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What can it mean when anterior wear is greater than posterior?

Have you ever had a patient in your chair, you're doing a complete exam, you're evaluating the wear, and you notice that the wear on their anterior teeth is more than the posterior teeth? Are you wondering, "Why is this happening?" Well, let's talk about some possibilities that could be causing this.

Make sure you know the differences in wear.

First of all, if the lingual of the anteriors is worn smoothly all the way to the gingiva, then we're thinking the cause is bulimia. If you have a patient where their canines are worn and the wear facets match up, then we are thinking the cause of being bruxism.

The 3 causes of anterior wear 

Posterior WearNow, if you have a patient that has wear going on in regards to around where the centric stop is, there are like three possibilities that we're thinking of at that point that we need to decide what's the cause is.

  1. There could be a discrepancy between centric relation and maximum intercuspation.
  2. The patient is suffering from sleep apnea, and what they're doing is bringing that lower jaw forward at night in order to be able to breathe and is causing the wear to occur.
  3. There is a restriction to their envelope of function which is caused by the positioning of the teeth, which the wear has to occur in order for them to go ahead and bring their teeth together.

So the next time you're in a complete exam and you see more anterior wear on the anterior teeth and then the posterior teeth, think about these causes, which will lead you to the proper diagnosis and, ultimately, the proper treatment for the patient.

Attritional Wear

Dr. Laura Wittenauer is a senior faculty member at The Dawson Academy, where she teaches the Core Curriculum with fellow faculty members. She owns and operates her private practice in Newport Beach, California. Dr. Wittenauer’s practice focuses on helping patients achieve optimum oral health.