Erosion--chemical and biological factors of importance to the dental practitioner

Abstract

The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.