Relationships between attrition and lingual tilting in human teeth

Associations between occlusal dental attrition and the lingual tilting of human teeth were investigated in two aboriginal California populations. A literature survey suggests lingual tilting is related geographically and temporally to the helicoidal occlusal plane in humans; if true, lingual tilting should be expected throughout the Homo osteological record. Buccal alveolar abscesses, exposed pulp chambers, extent of tooth attrition, angle of lingual tilt, and amount of overjet were observed for lingually tilted teeth. These attributes were analyzed statistically, leading to a conclusion that lingual tilting is slight and infrequent unless tooth attrition is pronounced. It is suggested that lingual tilting is due in part to masticatory stress. A feedback model considers lingual tilting as one conspicuous manifestation of a more complex “severe attrition syndrome,” the initial stimulus for which may derive from heavy occlusal tooth wear. Untested possibilities should be examined–e.g., age‐related changes, the impact of the helicoidal occlusal plane, and the role of masticatory forces.