Dental erosion – diagnosis and risk factors.

Erosive tooth wear is becoming increasingly important when considering the long-term health of the dentition. There is some evidence that the presence of this condition is growing steadily. It is important that diagnosis of dental erosion is made early. Clinical detection is important once dissolution has started. The clinical appearance is the most important sign for dental professionals to diagnose erosion. This is of particular importance in the early stages of erosive tooth wear. The appearance of smooth silky-glazed sometimes dull enamel, intact enamel along the gingival margin and grooving on occlusal surfaces are some typical signs of enamel erosion.

Adequate preventive measures can only be initiated when the risk factors are known and interactions between them are present. The interplay of chemical, biological and behavioural factors is crucial and helps explain why some individuals exhibit more erosion than others. The erosive potential of erosive agents like acidic drinks or foodstuffs depends on chemical factors, e.g. pH, titratable acidity, mineral content. Biological factors such as saliva, acquired pellicle, tooth structure and positioning in relation to soft tissues and tongue are related to the pathogenesis of dental erosion. Furthermore, behavioural factors like eating and drinking habits, regular exercise with dehydration and decrease of salivary flow, excessive oral hygiene and, on the other side, an unhealthy lifestyle, e.g. chronic alcoholism, are predisposing factors for dental erosion. This points will be covered in this lecture.