dentine erosion

Dentine Erosion: A Detailed Description

Dentine erosion, also known as dentinal wear or dentin exposure, refers to the wearing away of the dentin layer beneath the enamel surface of teeth. This condition occurs when the acid dissolves the enamel and dentin, leading to a loss of tooth surface.

Characteristics of Dentine Erosion

• The eroded enamel stands higher than the underlying dentine, as dentine is less mineralized compared to enamel.
• In moderate to severe cases, cupping out of the incisal edges can occur, especially in anterior teeth.
• Increased incisal translucency and incisal chipping may also be observed.

Causes of Dentine Erosion

Dentine erosion has six primary causes:

1. Diet: Consuming acidic foods and drinks can lead to dentine erosion.
2. Regurgitation: Gastroesophageal reflux disease (GERD) or acid regurgitation can cause dentine erosion.
3. Environmental factors: Exposure to environmental acids, such as those found in swimming pools or industrial settings, can contribute to dentine erosion.
4. Flow of saliva: A reduced flow of saliva can increase the risk of dentine erosion.
5. Exposed dentin: When enamel is worn away, exposing dentin, it can lead to further wear and tear on the tooth surface.
6. Idiopathic: In some cases, the exact cause of dentine erosion may be unknown (idiopathic).

Prevention and Treatment

While dentine erosion cannot be reversed, practicing good oral hygiene and visiting a dentist regularly can help prevent further wear and tear on teeth. A dental professional can assess the extent of dentine erosion and provide guidance on treatment options.

References:

• [3] Dental erosion is defined as the irreversible loss of tooth surface due to acids not generated by microbiological sources.
• [11] Tooth erosion is the wearing away of the tooth surface by an acid, which dissolves the enamel and dentine.
• [12] Dental erosion is a multifactorial condition: The interplay of chemical, biological, and behavioural factors is crucial and helps explain why some individuals exhibit more erosion than others.

Dentine erosion, also known as dentin hypersensitivity or exposed dentin, can cause a range of signs and symptoms that affect the overall health and appearance of your teeth.

Common Signs and Symptoms:

• Sensitivity: One of the most common symptoms of dentine erosion is sensitivity to hot and cold temperatures, sweet or sour tastes, and even gentle pressure on the affected tooth. This sensitivity can be sharp and fleeting or dull and persistent [3].
• Exposure of Dentin: As the enamel wears away, the underlying dentin becomes exposed, giving the teeth a yellowish or brownish hue. The dentin is softer than enamel and more prone to decay [5].
• Hollows in Teeth: Dentine erosion can cause hollows or depressions on the surface of the teeth, especially on the biting edges [5].
• General Wearing Away: Over time, the tooth surface can become worn away, exposing the dentin underneath. This can lead to a smooth, shiny appearance of the teeth [9].

Other Possible Symptoms:

• Tooth Stains: Enamel erosion can cause stains on the teeth, especially if the underlying dentin is exposed [6].
• Cavities and Decay: If left untreated, dentine erosion can progress to cavities and decay, leading to more severe symptoms like tooth pain and infection [8].

It's essential to note that these signs and symptoms can vary in severity and may not be immediately apparent. Regular dental check-ups and good oral hygiene practices can help identify and address dentine erosion early on.

References:

[3] - Shallow defects (typically on smooth surfaces) are common signs of erosive tooth wear, which can indicate dentine erosion [4]. [5] - Erosion usually shows up as hollows in the teeth and a general wearing away of the tooth surface and biting edges, exposing the dentin underneath [5]. [6] - Enamel erosion can cause symptoms like tooth stains and sensitivity. Tooth enamel can’t be regrown, but you can prevent erosion from getting worse with dental treatment and by taking care of your oral health [6]. [8] - Over time, the enamel on teeth can erode, resulting in the yellowing of teeth, cavities, severe tooth pain, and even infection [8].

Diagnostic Tests for Dentine Erosion

Dentine erosion can be diagnosed through various clinical and laboratory tests. Here are some of the most useful diagnostic tools:

• Clinical Examination: A dentist can diagnose tooth erosion during a routine dental examination by checking for wear and tear, texture changes, pitting, and other signs of enamel loss [2].
• Air/Water Syringe (Thermal) Test: This test involves using an air/water syringe to detect sensitivity in the teeth. If the dentine is exposed due to erosion, it may be sensitive to thermal stimuli [5].
• Dental Explorer (Touch) Test: A dental explorer can be used to check for texture changes and pitting on the surface of the teeth. Eroded areas may feel rough or have a different texture [2].
• Percussion Testing: This test involves tapping the teeth with a dental instrument to detect sensitivity. If the dentine is exposed, it may be sensitive to percussion [5].
• Bite Stress Tests: These tests involve applying pressure to the teeth to check for signs of erosion or wear [5].

Additional Diagnostic Tools

Other diagnostic tools that can be used to assess dentine erosion include:

• Contact X-ray Microradiography Microdensitometer: This is a low-cost technique that can be used to evaluate dental erosion [3].
• Surface Profilometry: This method involves measuring the surface topography of the teeth to detect signs of erosion or wear [1, 7].

Importance of Early Diagnosis

Early diagnosis and detection of dentine erosion are crucial for effective management and prevention of further tooth damage. Regular dental check-ups can help identify signs of erosion, allowing for prompt treatment and prevention of more severe problems [8].

Treatment Options for Dentine Erosion

Dentine erosion can be challenging to treat, but various drug treatments have been explored to manage this condition. While there is no definitive cure, some medications may help alleviate symptoms and prevent further progression.

• Fluoride-based treatments: Fluoride has been widely used to strengthen tooth enamel and prevent erosion. Topical fluoride applications, such as varnishes or gels, can be applied directly to the affected teeth to promote remineralization and reduce sensitivity [5].
• Chlorhexidine: This antimicrobial agent has been shown to have anti-erosive properties by forming a protective layer on the tooth surface, thereby reducing acid exposure [3]. However, its use is limited due to potential side effects and interactions with other medications.
• Epigallocatechin gallate (EGCG): A polyphenol extracted from green tea, EGCG has been found to have anti-erosive properties by inhibiting the activity of enzymes involved in tooth demineralization [4].
• Sodium fluoride: This compound is commonly used as a treatment for early-stage enamel erosion. It helps strengthen the remaining enamel and prevent further erosion [6].

Important Considerations

While these drug treatments may offer some benefits, it's essential to note that:

• Dentine erosion is often irreversible, and treatment goals focus on managing symptoms and preventing further progression.
• The effectiveness of these treatments can vary depending on individual factors, such as the severity of erosion and overall oral health.
• A comprehensive treatment plan should involve a combination of drug therapy, good oral hygiene practices, and regular dental check-ups to ensure optimal outcomes.

References

[3] Context result 3: "1% chlorhexidine [ ... ]" [4] Context result 3: "6 experimental groups (n = 5) were treated with 1% epigallocatechin gallate [EGCG], 1% chlorhexidine [ ..." [5] Context result 5: "Topical fluoride is the most common treatment for early-stage enamel erosion." [6] Context result 5: "Fluoride helps strengthen your enamel and stop erosion from getting worse."

Differential Diagnosis of Dentine Erosion

Dentine hypersensitivity (DHS) and dentine erosion are two distinct conditions that can be challenging to diagnose, as they share similar symptoms. The differential diagnosis of dentine erosion involves identifying the underlying cause of the condition.

Causes of Dentine Erosion

• Tooth decay: Tooth decay can expose dentin, leading to sensitivity and pain.
• Gum recession: Gum recession can expose roots and dentin, causing sensitivity.
• Tooth erosion: Acid dissolution of dental hard tissue can lead to dentine exposure.
• Fractured teeth: Fractured teeth can expose dentin, leading to sensitivity.

Diagnostic Process

The diagnostic process for dentine erosion involves a thorough clinical examination and testing. The presence of exposed dentin is a key indicator of DHS or dentine erosion. Other factors such as the patient's medical history, dietary habits, and oral hygiene practices should also be considered.

• Clinical examination: A visual examination of the teeth and surrounding tissues can help identify signs of dentine exposure.
• Testing: Various tests such as thermal, evaporative, tactile, and chemical tests can be used to confirm the presence of exposed dentin.

Differential Diagnosis

The differential diagnosis of dentine erosion involves ruling out other conditions that may cause similar symptoms. These include:

• Dentin hypersensitivity (DHS): A short, sharp pain that arises from exposed dentin in response to non-noxious stimuli.
• Tooth decay: Tooth decay can expose dentin and cause sensitivity.
• Gum recession: Gum recession can expose roots and dentin, causing sensitivity.

References

• [1] Liu XX. Clinical examination and testing are requisite for differentiating DHS from other causes of hypersensitivity. Initially, the presence of exposed dentine is a key indicator of DHS or dentine erosion.
• [3] The erosion is seen as a light yellow patch on the tooth, indicating that the enamel has been dissolved and the sensitive dentine under the enamel is exposed.
• [8] DHS has been defined as a short, sharp pain that arises from exposed dentin in response to non-noxious stimuli, typically thermal, evaporative, tactile, or chemical tests.
• [9] This review will consider evidence that dentine hypersensitivity is a tooth-wear phenomenon characterised predominantly by erosion.

Note: The numbers in square brackets refer to the search results provided in the context.