Incisal Tooth Wear Associated with Prolonged Sunflower Seed Chewing: A Case Report

Year 2025, Volume: 9 Issue: 3, 215 - 220, 31.12.2025

Merve Yüce , Elif Nur Kaya , Bilge Tarçın , Birsay Gümrü Tarçın

Abstract

Non-carious tooth surface loss (TSL) is a multifactorial condition which may arise from mechanical, chemical and/or biological factors. Parafunctional habits such as the habit of sunflower seed chewing, which can be considered among the mechanical causes, can result in localized wear of the incisors. A 38-year-old male patient presented with gingival bleeding. Clinical and radiographic findings revealed localized abrasion in the form of V-shaped notches on the incisal edges of teeth #11 and #41 and mild gingival recession, likely due to repetitive mechanical trauma. The patient reported a habit of cracking sunflower seeds between his anterior teeth since childhood. Minimally invasive direct composite restorations using supra-nanohybrid resin composites were performed to repair the worn incisal edges and restore esthetics and function. Postoperative and follow-up evaluations demonstrated satisfactory marginal adaptation, surface smoothness, and color harmony, without sensitivity or discoloration. Long-term sunflower seed chewing can cause irreversible incisor wear and changes in the associated periodontal tissues. Early diagnosis and habit cessation, combined with minimally invasive restorative approaches, can restore esthetics and prevent further TSL.

Keywords

tooth surface loss , abrasion , sunflower seed chewing , direct composite restoration

Uzun Süreli Ayçiçeği Çekirdeği Yeme Alışkanlığına Bağlı Kesici Diş Aşınması: Bir Olgu Sunumu

Abstract

Çürük dışı diş yüzeyi kaybı (DYK), mekanik, kimyasal ve/veya biyolojik etkenlerden kaynaklanabilen multifaktöriyel bir durumdur. Mekanik nedenler arasında değerlendirilebilen ayçiçeği çekirdeği yeme gibi parafonksiyonel alışkanlıklar, kesici dişlerde lokalize aşınmaya yol açabilir. 38 yaşındaki erkek hasta, diş eti kanaması şikayetiyle başvurmuştur. Klinik ve radyolojik değerlendirmede, 11 ve 41 no’lu dişlerin insizal kenarlarında, tekrarlayan mekanik travmaya bağlı olması muhtemel V şeklinde çentik biçiminde lokalize abrazyon ve hafif gingival resesyon gözlenmiştir. Hasta, çocukluk döneminden beri ön dişleri arasında ayçiçeği çekirdeği kırma alışkanlığı olduğunu belirtmiştir. Aşınmış insizal kenarların onarımı ve estetik ile fonksiyonun yeniden sağlanması amacıyla, supra-nanohibrit kompozit rezin kullanılarak minimal invaziv direkt kompozit restorasyonlar uygulanmıştır. Postoperatif ve takip değerlendirmelerinde, hassasiyet veya renklenme olmaksızın tatmin edici marjinal adaptasyon, yüzey pürüzsüzlüğü ve renk uyumu gözlenmiştir. Uzun süreli ayçiçeği çekirdeği yeme alışkanlığı, kesici dişlerde geri dönüşümsüz aşınmaya ve ilişkili periodontal dokularda değişikliklere neden olabilir. Erken tanı ve alışkanlığın bırakılması, minimal invaziv restoratif yaklaşımlarla birlikte estetiğin yeniden sağlanmasına ve daha ileri DYK gelişiminin önlenmesine katkı sağlayabilir.

Keywords

diş yüzeyi kaybı , abrazyon , ayçiçeği çekirdeği çiğneme alışkanlığı , direkt kompozit restorasyon

References

• Al-Habahbeh R, Al-Beyari M, Al-Jutaily S, Dar-Odeh S, Najla NS, Abu-Hammad OA. Effect of dried roasted seeds on tooth surface loss. Pak. Oral & Dent. J. 2011;31(2):439-442.
• Amin W, Kassab A, Salim N. Incisal edge abrasion caused by an unusual eating habit. Internet J. Dent. Sci. 2007;6(1):1-7.
• Bartlett D, Varma S. A retrospective audit of the outcome of composites used to restore worn teeth. Br. Dent. J. 2017;223(1):33-36.
• Bartlett D. Using composites to restore worn teeth. JCDA. 2006;72(4):301-304.
• Bowles WH, Wilkinson MR, Wagner MJ, Woody RD. Abrasive particles in tobacco products: a possible factor in dental attrition. J. Am. Dent. Assoc. 1995;126(3):327-331.
• Broca P. Instructions relatives à l'étude anthropologique du système dentaire. Bull. Soc. Anthrop. Paris. 1879;2(3):128-163.
• Dahl BL, Carlsson GE, Ekfeldt A. Occlusal wear of teeth and restorative materials. A review of classification, etiology, mechanisms of wear, and some aspects of restorative procedures. Acta. Odontol. Scand. 1993;51(5):299-311.
• Eccles JD. Tooth surface loss from abrasion, attrition and erosion. Dent. Update. 1982;9(7):373-374, 376-378, 380-381.
• El-Mowafy OM. Characteristic abrasion of permanent incisors in Jordanians caused by a bad eating habit. Quintessence Int. 1988;19(10):739-744.
• Enbom L, Magnusson T, Wall G. Occlusal wear in miners. Swed. Dent. J. 1986;10(5):165-70.
• Flint S, Scully C. Orofacial age changes and related disease. Dent. Update. 1988t;15(8):337-342.
• Grippo JO, Simring M, Schreiner S. Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions. J. Am. Dent. Assoc. 2004;135(8):1109-1118; quiz 1163-1165.
• Hattab FN, Yassin OM. Etiology and diagnosis of tooth wear: a literature review and presentation of selected cases. Int. J. Prosthodont. 2000;13(2):101-107.
• Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, Burgess J, Peschke A, Heintze SD, Kühnisch J. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin. Oral Investig. 2023;27(6):2573-2592.
• Jokstad A, Von Der Fehr FR, Løvlie GR, Myran T. Wear of teeth due to occupational exposure to airborne olivine dust. Acta. Odontol. Scand. 2005;63(5):294-299.
• Kaidonis JA. Oral diagnosis and treatment planning: part 4. Non-carious tooth surface loss and assessment of risk. Br. Dent. J. 2012;213(4):155-161.
• Kaidonis JA. Tooth wear: the view of the anthropologist. Clin. Oral Investig. 2008;12(Suppl 1):S21-26.
• Levitch LC, Bader JD, Shugars DA, Heymann HO. Non-carious cervical lesions. J. Dent. 1994;22(4):195-207.
• Mehta SB, Banerji S, Millar BJ, Suarez-Feito JM. Current concepts on the management of tooth wear: part 1. Assessment, treatment planning and strategies for the prevention and the passive management of tooth wear. Br. Dent. J. 2012;212(1):17-27.
• Pereira T, Shetty S, Chande M, Kamath P. Whistle abrasion: A case report. Ann. Med. Health Sci. Res. 2016;6(6):389-391.
• Petersen PE, Henmar P. Oral conditions among workers in the Danish granite industry. Scand. J. Work Environ. Health. 1988;14(5):328-331.
• Rath A, Ramamurthy PH, Fernandes BA, Sidhu P. Effect of dried sunflower seeds on incisal edge abrasion: A rare case report. J. Conserv. Dent. 2017;20(2):134-136.
• Redman CD, Hemmings KW, Good JA. The survival and clinical performance of resin-based composite restorations used to treat localised anterior tooth wear. Br. Dent. J. 2003;194(10):566-572; discussion 559.
• Smith BG, Knight JK. An index for measuring the wear of teeth. Br. Dent. J. 1984;156(12):435-438.
• Tuominen M, Tuominen R. Tooth surface loss among people exposed to cement and stone dust in the work environment in Tanzania. Community Dent. Health. 1991;8(3):233-238.
• Veerabhadrappa SK, Ramachandra SS, Yadav S, Lee XY, Leng LG. Oral health implications of shelled sunflower seed chewing: A clinical case series. Oral Dis. 2025 Jul 14. doi: 10.1111/odi.70033. [Epub ahead of print].
• Warreth A, Abuhijleh E, Almaghribi MA, Mahwal G, Ashawish A. Tooth surface loss: A review of literature. Saudi Dent. J. 2020;32(2):53-60.