Control of erosive tooth wear: possibilities and rationale

Abstract

Dental erosion is a type of wear caused by non bacterial acids or chelation. There is evidence of a significant increase in the prevalence of dental wear in the deciduous and permanent teeth as a consequence of the frequent intake of acidic foods and drinks, or due to gastric acid which may reach the oral cavity following reflux or vomiting episodes. The presence of acids is a prerequisite for dental erosion, but the erosive wear is complex and depends on the interaction of biological, chemical and behavioral factors. Even though erosion may be defined or described as an isolated process, in clinical situations other wear phenomena are expected to occur concomitantly, such as abrasive wear (which occurs, e.g, due to tooth brushing or mastication). In order to control dental loss due to erosive wear it is crucial to take into account its multifactorial nature, which predisposes some individuals to the condition.

In Vitro Erosive Effect of Pediatric Medicines on Deciduous Tooth Enamel

“…The erosion potential is also strongly influenced by the following substance features: titratable acidity (the greater the buffering capacity, the longer it takes saliva to neutralize the acid), calcium chelation properties, mineral content and adhesion to the dental surface (2,18).…”

Effect of foods and drinks on primary tooth enamel after erosive challenge with hydrochloric acid

“…2 It is a multifactorial condition with a complex aetiology and is common in children and adolescents. 3 It involves contact between acids and tooth structure, which may be due to intrinsic factors such as vomiting, regurgitation, and gastro-oesophageal reflux disease (GORD), and/or extrinsic factors such as industrial sources, 4 acid medicines, and diet.…”

“…3 It involves contact between acids and tooth structure, which may be due to intrinsic factors such as vomiting, regurgitation, and gastro-oesophageal reflux disease (GORD), and/or extrinsic factors such as industrial sources, 4 acid medicines, and diet. 2 Gastro-oesophageal reflux is a physiological process that commonly affects paediatric patients and is characterised by involuntary passage of gastric contents from the oesophagus 5 into the oral cavity. This is considered pathological when both intensity and frequency increase, causing GORD.…”

Protective effect of calcium nanophosphate and CPP-ACP agents on 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.…”