The role of erosion in tooth wear: aetiology, prevention and management.

Tooth wear is a universal experience. The cause is usually a combination of erosion, attrition and abrasion. Attrition usually presents with flattened incisal and occlusal tooth surfaces which accurately inter-digitate. Erosion from dietary or gastric acids forms smooth lesions which typically appear as cupped occlusal/incisal and concave buccal/facial surfaces. When combined with attrition or abrasion, acids have the potential to cause significant wear. Wear reduces the thickness of enamel exposing the underlying dentine and changing the colour from the white of enamel to yellow of dentine. Acids causing erosion originate from the stomach or from the diet. Gastric acid is associated with reflux disease and eating disorders. The frequency of acidic foods and drinks and how they are consumed is important in dietary erosion. The progression of tooth wear is recognised to be slow with periods of activity and inactivity. Although restorations can be indicated, prevention and monitoring remain important strategies in maintaining the life of the teeth.