Dental erosion is a progressive, non-carious loss of dental hard tissue caused by acidic dissolution without bacterial involvement. Unlike dental caries, dental erosion results from chemical wear driven by dietary acids, intrinsic acids, and lifestyle factors.
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1. What Is Dental Erosion?
Dental erosion refers to the irreversible loss of enamel and dentin caused by exposure to non-bacterial acids. Over time, this leads to thinning enamel, dentin hypersensitivity, aesthetic changes, and increased susceptibility to mechanical wear. Early identification is crucial to minimize long-term consequences.
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2.1 Dietary Acids
Acidic beverages and foods—such as soft drinks, citrus fruits, sports drinks, and vinegar—are significant risk factors. Frequent consumption of acidic beverages dramatically increases erosion progression.
2.2 Intrinsic Acids
Conditions like gastroesophageal reflux disease (GERD), chronic vomiting, and eating disorders expose teeth to gastric acids with a pH of 1–2, causing severe erosive wear, especially on palatal surfaces.
2.3 Environmental and Behavioral Factors
▪️ Occupational exposure (e.g., wine tasting, battery factory workers).
▪️ Dry mouth and reduced buffering capacity.
▪️ Aggressive brushing immediately after acid exposure.
These factors contribute to accelerated enamel breakdown.
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3.1 Dietary Modifications
Reducing acidic beverage intake and avoiding sipping throughout the day significantly lowers erosion risk. Encourage patients to consume acidic drinks with meals and use a straw.
3.2 Enhancing Salivary Protection
Adequate hydration, sugar-free gum, and managing xerostomia enhance natural buffering capacity.
3.3 Fluoride and Remineralization Therapy
Topical fluorides, CPP-ACP, and high-fluoride varnishes increase enamel resistance to acid attack. Professional application plays a crucial preventive role.
3.4 Behavioral and Oral Hygiene Recommendations
Patients should avoid brushing for at least 30 minutes after acid exposure, use soft-bristled brushes, and choose non-abrasive toothpaste.
📊 Comparative Table: Key Clinical Factors in Dental Erosion Prevention
| Aspect | Advantages | Limitations |
|---|---|---|
| Fluoride Therapy | Enhances enamel resistance; reduces erosion progression | Requires repeated applications; limited effect without behavior change |
| Dietary Modifications | Reduces acid exposure; improves long-term outcomes | Patient compliance varies; lifestyle habits hard to change |
| Salivary Stimulation | Improves natural buffering; protects against acid attacks | Less effective in patients with xerostomia or systemic conditions |
| Behavioral Adjustments | Simple, low-cost strategies; reduces mechanical wear | Effectiveness depends heavily on patient adherence |
Dental erosion remains a growing global concern due to lifestyle changes, increased consumption of acidic beverages, and rising rates of GERD in both adults and children. The interplay between dietary habits, intrinsic acids, and behavioral factors requires a multifactorial approach. Prevention must focus on patient education, regular monitoring, and targeted remineralization therapies.
Clinicians should recognize erosion patterns early and differentiate them from abrasion and attrition. Without timely intervention, erosion can lead to dentin hypersensitivity, aesthetic deterioration, and costly restorative treatments.
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Dental erosion is a preventable yet progressive condition. Identifying its causes—dietary, intrinsic, and environmental—is essential for effective clinical management. Preventive strategies, patient education, and early professional intervention significantly reduce long-term damage. A combination of lifestyle modifications, saliva promotion, and remineralization therapies provides the strongest defense against erosive tooth wear.
🔎 Recommendations
▪️ Limit acidic beverages and avoid prolonged sipping.
▪️ Implement remineralization therapies such as fluoride varnishes and CPP-ACP.
▪️ Encourage salivary stimulation and hydration.
▪️ Avoid aggressive brushing immediately after consuming acids.
▪️ Monitor high-risk patients (GERD, xerostomia, eating disorders) more frequently.
📚 References
✔ Bartlett, D. W., Lussi, A., & West, N. X. (2013). Dental erosion: An overview of its etiology, diagnosis, and management. Dental Clinics of North America, 57(3), 495–512. https://doi.org/10.1016/j.cden.2013.04.006
✔ Lussi, A., & Carvalho, T. S. (2014). Erosive tooth wear: A multifactorial condition of growing concern and increasing knowledge. Monographs in Oral Science, 25, 1–15. https://doi.org/10.1159/000360380
✔ West, N. X., Joiner, A., & Brookes, S. J. (2018). Enamel erosion: Prevention and therapy. Clinical Oral Investigations, 22(2), 821–831. https://doi.org/10.1007/s00784-017-2321-7
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