The caries-attrition competition

Contradictory reports on the interreation of caries and attrition concerning their destructive activity at the occlusal surface of teeth required more investigation. Some suggested that the abrasive action of attrition worked against the progress of decay. Others proposed that attrition facilitated the development of caries in dentine exposed due to the dental wear. A comparison of the condition of teeth in western societies from an intermediate stage, with the preceding period characterized by excessive attrition, and with the following period of ongoing reduction of dental wear, might elucidate the mutual relationship. For this reason the almost complete dental assemblage of fifty men, whalers buried during their short sojourn in the Arctic in the 17th and 18th centuries at a Dutch whaling station, and the data of their contemporaries, were evaluated. The results confirmed the proposition that the rise in caries incidence from (pre-) medieval times on, was associated with an ongoing fall of dental attrition. Within this sample of an intermediate phase, one sees that the percentage of carious molars decreases considerably when the degree of dental wear increases. Besides, at the occlusal surface the decay was almost exclusively located in the natural fissures and pits of teeth, not in the exposed dentine due to wear. These findings strongly suggest a competitive relationship between progress of caries and attrition. The best impression of the attrition rate is gained by linkage of degree of dental attrition (i.e. functional age) to age at death. The wide age ranges fitting to the degrees of molar wear make it hazardous to use attrition for age determination.