Abrasion involves wearing away of tooth substance by the repeated friction of a foreign body against the tooth, independent of occlusion.4 Grippo5, who introduced the term abfraction, defined it as the pathologic loss of dental hard tissue as a result of biomechanical loading forces that results in flexure and eventual material fatigue of susceptible teeth at locations distant from the loading region. Resorption of dental hard tissue can be a physiological or pathological process that involves clastic activity.2 Wearing away of tooth substance in the course of chewing of food is termed demastication and this depends on the abrasiveness of the food.2
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