Erosive Tooth Wear: A Multifactorial Condition of Growing Concern and Increasing Knowledge

Abstract

Dental erosion is often described solely as a surface phenomenon, unlike caries where it has been established that the destructive effects involve both the surface and the subsurface region. However, besides removal of the surface, erosion shows dissolution of mineral within the softened layer - beneath the surface. In order to distinguish this process from the carious process it is now called 'near surface demineralization'. Erosion occurs in low pH, but there is no fixed critical pH value concerning dental erosion. The critical pH value for enamel concerning caries (pH 5.5-5.7) has to be calculated from calcium and phosphate concentrations of plaque fluid. In the context of dental erosion, the critical pH value is calculated from the calcium and phosphate concentrations in the erosive solution itself. Thus, critical pH for enamel with regard to erosion will vary according to the erosive solution. Erosive tooth wear is becoming increasingly significant in the management of the long-term health of the dentition. What is considered as an acceptable amount of wear is dependent on the anticipated lifespan of the dentition and is, therefore, different for deciduous compared to permanent teeth. However, erosive damage to the teeth may compromise the patient's dentition for their entire lifetime and may require repeated and increasingly complex and expensive restorations. Therefore, it is important that diagnosis of the tooth wear process in children and adults is made early and that adequate preventive measures are undertaken. These measures can only be initiated when the risk factors are known and interactions between them are present.

Effect of sodium fluoride and stannous chloride associated with Nd:YAG laser irradiation on the progression of enamel erosion

“…When this process is associated with physical insults, such as toothbrushing, the tooth can undergo a chemical-mechanical wear process, known as erosive tooth wear [2]. The prevalence of erosive tooth wear is thought to be increasing; this has been attributed to the overall increase in the consumption of acidic foods and drinks and to the changes in perception of this condition by dental professionals over the last few years [3]. When the enamel surface is frequently exposed to erosive acids, a demineralization extending a few micrometers below the surface occurs [4].…”

The Mature Stomatognathic System Is a Complex Adaptive System

“…soft drinks, citrus fruits and alcoholic beverages) at around pH 3.0 or less [7]. Dental erosion results in immediate surface loss and softening after acid contact [8,9], and it is a growing concern because of increasing prevalence in recent decades [10]. Repeated exposure to such agents results in the clinically apparent loss of tooth structure.…”

Sour Gummy Candies and their Effect on Salivary pH kinetics

“…Usually researchers have reported that it is present in more than one third of children, adolescents and adults [1][2][3]. The manifestation of dental erosion is primarily due to non-bacterial acid substances and is regarded as a multifactorial process, triggered by the interplay among chemical, biological and behavioral factors [4]. In fact, the erosive potential of acidic beverages and foodstuffs have been related to their pH, titratable acidity, calcium-chelation ability and adhesiveness [5].…”