Dentoword : Today's Word is 'Dental Erosion'

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Today's word is "Dental Erosion"

Dental Erosion : 'The Silent Teeth Eater'

In the previous blog, we discussed dental attrition. Today, we are going to delve into another non-carious lesion: dental erosion. Dental erosion slowly dissolves the hardest structure of our teeth, the enamel, and reduces tooth dimension in an acidic medium. In this blog, we'll understand how it happens, its causes, prevention, and treatment. So, let's dive into this journey with today's word: dental erosion.

Definition:

Dental erosion is the wear or loss of tooth surface due to chemical action by demineralizing agents with low pH.

 

Classification of Dental Erosion :

Based on Etiology (Cause) :

1. Intrinsic Erosion : 

Caused by endogenous acids of gastric origin.

 Examples :

 A)  Recurrent Vomiting: 

Due to anorexia nervosa, bulimia nervosa, and certain medical conditions like peptic ulcers, hiatus hernia, intestinal obstruction, metabolic and endocrine disorders, side effects of drugs, and chronic alcoholism.

 B) GERD (Gastroesophageal Reflux Disease) : 

Acid reflux occurs without nausea or abdominal contraction, causing acid to reach the mouth and lead to dental erosion.

2. Extrinsic Erosion : Associated with external factors :

 

a) Occupational : 

• Professional wine tasters
•  Professional swimmers.

  b) Diet : 

• Consumption of citrus fruits
•  Acidic beverages.

 

c) Medications : 

• Aspirin 
• Ascorbic acid.

 

 d) Lifestyle:

• Personal habits and routines.

Clinical Features of Dental Erosion :

1. Diagnosis of dental erosion varies based on its location.

2. Erosion on the palatal surface of upper teeth suggests regurgitation of stomach acid.

3. Erosion on the facial aspects of anterior teeth and buccal aspects of posterior teeth points to extrinsic factors.

4. Dental erosion causes loss of tooth structure, often presenting as cupped-out areas on occlusal surfaces.

5.Increased tooth sensitivity due to enamel loss.

6.Discoloration of teeth, as the underlying dentin becomes exposed.

7.Transparency or thinning of teeth, especially at the edges, due to enamel erosion.

Prevention and Management of Dental Erosion:

Identification of the etiology is crucial as the first step in managing dental erosion.

1.Diet Modifications: Counseling patients who habitually consume acidic drinks or foods (e.g., lemons) is essential to halt erosion.

2.GERD Management: Referral to a physician for complete evaluation and treatment is necessary if GERD symptoms are present.

3.Eating Disorders: 

Patients with conditions like bulimia nervosa should be referred to a physician for appropriate treatment.

4.Dry Mouth or Reduced Saliva Production: Sugarless chewing gum or medications like pilocarpine can increase saliva flow, acting as a buffer to reduce erosion.

5.Chronic Alcoholism: Counseling patients is crucial to reduce erosion risks associated with chronic alcohol consumption.

Erosion prevention heavily relies on patient compliance with dietary changes, use of topical fluorides, and sometimes the use of occlusal splints.

Diagnosis of Dental Erosion:

1.Visual Examination: Observe for smooth, shiny enamel surfaces or transparent edges, and note any yellow discoloration. Perform tactile assessment to detect pitting enamel.

2.Patient Medical and Diet History :

 Include inquiry about acidic beverages or fruits in the patient's diet, as this is crucial. Also, assess for a history of chronic acidity issues, dry mouth, or any eating disorders to identify potential causes.

3.Radiographic Diagnosis: Utilize radiographs to assess the extent of erosion and identify any underlying issues.

Conclusion :

Dental erosion is a common condition that can significantly impact your oral health if the underlying causes are not treated or eliminated early. By understanding its etiology, prevention, and management, we can protect our teeth from this silent eater in its early stages and preserve our beloved smiles.

Request to Readers: 

Thank you for reading today's blog. If you found it helpful or have any queries, please let me know in the comments section. Don't forget to visit your dentist if you experience any of the issues mentioned. Stay tuned for more detailed blogs.

References :

1.Sturdevant’s 
Art and Science of 
Operative Dentistry (Second South Asia Edition-2019),Adaptation Editor
V. Gopikrishna,Elsevier.

2.Image credit : www.shutterstock.com.

3.Shafer’s Textbook of Oral

Pathology

NINTH EDITION,

B Sivapathasundharam, MDS.(2020).