Use of dentifrices to prevent erosive tooth wear: harmful or helpful?

Abstract

Dental erosion is the loss of dental hard tissues caused by nonbacterial acids. Due to acid contact, the tooth surface becomes softened and more prone to abrasion from toothbrushing. Dentifrices containing different active agents may be helpful in allowing rehardening or in increasing surface resistance to further acidic or mechanical impacts. However, dentifrices are applied together with brushing and, depending on how and when toothbrushing is performed, as well as the type of dentifrice and toothbrush used, may increase wear. This review focuses on the potential harmful and helpful effects associated with the use of dentifrices with regard to erosive wear. While active ingredients like fluorides or agents with special anti-erosive properties were shown to offer some degree of protection against erosion and combined erosion/abrasion, the abrasive effects of dentifrices may increase the surface loss of eroded teeth. However, most evidence to date comes from in vitro and in situ studies, so clinical trials are necessary for a better understanding of the complex interaction of active ingredients and abrasives and their effects on erosive tooth wear.

Do fluoride toothpastes have similar preventive effect in permanent and primary teeth against erosive tooth wear?

“…Toothpastes are an important part of oral hygiene practices. They are the main vehicle for fluoride compounds, and they have an established preventive effect on both dental caries and erosive tooth wear . For ETW prevention, the active ingredients from toothpastes are supposed to increase the acid resistance of tooth surface and pellicles .…”

“…3 For ETW prevention, the active ingredients from toothpastes are supposed to increase the acid resistance of tooth surface and pellicles. [3][4][5] Apart from conventional sodium fluoride toothpastes, which presented a range between 0% and 37% more preventive effects than placebo toothpaste, other compounds have been investigated. 5 Some polyvalent metal ions, such as stannous or titanium, in combination to sodium or amine fluorides have shown to produce more acid-resistant precipitates.…”

Hipersensibilidade dentinária e desgaste dental: abordagem epidemiológica, sobre auto-percepção e conhecimento, caracterização física e biológica e estudo in situ do desgaste e oclusão tubular de cremes dentais dessensibilizantes e/ou anti-erosivos

“…Uma percepção errônea de que a escovação com maior frequência previne a erosão é uma questão alarmante, pois sabe-se que a abrasão em excesso pode aumentar o graus de perda de superficie. O uso de dentifrícios para evitar a erosão e a forma de como e quando a escovacão deve ser realizada é uma questão ainda controversa, pois a mesma pode ser util ou prejudicial (Magalhaes et al, 2014). Porém sabe-se que é preciso utilizar um dentifrício de baixa abrasividade para que o desgaste não seja irreversível e realizar a escovação de duas a três vezes por dia (West et al, 2011a;Canadian Advisory Board, 2003).…”

Resistência de união à dentina erodida em função da aplicação de um agente antiproteolítico para prevenção/controle do desgaste

“…É definida como uma perda de tecido duro dentário resultante de quelação ou, mormente, de processo químico envolvendo ácidos não bacterianos, advindos de fontes extrínsecas, como a dieta, por exemplo, e/ou de fontes intrínsecas, tal qual o suco gástrico (Ten Imfeld,1996;Lussi et al, 2004;Magalhães et al, 2014).…”