Dental erosion - diagnosis and prevention in children and adults

Erosion is becoming an increasingly important factor when considering the long term health of the dentition. There is some evidence that the presence of this condition is growing steadily. What is considered as an acceptable amount of wear is dependent on the anticipated lifespan of the dentition and therefore it is different for deciduous teeth compared to permanent teeth. Erosive tooth wear in children is a common condition. The overlapping of erosion with mechanical forces like attrition or abrasion is more pronounced probably in deciduous teeth than in permanent teeth. Early erosive damage to the permanent teeth may compromise the dentition for the entire lifetime and require extensive restorative procedures. Therefore, it is important that diagnosis of the tooth wear process in children and adults is made early. Clinical detection of erosive tooth wear is important once dissolution has started and the clinical appearance is the most important sign for dental professionals to detect in order to diagnose erosion. Adequate preventive measures can only be initiated when the different risk factors are known and interactions between them are present, following which an individually tailored preventive programme may be suggested to patients. It may comprise dietary advice, optimisation of fluoride regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for non-destructive tooth brushing habits with a low abrasive toothpaste. The frequent use of fluoride gel and fluoride mouthrinse in addition to everyday fluoride toothpaste offers the opportunity to minimise wear of tooth substance.