Page 24 - GP Spring 2020

or prevent a loss of vertical dimension (ver- Erosion (Corrosion) Age/Sex/Race: Males have a higher inci-
tical collapse) while maintaining a healthy Etiology: Erosion is the loss of tooth ma- dence of erosion than females. No racial
temporomandibular joint. terials through chemical action that does differences have been noted, however so-
not involve bacteria. It can be the result cioeconomic differences might demonstrate
Attrition of intrinsic or extrinsic acids. Intrinsic ac- a difference with wealthier cohorts showing
Etiology: Attrition is the loss of enamel, ids include stomach acids through GERD, less erosion. Erosion is present in children
dentin, or restorations due to tooth-on- acid reflux, or eating disorders like bulimia. as well as adults and can be correlated to
tooth contact. It is secondary to mechanical Examples of extrinsic acids in the diet are the degree of caries. The more erosion, the
friction. citrus fruit and juices, carbonated beverages greater likelihood of tooth decay.
and sports drinks. With both intrinsic and
Clinical: Occlusal and incisal attrition may extrinsic acids the oral pH can become acid- Treatment: Initial approach to treating pa-
present with normal processes of eating ic and capable of softening the dental hard tients with erosion is to stop the extrinsic
and swallowing as well as through clench- tissues. Xerostomia may worsen erosion as factors that cause the erosion, maintain a
ing and bruxism. Proximal attrition occurs saliva both clears out acids from the oral basic rather than acidic oral environment. It
at the contact areas between teeth and may cavity and buffers the oral mucosa. There is is important to treat any underlying medical
result in a decrease in the size of the den- an association of children with asymptom- concerns such as acid reflux, eating disor-
tal arch. Attrition can be seen on its own or atic acid reflux and asthma. Any child with ders, and reduced salivary flow. Topical flu-
in combination with abrasion or corrosion erosion may have asymptomatic acid re- oride and fluoride containing rinses, tooth-
(chemical breakdown of tooth structure). flux, which may instigate asthmatic attacks. pastes and varnishes can be used in office
Most often attrition is found on opposing Dental erosion has also been found in peo- and at home. Referral to either pediatric or
teeth and tends to be equal in loss of tooth ple who swim in chlorinated pools and with general dentists is indicated, as teeth may
structure and creates matching wear facets certain occupations such as wine tasters. need restorations to improve esthetics and
so the teeth fit together like a jigsaw puzzle. maintain function.
(Figures 6,7) Clinical: The affected teeth often present
with a glassy surface and may appear yel- We hope that this review is beneficial for
low rather than white if enamel is thinned clinicians as well as for your patients and
out or dentin is exposed. Once the erosion that this will increase your ability to both
has gone through the enamel and into the explain the etiologies of diseases that may
dentin, patients may suffer from sensitivity mimic each other and provide effective
to both hot and cold. Molars may present treatments for your patients.
with a shelled out appearance and resto-
rations may be clinically above the adjacent
tooth structures. (Figures 8,9)

Figure 6. Attrition.

Figure 8. Erosion of maxillary anterior teeth.

Figure 7. Attrition.

Age/Sex/Race: Most patients are older or
have a malocclusion that contributes to the
wear pattern consistent with attrition.

Treatment: Treatment consists of restoring
the tooth structure when possible and restor-
ing the lost height of the teeth to restore or
prevent a loss of vertical dimension (verti- Figure 9. Erosion of mandibular teeth.
cal collapse) while maintaining a healthy
temporomandibular joint.

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