Human tooth wear in the past and the present: tribological mechanisms, scoring systems, dental and skeletal compensations

This review of human tooth wear describes the fundamental mechanisms underlying this process. Using the tribological approach they can be systematised and this in turn aids our understanding of them. In past populations wear was ubiquitous, intense, abrasive and physiological as it was related to their food and their technologies. In these populations, it affected the proximal surfaces, and the occlusal surfaces which modified the occlusal plane profoundly. To categorise this wear many different classification systems are used, from which we can determine diet, cultural changes and the age at death of individuals. They also illustrate the evolution of certain functional dental and skeletal compensations in the masticatory apparatus such as continuous dental eruption, mesial drift of the arches and incisor lingual tipping which can then be monitored. These physiological adaptations related mainly to function and ontogenesis can also be found in present-day populations where wear is moderate, although they are much less obtrusive. Apart from certain pathological cases associated with a specific parafunction, iatrogenic tooth brushing or an eating disorder and encouraged by an acid environment, they are the result of a physiological process that should not be halted. To ensure this, it is essential to prevent lesions related to tooth wear, to detect them early and establish a reliable diagnosis. Types of tooth wear that had remained unchanged since the origin of humanity have undergone profound changes in a very short space of time. Today's tribochemical pathological model has replaced the abrasive physiological model of the past.