Definitions of tooth wear
Different countries interpret the definition slightly. The focus tends to be on erosion, but abrasion and attrition are also important, and these are combined with erosion, the result is extremely damaging.
Clinical appearance of erosion
A classic picture of erosion is cupping out of the occlusal surface and exposed dentine. In some patients, there is palatal erosion and exposed pulp, which is usually indicative of erosion from regurgitation acid.
Clinical appearance of attrition
Attrition is completely different in its clinical presentation; it appears as if the teeth have been filed down with sandpaper or a file. This extensive action is attributed to teeth grinding, but it is more likely due to a clenching act.
Clinical appearance of abrasion
Abrasion affects different surfaces of the teeth, along the cervical margins. It may be called “abrasion” or “abrasion and erosion”.
The most common presentation of tooth wear involves attrition, erosion, and abrasion combined. One may be more dominant but all three are commonly evident.
Factors important in erosion
Dietary acids in food such as acidic drinks, citrus fruits, and wine erode the buccal surface of upper incisors, as this is the first point of contact with the food. How a drink is consumed is important. Palatal erosion can occurs if drinks are held in the palatal vault or swilled around the mouth, but this is more frequently associated with regurgitation or vomiting. The role of the PH and titratability is also important. The most significant cause of erosion, however, is gastric acid insult. Gastro-oesophageal reflux (GOR or GER) and getting disorders are its two main causes.
Several factors are important in the management of patients with erosion. It is important to firstly categorise the tooth wear as mild, moderate or severe, and to promptly diagnose its cause (e.g. acid examine a patient’s diet and check the frequency of acidic food and drink intake. Their dietary habits such as the time taken to eat food are also pertinent. Gastric causes such as heartburn, regurgitation, and the relatively rare ruminant are then investigated. Patients are then provided with advice on changing their lifestyle that is practical and realistic (such as using less abrasive toothpaste). Further tooth wear is monitored with casts. It should also be note that materials used to restore worn teeth fail. The average life of composite is 5 years and crowns 10 years, however the rate of tooth wear is probably slow. Prevention is more cost effective and more likely to prolong tooth survival