Clinical guidelines for dental erosion

Toothwear is recognised as a major dental problem in both children and adults. The triad of
erosion, attrition and abrasion has been known for many years, and the contribution of erosion to
toothwear is increasing.

Dental erosion is the irreversible softening and subsequent loss of dental
hard tissue due to a chemical process of acid dissolution but not involving bacterial plaque acid,
and not directly associated with mechanical or traumatic factors, or with dental caries. Attrition
may be defined as direct tooth-to-tooth contact wear while external foreign agents moving across
and contacting the tooth surface results in abrasion. Erosion usually coexists with attrition and/
or abrasion but one of these factors may be more significant than the others, making differential
diagnosis difficult.

Erosive wear is now deemed a common global phenomenon of developed countries,2
and its financial burden on patients and public health services is significant.

More importantly,the morbidity associated with erosive wear may be high, and can include pain/sensitivity,
dissatisfaction with aesthetics and reduced function. While the ultimate causative factors of dental
erosion are non-bacterial acids, it is a multifactorial condition, and the progression of the lesions
are driven by a complex interplay between nutritional and patient related factors.

Owing to its progressive nature, preventative measures implemented (ideally, in the early stages
of erosive wear) can be effective in reducing the need for dental intervention and symptoms
experienced by patients.

Operative measures will still be necessary for those with advanced
erosion progression in order to eliminate pain, and to restore function and aesthetics. Additionally,
interventive treatment may be warranted to preserve the structural integrity of the reduced and
remaining tooth structure, and to protect against further tissue loss.

This guideline aims to assist the dentist to diagnose, prevent and manage erosion in children,
adolescents and adults. This may be complex, and can require interdisciplinary long-term
management and liaison with medical colleagues