Introduction

Although erosive tooth surface loss was described as a different condition to caries as early as the 18th century, it was not considered with much importance until the 1990s. In 1996, the European Journal of Oral Science stated that “dental erosion is an area of research and clinical practice that will undoubtedly experience expansion in the next decade”.1 Yet, many dental professionals today are unable to correctly identify signs and symptoms. Considering the increasing longevity of teeth as dental advances have reduced tooth loss, the damaging effect of dental erosion—the non-bacterial chronic loss of dental tissues—is emerging as a serious public health issue.2 In fact, erosive tooth surface loss is highly prevalent in developed countries, including the United States, Canada, Great Britain, and Sweden. Studies suggest a prevalence of 6% to 50% in preschool children, 24% to 100% in school-aged children, and as high as 82% in adults 18 to 88 years old.3-8

The reason for concern is that erosive tooth surface loss can be pathological if the teeth are so worn down that they change in appearance or can no longer function properly.9 When natural reparative processes, such as remineralization, are no longer sufficient to protect the tooth, complications can include pain, dentin hypersensitivity, pulpal inflammation, necrosis, and pathology around the apex of the root of a tooth. There can also be increased risk of temporomandibular disorders.2 What follows is a discussion of physical and chemical tooth wear mechanisms, and the many factors that increase the risk of tooth surface loss.