Erosive Tooth Wear — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRestorative DentistryErosive Tooth WearORE Part 1

A patient presents with widespread tooth wear affecting multiple tooth surfaces. The wear pattern shows cupping of the occlusal surfaces of the lower posterior teeth and flattening of the palatal surfaces of the upper anterior teeth. What is the most likely type of tooth wear?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Erosion combined with attrition

The question requires discrimination between single-process and combined-process tooth wear. The key diagnostic feature is the dual pattern: cupping (characteristic of erosion from acid exposure) and flattening (characteristic of attrition from tooth grinding/clenching or mastication). Cupping on posterior occlusal surfaces is produced by preferential loss of exposed dentine in acidic conditions, whilst flattening of anterior palatal surfaces results from direct tooth-to-tooth contact wear. Neither erosion alone nor attrition alone produces this combination. Abrasion typically causes more generalised surface wear without discrete cupping. Abfraction is primarily a cervical lesion resulting from occlusal stress concentration. UK clinical guidance explicitly states that on anterior teeth, attritional wear combined with erosion is a common presentation, and that tooth wear is normally multifactorial.

Reference: GOV.UK, Delivering Better Oral Health: An Evidence-based Toolkit for Prevention, Chapter 7: Tooth Wear, 2025. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-7-tooth-wear