Hands On

Modifying erosive tooth wear

Background

Both dentists and the public are becoming aware of the role of erosion in compromising dental health status. In the United Kingdom, tooth wear is seen as comprising erosion, attrition, and abrasion (Fig 1, Fig 2, Fig 3, Table 1), whereas in Europe, erosion is emphasized, with attrition and abrasion seen as independent processes. As a result, differing terminology has complicated the discussions of tooth wear. Currently the term erosive tooth wear is being increasingly adopted as a compromise

Prevalence of the Problem

Erosive tooth wear appears to be common and increases with age. Between 2% and 10% of adults have wear, with the values for children even higher. Use of the BEWE index in a European sample identified wear in 30% of adults that was visible during the dental examination. In about 3% of the individuals screened, wear was severe.

No data are available to define a normal rate of wear. However, wear appears to occur at a natural level throughout life with periods of increased activity when risk

Clinical Findings

The BEWE was developed to record tooth wear severity in an attempt to make practitioners aware of tooth wear and raise awareness among patients so that preventive programs can be put into place (Table 2). The measure grades the most severely worn surface of a tooth in each sextant on a scale from 0 to 3, then the grade is recorded in the patient’s clinical record. The BEWE recognizes the importance of erosion but also the impact of tooth wear in progression. A drawback of the scale is the

Current Research and Preventive Efforts

The current research confirms that the enamel lesion is more relevant, leading to the development of fluoride and other minerals. Dentin exposure indicates a more severe condition; research on prevention efforts for dentin lesions is lacking.

Fluoride appears to be preventive of erosion in a way similar to its effect on caries. Specifically, it either hardens the enamel, which increases resistance to demineralization, or remineralizes the surface. Erosion may create a softened layer after acid