This summary is based on the Critical Appraisal published in the Journal of Esthetic and Restorative Dentistry: Dental Erosion (June 2013)
Context
Dental erosion or erosive tooth wear not only can be caused by extrinsic (dietary) acids but also intrinsic acids. Historically, anorexic and bulimic patients have been the population dentists have had to be aware of, but with the increasing prevalence of gastroesophageal reflux disease (GERD) in the general population, another population must be monitored. Tooth wear is usually multifactorial, and it is often difficult to assign a specific etiology; abrasion, attrition, and erosion must all be considered as potential etiologies. This critical appraisal reviews four articles looking at dental erosion and its relationship with GERD.
Studies Reviewed
- A Difference in Perspective—The North American and European Interpretations of Tooth Wear. International Journal of Prosthodontics 1999 (12:401–8)
- Systematic Review: Gastroesophageal Reflux Disease and Dental Lesions. Alimentary Pharmacology and Therapeutics 2008 (27:1179–86)
- Gastroesophageal Reflux and Dental Erosion. Evidence-Based Dentistry 2008 (9:54)
- Quantitative Analysis of Tooth Surface Loss Associated with Gastroesophageal Reflux Disease: A Longitudinal Clinical Study. Journal of the American Dental Association 2012 (143:278–85)
Key Messages
- Tooth wear is multifactorial, and it is rarely possible to identify a single etiology in a specific patient. North America has been slower in understanding the erosive component of tooth wear because of the focus on attrition as the primary etiology.
- Dental erosion and GERD are associated; however, the strength and prevalence of this association is highly variable. Dentists should closely monitor GERD patients and be proactive at treating them for dental erosion. Patients who have erosion on palatal and lingual surfaces should be questioned for a history of heartburn and GERD. If they are not being seen by a physician regarding these symptoms, they should be referred to their primary care physician.
- The presence of erosion and attrition appears to be a particularly harmful combination and demands active intervention.
- Factors that determine whether an individual with GERD will or will not develop dental erosion have not been clearly identified. More research is needed to identify specific risk factors for erosion.
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