Dental Diseases
Dental Erosion
aka Acid Erosion · Chemical Erosion
Loss of tooth structure by chemical dissolution from non-bacterial acids.
§ overviewOverview
Irreversible loss of dental hard tissues caused by extrinsic or intrinsic acid exposure without bacterial involvement.
§ icdICD Classification
K03.2
§ etiologyEtiology
- 01Extrinsic: dietary acids (citrus, carbonated drinks, wine)
- 02Intrinsic: GERD, bulimia, chronic vomiting
§ riskRisk Factors
- 01High acidic beverage intake
- 02Eating disorders
- 03GERD
- 04Reduced salivary flow
§ epidemiologyEpidemiology
Increasing prevalence, especially in young adults with high soft drink consumption.
§ pathogenesisPathogenesis
Acid demineralises enamel surface layer; saliva cannot remineralise faster than dissolution.
§ clinicalClinical Features
- 01Smooth, silky-shiny enamel surface
- 02Cupping of cusps and incisal edges
- 03Palatal erosion of upper anteriors (intrinsic)
- 04Facial erosion (extrinsic)
- 05Restorations standing proud ('amalgam islands')
§ differentialDifferential Diagnosis
- 01Attrition
- 02Abrasion
- 03Abfraction
§ investigationsInvestigations
- 01Dietary history
- 02Medical history (GERD, bulimia)
- 03BEWE (Basic Erosive Wear Examination)
§ treatmentTreatment
- 01Identify and reduce acid source
- 02Dietary counselling
- 03Fluoride/CPP-ACP remineralisation
- 04Restore with composite/crowns if severe
§ complicationsComplications
- 01Sensitivity
- 02Pulp exposure
- 03Aesthetic concerns
§ prognosisPrognosis
Good if behaviour modified early; irreversible once lost.
§ preventionPrevention
- 01Limit acidic beverages
- 02Use straw
- 03Rinse with water after acid exposure
- 04Avoid brushing immediately after acid challenge
§ examKey Examination Points
- 01Palatal erosion of 16, 26 = GERD/bulimia
- 02Cupping of cusps
- 03Restorations standing above tooth surface
§ revisionQuick Revision Summary
- 01Non-bacterial acid = erosion
- 02Intrinsic = palatal maxillary anteriors
- 03BEWE scoring system
§ vivaBDS Viva Questions
- 01How do you differentiate erosion from attrition?
- 02What is the BEWE index?
- 03What dietary advice would you give?
§ mcqsMCQs — Assessment (3)
Question 1
Perimylolysis refers to erosion from:
Question 2
Characteristic distribution of intrinsic erosion:
Question 3
Why avoid brushing immediately after acid exposure?
References
- Lussi A. Erosive Tooth Wear, 2e
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.