Insights into preventive measures for dental erosion

Abstract

Dental erosion is defined as the loss of tooth substance by acid exposure not involving bacteria. The etiology of erosion is related to different behavioral, biological and chemical factors. Based on an overview of the current literature, this paper presents a summary of the preventive strategies relevant for patients suffering from dental erosion. Behavioral factors, such as special drinking habits, unhealthy lifestyle factors or occupational acid exposure, might modify the extent of dental erosion. Thus, preventive strategies have to include measures to reduce the frequency and duration of acid exposure as well as adequate oral hygiene measures, as it is known that eroded surfaces are more susceptible to abrasion. Biological factors, such as saliva or acquired pellicle, act protectively against erosive demineralization. Therefore, the production of saliva should be enhanced, especially in patients with hyposalivation or xerostomia. With regard to chemical factors, the modification of acidic solutions with ions, especially calcium, was shown to reduce the demineralization, but the efficacy depends on the other chemical factors, such as the type of acid. To enhance the remineralization of eroded surfaces and to prevent further progression of dental wear, high-concentrated fluoride applications are recommended. Currently, little information is available about the efficacy of other preventive strategies, such as calcium and laser application, as well as the use of matrix metalloproteinase inhibitors. Further studies considering these factors are required. In conclusion, preventive strategies for patients suffering from erosion are mainly obtained from in vitro and in situ studies and include dietary counseling, stimulation of salivary flow, optimization of fluoride regimens, modification of erosive beverages and adequate oral hygiene measures.

The effect of theobromine 200 mg/l topical gel exposure duration against surface enamel hardness resistance from 1% citric acid

“…This is in accordance with previous research, which found that citric acid is strong and can cause faster erosion, especially at a low pH. This acid is also twice as destructive to enamel as hydrochloric acid or nitric acid because of its great affinity for calcium [16]. Citric acid is commonly used in soft drinks and is very erosive.…”

Protective effect of calcium nanophosphate and CPP-ACP agents on enamel erosion

“…14 High-concentrated F applications have been considered very effective in reducing the enamel erosion. 6,20 The agents investigated contain approximately 22600 ppm F (varnish), 9000 ppm F (nanophosphate paste) and 900 ppm F (CPP-ACP paste), according to the manufacturers' information. Although the varnish contained the highest F concentration among the agents tested, according to our protocol, it showed no protective effect against enamel erosion.…”

“…[2][3][4] Many strategies have been developed for the prevention and treatment of erosion, and fluoride is the main agent used to enhance enamel remineralization. 5,6 However, to control mineral loss caused by erosion, high concentrations and frequency seem to be needed, because the protective effect of fluoride against demineralization depends on the pH level, F Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.…”

“…[5][6][7] Sodium fluoride varnishes have been used due to their ability to adhere to the tooth surface and their high fluoride concentration, which increases the formation of calcium fluoride (CaF 2 ) deposits that act as fluoride reservoirs. [4][5][6] In recent years, other agents for inhibiting erosion have been investigated, such as casein phosphopeptides with amorphous calcium phosphate complex (CPP-ACP). [8][9][10] CPP-ACP complex may increase the level of calcium and inorganic phosphate ions at the tooth surface, thereby permitting immediate enamel surface remineralization.…”

In vitro evaluation of the erosive potential of viscosity-modified soft acidic drinks on enamel

“…Besides the reduction of the erosive potential, the modification of drinks might lead to an alteration in the taste [3,29,30]. As the taste is an important criterion for a successful dietary modification [30] the authors of the present study were asked for estimation of the taste of the viscosity-modified beverages compared to the original decarbonized ones.…”