I appreciate Dr. John Grippo and colleagues’ organizing a complicated series of conditions, the common feature of which is non-carious loss of tooth structure ("Attrition, Abrasion, Corrosion and Abfraction Revisited: A New Perspective on Tooth Surface Lesions," August JADA).
Although "dentifrice" was mentioned once in the table, "Etiology of Tooth Surface Lesions," there was no specific mention of it in the body of the article. Perhaps added emphasis might be warranted for the effect of three-body abrasion occurring when toothpastes become involved.
When I question patients with excessive noncarious loss of enamel and dentin, they typically describe applying dentifrice to the brush with complete coverage of the bristles, sometimes using two layers, as compared with the amount like a "small pea" usually suggested. Abrasive(s) from toothpaste are harder than teeth and, microscopically, have coarse shapes. The more dentifrice that is available in the mouth, the more rapidly abrasion will proceed.
I believe this three-body abrasion, in which the main culprit is excessive amounts of dentifrice, is a significant factor in loss of healthy tooth structure. Perhaps toothbrush abrasion might be better renamed "toothpaste abrasion."
