Prevalence of Tooth Attrition in the Population
Approximately 75% of young adults have dental attrition, with prevalence increasing substantially with age—15% of the general population shows moderate wear and 3% shows severe wear, with 80% of individuals over 50 years displaying signs of tooth wear. 1, 2
Age-Specific Prevalence Data
The prevalence of attrition follows a clear age-related pattern:
Young adults (18-40 years): 74.7% (95% CI: 68-81%) demonstrate dental attrition, based on systematic evaluation using standardized tooth wear assessment systems 2
General adult population: Over 30% show tooth wear in early adulthood, with prevalence increasing progressively with age 3
Adults over 50 years: 80% exhibit signs of wear, with 15% showing moderate wear and 3% demonstrating severe wear 1
Key Risk Factors and Associations
Dental attrition is strongly associated with erosive tooth wear (adjusted OR 6.3; 95% CI 2.8-14.2), body mass index (adjusted OR 1.3; 95% CI 1.1-1.5), and increasing age (adjusted OR 1.2; 95% CI 1.0-1.3). 2
Additional contributing factors include:
Bruxism: Both daytime and nighttime grinding significantly contribute to attrition patterns, particularly in older individuals 1
Male sex: Men demonstrate higher rates of attrition compared to women in univariate analyses 2
Awake bruxism frequency: Increased frequency of conscious grinding correlates with greater attrition severity 2
Clinical Significance
Tooth wear is fundamentally an age-related phenomenon and part of the normal aging process, though the rate of progression varies considerably between individuals. 3
Important clinical considerations:
The biological impact of wear on teeth is relatively benign—pulpal death from attrition alone is rare despite progressive dentine exposure 3
Dentine hypersensitivity may develop depending on the etiology and rate of wear 3
Patient perception and concern about tooth wear often drives management decisions more than the objective severity of wear itself 3
Salivary alterations do not appear to predict dental attrition in young adults 2
Population-Level Implications
Attrition should be recognized as a nearly universal condition affecting the majority of adults, with clinical intervention reserved for cases causing functional impairment, aesthetic concerns, or rapid progression. 1, 3
The high prevalence (>70% in young adults, >80% in older adults) indicates this is a normal physiological process rather than a pathological condition requiring universal treatment 1, 2