MOBILE

Management of Dental Erosion

Recommendations

Foundational Articles

Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Invest. 2008;12:65-68.

Ganss C. Is Erosive Tooth wear an oral disease. Erosive tooth wear. Lussi A, Ganss C. (eds) Monogr Oral Sci. Basel, Kager, 2014;25:16-21.

Loomans B, Opdam N, Attin T, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19:111-119.

Lussi A. Erosive tooth wear – a multifactorial condition of growing concern and increasing knowledge. Monogr Oral Sci. Basel, Kager, 2006, 20:1-8.

Lussi A, Buzalaf MAR, Duangthip D, et al. The use of fluoride for the prevention of dental erosion and erosive tooth wear in children and adolescents. Eur Arch Paediatr Dent. 2019;20:57-527.

Lussi A, Jaeggi T. Dental erosion in children. Monogr Oral Sci. Basel, Kager, 2006, 20:140-151.

O’Sullivan E, Milosevic A. UK national guidelines in Paediatric Dentistry: diagnosis, prevention and management of dental erosion. In J Paediatr Dent. 2008;18 Suppl 1:29-38.

Pace F, Pallotta S, Tonini M, Vakil N, Bianchi Porro G. Systematic review: Gastro-oesophageal reflus disease and dental lesions. Aliment Pharmacol Ther. 2008;27:1179-1186.

Ranjitkar S, Kaidonis JA, Smales RJ. Review Article: Gastroesophageal reflux disease and tooth erosion. International J Dent. 2012;1-10. DOI:10.1155/2012/479850

Scheutzel P. Etiology of dental erosion – intrinsic factors. Eur J Oral Sci. 1996;104:178-90

Taji S, Seow WK. A literature review of dental erosion in children. Australian Dent J. 2010; 55:358-367.

Zero DT. Etiology of dental erosion – extrinsic factors. Eur J Oral Sci. 1996;104:162-77.

Background

Dental erosion is defined as the irreversible loss of tooth structure due to chemical dissolution by acids not of bacterial origin. The acid source can be intrinsic (e.g. gastric acid) or extrinsic (e.g. dietary acids). The primary dentition is more susceptible to erosion compared to the permanent dentition due to its thinner and less mineralized enamel. In Background pediatric patients, dental erosion on the molars is more common with GERD and dental erosion on the lingual of the upper incisors is associated with bulimia. Dental erosion from dietary acids can appear on any tooth surface dependent upon how the individual drinks, chews, swishes, gargles or holds the acidic beverage or food in their mouth.

IAPD Recommendations

  1. Once dental erosion is observed, the location and level of erosion should be documented by utilizing an appropriate scale. At each subsequent dental visit, dental erosion should be monitored, documented, and managed. Consensus-based statement > Global agreement 87%

  2. The etiology of dental erosion should be explored. Acidic dietary exposures, history of gastroesophageal reflux disease (GERD) and bulimia should be considered. Consensus-based statement > Global agreement 100%

  3. If dietary acidic exposure is the cause of dental erosion, then the patient should be counseled to reduce acidic food and beverages. Consensus-based statement > Global agreement 97%

  4. One should avoid swishing any acidic beverages to avoid erosion of the facial surfaces of all teeth. Consensus-based statement > Global agreement 96%

  5. If the child reports symptoms of GERD (e.g. stomach aches, hot burps, heart or throat burning) referral to their medical provider should be made. Consensus-based statement > Global agreement 96%

  6. If bulimia is suspected as the cause of erosion, referral to the patient’s medical provider is indicated. Consensus-based statement > Global agreement 96%

  7. Patients with erosive tooth wear should use an additional fluoride source like toothpaste or rinse preferably containing stannous fluoride. Consensus-based statement > Global agreement 87%

  8. If the dental erosion is progressing, then the etiology needs to be re-addressed and appropriate management offered. Consensus-based statement > Global agreement 100%

  9. If the dental erosion is progressing, then the etiology needs to be re-addressed and appropriate management offered. Consensus-based statement > Global agreement 100%

  10. Erosive lesions causing pain should be treated with the appropriate restorative material to eliminate pain. Consensus-based statement > Global agreement 87%

Other Recommendations