Dental erosion: possible approaches to prevention and control.

OBJECTIVES To discuss the key elements for establishment of a preventive programme for dental erosion. DATA AND SOURCES The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, epidemiological, cohort, animal, in vitro and in vivo studies. References have been traced manually or by MEDLINE. STUDY SELECTION The aetiology, pathogenesis and modifying factors of dental erosion were reviewed. Strategies to either prevent the occurrence or limit the damage of dental erosion or protect the remaining tooth tissues from further erosive destruction were reviewed and discussed. These includes: (A) measures to (1) enhance remineralisation and acid resistance of enamel surface softened by erosive challenge, (2) reduce the erosive potential of acidic products, (3) enhance salivary flow, (4) protect and restore erosively damaged tooth, and (5) provide mechanical protection against erosive challenge. (B) Health education geared towards (1) diminution of frequency of intake of dietary acids, and (2) change of habits and lifestyles that predispose teeth to erosion development. CONCLUSIONS It may be easier to gain patients' compliance with the advice that immediately following an acidic challenge, a remineralising agent, such as fluoride mouthrinses, fluoride tablets, fluoride lozenges or dairy milk, should be administered to enhance rapid remineralisation of the softened tooth surface as well as serve as a mouth refresher, or an alternative, a neutralising solution should be used. Effective counselling on erosion preventive regimes should involve all healthcare personnel, dentists, doctors, pharmacist, nurses/hygienists and clinical psychologists.

[1]  R. Newcombe,et al.  Development and evaluation of a low erosive blackcurrant juice drink. 3. Final drink and concentrate, formulae comparisons in situ and overview of the concept. , 1999, Journal of dentistry.

[2]  W. B. Davis,et al.  The effect of abrasion on enamel and dentine and exposure to dietary acid , 1980, British Dental Journal.

[3]  J. Nunn,et al.  Prevalence of dental erosion and the implications for oral health. , 1996, European journal of oral sciences.

[4]  T. Attin,et al.  Brushing Abrasion of Softened and Remineralised Dentin: An in situ Study , 2003, Caries Research.

[5]  B G Smith,et al.  An index for measuring the wear of teeth , 1984, British Dental Journal.

[6]  L. Shapira,et al.  Enamel softening with Coca-Cola and rehardening with milk or saliva. , 1991, American journal of dentistry.

[7]  L Shaw,et al.  Continuous monitoring of salivary flow rate and pH at the surface of the dentition following consumption of acidic beverages. , 1997, Caries research.

[8]  R. Newcombe,et al.  Studies in vitro of abrasion by different manual toothbrush heads and a standard toothpaste. , 2000, Journal of clinical periodontology.

[9]  B T Amaechi,et al.  Influence of abrasion in clinical manifestation of human dental erosion. , 2003, Journal of oral rehabilitation.

[10]  J. Meurman,et al.  Effect of fluoride varnish and solution on enamel erosion in vitro. , 1994, Caries research.

[11]  M. Teaford,et al.  Differences in the Rate of Molar Wear between Monkeys Raised on Different Diets , 1989, Journal of dental research.

[12]  D. Birkhed,et al.  Effect of urea in sugar-free chewing gums on pH recovery in human dental plaque evaluated with three different methods. , 1995, Caries research.

[13]  T. Attin,et al.  Influence of fluoride on the prevention of erosive lesions--a review. , 2003, Oral health & preventive dentistry.

[14]  T. Attin,et al.  Influence of Acidified Fluoride Gel on Abrasion Resistance of Eroded Enamel , 1999, Caries Research.

[15]  P. Suter,et al.  Dental erosion in a population of Swiss adults. , 1991, Community dentistry and oral epidemiology.

[16]  C. Ganss,et al.  Dental Erosions in Subjects Living on a Raw Food Diet , 1998, Caries Research.

[17]  B. Amaechi,et al.  In vitro remineralisation of eroded enamel lesions by saliva. , 2001, Journal of dentistry.

[18]  N. Robb,et al.  Prevalence of pathological tooth wear in patients with chronic alcoholism , 1990, British Dental Journal.

[19]  B. Amaechi,et al.  Use of Transverse Microradiography to Quantify Mineral Loss by Erosion in Bovine Enamel , 1998, Caries Research.

[20]  L. Shapira,et al.  Effect of hard cheese exposure, with and without fluoride prerinse, on the rehardening of softened human enamel. , 1992, Caries research.

[21]  C. Armstrong,et al.  Erosion of dental enamel among competitive swimmers at a gas-chlorinated swimming pool. , 1986, American journal of epidemiology.

[22]  T. Grenby Lessening dental erosive potential by product modification. , 1996, European journal of oral sciences.

[23]  M. O'Brien Children's dental health in the United Kingdom 1993 , 1994 .

[24]  B. Amaechi,et al.  Factors influencing the development of dental erosion in vitro: enamel type, temperature and exposure time. , 1999, Journal of oral rehabilitation.

[25]  J. Graubart,et al.  Effects of Fluoride Pretreatment in Vitro on Human Teeth Exposed to Citrus Juice , 1972, Journal of dental research.

[26]  R. Averbach,et al.  Dental management of the chronic vomiting patient. , 1984, The Journal of the American Dental Association (1939).

[27]  J. Arends,et al.  Influence of tooth paste particle size and tooth brush stiffness on dentine abrasion in vitro. , 1985, Caries research.

[28]  P. Petersen,et al.  Oral conditions among German battery factory workers. , 1991, Community dentistry and oral epidemiology.

[29]  W M Edgar,et al.  Sugar substitutes, chewing gum and dental caries--a review , 1998, British Dental Journal.

[30]  Golomb Im Children's dental health. , 1978 .

[31]  D. Bartlett,et al.  A study of the association between gastro-oesophageal reflux and palatal dental erosion , 1996, British Dental Journal.

[32]  J. Wickens Tooth surface loss: Prevention and maintenance , 1999, British Dental Journal.

[33]  T. Attin,et al.  Brushing Abrasion of Eroded Dentin after Application of Sodium Fluoride Solutions , 1998, Caries Research.

[34]  S. Grobler,et al.  Biochemical analysis of various cool drinks with regard to enamel erosion, de- and remineralization. , 1982, The Journal of the Dental Association of South Africa = Die Tydskrif van die Tandheelkundige Vereniging van Suid-Afrika.

[35]  C. Ganss,et al.  Effects of Two Fluoridation Measures on Erosion Progression in Human Enamel and Dentine in situ , 2001, Caries Research.

[36]  A. Smith,et al.  Dental erosion in four-year-old children from differing socioeconomic backgrounds. , 1994, ASDC journal of dentistry for children.

[37]  T. Attin,et al.  In situ Evaluation of Different Remineralization Periods to Decrease Brushing Abrasion of Demineralized Enamel , 2001, Caries Research.

[38]  J. Meurman,et al.  Surface ultrastructure of rat molar teeth after experimentally induced erosion and attrition. , 1996, Caries research.

[39]  T. Imfeld,et al.  Prevention of progression of dental erosion by professional and individual prophylactic measures. , 1996, European journal of oral sciences.

[40]  D. Bartlett,et al.  The prevalence of tooth wear in a cluster sample of adolescent schoolchildren and its relationship with potential explanatory factors , 1998, British Dental Journal.

[41]  B Angmar-Månsson,et al.  Laser fluorescence quantification of remineralisation in situ of incipient enamel lesions: influence of fluoride supplements. , 1997, Caries research.

[42]  B. Amaechi,et al.  The influence of xylitol and fluoride on dental erosion in vitro. , 1998, Archives of oral biology.

[43]  A. Smith,et al.  Comparison of rates of clearance of glucose from various oral sites following drinking with a glass, feeder cup and straw , 1993 .

[44]  B. Amaechi,et al.  Thickness of Acquired Salivary Pellicle as a Determinant of the Sites of Dental Erosion , 1999, Journal of dental research.

[45]  T. Attin,et al.  Influence of buffering effects of dentifrices and fluoride gels on abrasion on eroded dentine. , 2004, Archives of oral biology.

[46]  T. Jaeggi,et al.  Toothbrush Abrasion of Erosively Altered Enamel after Intraoral Exposure to Saliva: An in situ Study , 1999, Caries Research.

[47]  M. Lenander-Lumikari,et al.  Release of cariostatic agents from a new buffering fluoride- and xylitol-containing lozenge to human whole saliva in vivo. , 1997, Journal of oral rehabilitation.

[48]  P Scheutzel,et al.  Etiology of dental erosion--intrinsic factors. , 1996, European journal of oral sciences.

[49]  B. Amaechi,et al.  Eroded enamel lesion remineralization by saliva as a possible factor in the site-specificity of human dental erosion. , 2001, Archives of oral biology.

[50]  I. Gedalia,et al.  Fluoride in teeth of rats using citrus beverage. , 1974, Annals of dentistry.

[51]  P. King tooth surface loss: Adhesive techniques , 1999, British Dental Journal.

[52]  Prof. B. Morpurgo Eine experimentelle Studie , 1897, Archiv für pathologische Anatomie und Physiologie und für klinische Medicin.

[53]  J. T. ten Cate,et al.  Pathogenesis and modifying factors of dental erosion. , 1996, European journal of oral sciences.

[54]  A. Duxbury Ecstasy--dental implications , 1993, British Dental Journal.

[55]  M. Addy Tooth wear and sensitivity : clinical advances in restorative dentistry , 2000 .

[56]  H. Markkanen,et al.  Dental erosions in relation to lactovegetarian diet. , 1985, Scandinavian journal of dental research.

[57]  K. Toumba,et al.  Slow-Release Devices for Fluoride Delivery to High-Risk Individuals , 2001, Caries Research.