Tooth Wear F093

Current RMA Instruments

Changes from previous Instruments

ICD Coding:

• ICD-10-AM Codes: K03.0, K03.1, K03.2

Brief description

Tooth wear is the loss of dental hard tissues, including enamel, dentine and dental restorative material, due to intrinsic or extrinsic mechanical or chemical processes. For the purposes of this SOP, tooth wear requires exposure of dentine on at least one tooth surface, with associated severe tooth pain or sensitivity, or significant impairment of effective tooth function. 

This SOP covers three different types of tooth wear:

• Dental attrition is tooth wear caused by tooth-to-tooth contact.
• Dental abrasion is tooth wear caused by friction from external mechanical forces or objects.
• Dental erosion is tooth wear caused by chemical dissolution from acids.

The specific type or types of tooth wear should be specified. More than one type of tooth wear may be present and should be assessed separately. 

The SOP excludes mild tooth wear confined to the enamel, and loss of tooth substance caused by dental caries or discrete dental trauma. 

Confirming the diagnosis

This diagnosis is made by a dental clinician on clinical grounds based on symptoms and findings on examination, including the use of a recognised tooth wear evaluation system. Clinical evaluation may include evaluation of dentine exposure, tooth pain or dentine hypersensitivity, impairment of masticatory or oral function, and associated loss of tooth structure. 

Symptoms may include persistent tooth pain or sensitivity during eating, drinking or tooth cleaning, of sufficient severity to interfere with normal oral function or requirement dental assessment. 

Additional diagnoses covered by SOP

• Dental abrasion
• Dental attrition
• Dental erosion

Conditions not covered by SOP

• Mild tooth wear confined to the enamel-Not an Injury or Disease
• Tooth Loss *
• Cracked tooth #
• Fractured tooth #
• Tooth decay/Dental caries * - Tooth Decay (Dental Caries) SOP
• Bruxism *
• Temporomandibular joint disorders * 

* another SOP applies - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

Tooth wear is generally a gradually progressive condition. Clinical onset corresponds to the time when tooth wear first becomes significant enough to meet the SOP definition requirements (as assessed and confirmed by a dental clinician), including exposure of dentine and associated severe symptoms or significant impairment of effective tooth function.

Clinical worsening

Clinical worsening may be indicated by progression of tooth substance loss, increasing dentine exposure, worsening tooth pain or hypersensitivity, or increasing impairment of effective tooth function. Clinical worsening may also be evidenced by progression beyond the expected natural course of the condition, including rapid deterioration requiring significant dental management or reconstruction. Where tooth wear leads to associated dental conditions, such as tooth loss or dental caries, each condition should be diagnosed separately and the relevant SOP applied where appropriate.