Chapter 1

Erosion – Is it a Problem?

‘There are no new truths, but only truths that have not been recognised by those who have perceived them without noticing.’

Mary MacArthur from On The Contrary (1961)

Aim

To appreciate other forms of tooth surface loss, the nature and prevalence of dental erosion.

Outcome

After reading this chapter the reader should have an understanding of:

• other forms of tooth surface loss

• the historical background surrounding dental erosion

• the prevalence of dental erosion

• the limitations of the present evidence base.

Introduction and Historical Background

In its true sense dental erosion may be defined as the loss of enamel and dentine from chemical attack other than those chemicals produced intraorally by bacteria. This distinguishes it from dental caries, in which the damaging acid is produced from the fermentation of carbohydrates and the microorganisms of dental plaque. Although many would attribute the classical appearance of palatal tooth surface loss (Fig 1-1) to this process, it should never be forgotten that such surfaces may also wear due to both abrasion and attrition working in combination with the erosive process. Abrasion is physical wear brought about by contact with objects other than a tooth (Fig 1-2). Attrition is the physical wear of one tooth surface against another, with tooth tissue loss occurring on the contacting surfaces (Fig 1-3). In any patient all three mechanisms may be at work to a lesser or greater extent. As a result the dentist should always conduct a detailed examination to determine the major cause of the tooth surface loss that presents.

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