Let’s talk Attrittion, Abrasion and Erosion
These three very distinctly separate entities result in a loss of tooth structure. Insurance carriers are very particular about coverage when it comes to benefiting this type of lesion. Let’s explore the difference.
Attrition is the physiologic wearing of the occlusal or incisal surfaces in response to age or pernicious oral habits. Is the pulp involved?
Abrasion is the mechanical wearing of the occlusal or cervical surfaces of the teeth due to improper brushing or the use of abrasive materials.
Erosion is due to chemical action, usually acids or low ph fluid. It is frequently associated with Bulimia. It manifests itself by demineralization and the subsequent erosion of the surfaces of the teeth that come into contact with harmful fluids; usually the lingual of upper anterior teeth and the occlusal and lingual of the posteriors. For argument sake, you could say that erosion could be viewed as a disease entity analogous to caries.
There are some commercial carriers that will not issue a benefit for attrition, abrasion or abfraction. Does that mean that the patient doesn’t require the restoration? Certainly based on your clinical findings, professional judgment, and the patient’s chief complaint, you need to make a determination on how or if this situation warrants a restoration – but that is completely different and separate from “is it a covered expense”.
Learn about "Trends in Coding, Reimbursement and the new ICD-10 Requirements" with Dr. Joan Monaco on Friday, May 18 at the Garden State Dental Conference & Expo.