Tooth wear
that is non-carious in nature and caused by different factors
is called tooth abrasion and erosion. Erosion is the most common
tooth wear while sometimes aggravated by other forms of tooth
wear. Chewing of pipe stems and brushing of teeth is thought
to be the causes of tooth wear. People experiencing gastric,
anorexia and bulimia or people with abnormal diets are usually
most affected by erosion. Occupations may also cause erosion;
it affects people who are exposed to acidic fumes. Wine tasters
are also common victims.
Because of high consumption of carbonated drinks, there is a
constant raise of erosion in youngsters in the past 10 to 15
years. Erosion has not received sufficient awareness like any
other non-carious dental problems.
Diagnosis of tooth abrasion - erosion
Initially, the presence of tooth wear must be known and then
rated for its severity. Then, the factors should be determined.
Next, the needed treatment must be done and the development monitored
to evaluate the effects of the treatment. It should be kept in
mind that there are tooth wear conditions that cannot be categorized
as either abrasion or erosion. Abrasion and erosion can only
be identified by dental assessment. After the examination, the
location of the tooth wear has to be determined.
Causes of tooth abrasion - erosion
Normally, tooth wear is caused by frictional forces or acids,
or both. While it is easily detected, the determination of its
cause is difficult. Clinical experience, assessment of worn out
surface, restorations focusing among the enamel, loss of vertical
dimension and pattern of tooth wear are the basis on the process
of detection.
Tooth wear is seen on the palatal area of the maxillary and
maxillary front teeth, and the buccal surface of mandibular molars
indicates gastric acid as cause of the erosion. Step-like erosion
on the palatal of the maxillary front teeth is developed from
loss of vertical dimension which is caused by occlusal enamel
loss. It is necessary that the nature of the patient’s
diet be determined. Regular intake of soft drinks, fruit juices
and other food products may result to erosion. Other contributors
include effervescent medications, asthma inhalers and improper
brushing. Function of the saliva glands must be also checked,
because saliva increases the resistance of the enamel.
To be able to determine the state of the tooth wear that the
patient is experiencing, it is necessary to know the cause especially
anorexia and bulimia are involved. It is also necessary not to
blame the patient for the clinical results or an incorrect history
may be obtained. Particularly when the cost is involved, or when
the patient is not willing to confess certain illnesses.
Prevention of tooth abrasion - erosion
Since restoration is costly, tooth wear prevention is a good
option for most cases. It is harder to prevent tooth wear since
it is not easy to foresee. Hence one can only start preventing
when tooth wear has occurred. Nevertheless, it is targeted largely
at only arresting further tooth wear.
Tooth wear is now considered as a problem of society as an individual
problem. Yet, population-based strategies may not be as effective
for tooth wear as they have been on dental caries. Other strategies
should be used in dealing with tooth wear caused by cultural
and environmental reasons. Educating the community may be considered
in changing or reducing of responsible food products. Still,
the aimed population of youths, who are usually the major consumer
of these beverages, may not be influenced by such approach, owing
to the fact that these signature beverages are a proclamation
of their lifestyle.
Strategies are more concentrated individually at present prevention.
Abrasion is also individual-based. However, erosion is related
to diet, so population based strategies may help in this case.
Yet, only a number of population-based strategies in tooth wear
have been a success.
Since the addition of fluoride has been successful in preventing
caries, it is also attempted to add fluoride in different beverages
to prevent tooth wear. Fluoride is reported to be able to lessen
the corrosive effect of sports beverages. However, further research
concluded that fluoride has minimal effect.
Even population strategies have not flourished in tooth wear,
like strategy concerning change of erosive beverages, medicines
and food remains the only choice in tackling the ascending cases
of tooth wear among the youngsters. Support of the manufacturers
and the consumers is highly needed. lack of support resulted
to the failure of calcium lactate which can reduce the corrosive
potential of Coca-cola when added to the drink.
The patient may avoid costly restorative treatments by removing
of causes, simple dental treatments and close monitoring that
diagnosis is being followed.