Anomalies of Tooth Structure
Abrasion

In abrasion, the loss of tooth structure is not from physiologic wear but rather from contact with substances or devices that cause friction.⁹ These frictional forces are often associated with improper toothbrush and flossing habits that wear away the tooth structure.^7,9,16 Toothbrush abrasion can be the result of vigorous scrub-brushing methods and the use of abrasive toothpastes or powders. The back-and-forth scrubbing action produces V-shaped notches or grooves in the cervical aspect of the tooth buccally near the gingival tissue (Figure 46).⁹ The side of the dentition that is most severely affected is the side opposite the tooth brusher’s dominant hand.^7,9,16 In addition, wear can result from incorrect dental floss usage producing interproximal cervical notches or craters, deeper on the distal aspect than the mesial.^9,16 These areas of reduced tooth structure appear radiolucent on radiographs and may be misinterpreted as cervical or root caries. Parafunctional habits can be causal factors such as improper toothpick usage, hairpin opening, thread-biting, pipe smoking as well as grooves produced by partial denture clasp friction.^9,16