Possible role of tensile stress in the etiology of cervical erosive lesions of teeth.

A tensile stress hypothesis for the etiology of idiopathic cervical erosions of human teeth is presented. It is proposed that when occlusion is not ideal, lateral forces cause the teeth to bend. The tensile stresses created during bending disrupt the chemical bonds of the crystalline structures of enamel and dentin. Small molecules may enter between the crystals and prevent the reestablishment of the chemical bonds. As a result, the disrupted tooth structure is more susceptible to loss through dissolution and abrasion and results in the development of the typically wedge-shaped lesions. Patients with lesions typical of hundreds examined by the authors were presented to illustrate the concept. The possible consequences of the proposed hypothesis were discussed. The hypothetical conclusions made in this article will be tested by experimentation.