Non Carious Lesion: The Hidden Story of Tooth Surface Loss

Non-carious lesions (NCLs), also known as tooth surface loss, refer to the progressive and irreversible loss of dental hard tissues without bacterial involvement. They are multifactorial in origin and primarily include attrition, abrasion, erosion, and abfraction. Attrition occurs due to tooth-to-tooth contact, often seen in bruxism, leading to flattened occlusal surfaces. Abrasion results from external mechanical forces such as aggressive tooth brushing, presenting as cervical notches. Erosion is caused by chemical dissolution from non-bacterial acids, either intrinsic (e.g., gastric reflux) or extrinsic (e.g., acidic diet), producing smooth, shiny surfaces. Abfraction is associated with occlusal stress causing microfractures at the cervical region, forming wedge-shaped defects. Clinically, NCLs may present with dentinal hypersensitivity, loss of enamel, and altered tooth morphology. Diagnosis requires careful history, clinical examination, and identification of contributing factors. Management focuses on eliminating etiological causes, preventive strategies like dietary and habit modification, desensitization, and restorative treatment when necessary.