Current and Emerging Concepts in the Etiology of Erosive Tooth Wear

Douglas Young DDS, Michael D. Nelson DDS

Erosive tooth wear is multifactorial in nature involving biological, chemical, and behavioral factors leading to the pathologic loss of hard tissue by a process other than dental caries.

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It is affected by: erosion, attrition, and abrasive forces. This review will summarize current etiological theories as well as new emerging concepts.

Learning Objectives:

Upon completion of reading this article, the clinician will be able to appreciate the current and historical concepts relating to the effects of acid on dental hard tissues. Additionally, the clinician will understand the emerging concepts of how the damaging effects of erosive oral acid could also be related to intrinsic reflux of gastric contents; and secondly: tooth wear, attrition, and abrasion may be related to sleep disturbed breathing (SDB), obstructive sleep apnea (OSA), and upper airway resistance syndrome (UARS). With these new concepts in mind, mitigation and management of tooth wear and acid erosion should consider: treatment of SDB, OSA, and UARS, reduction of acid reflux, neutralizing the effects of oral acid and remineralization of remaining acid affected surfaces ideally before traditional reconstruction is needed or implemented.