What is acid erosion of teeth

Erosion: damage to the hard tooth structure caused by acids

Tooth defects due to demineralization

The acids lead to a demineralization of the hard tooth substance and thus first soften the tooth enamel and then the dentin. The first, barely visible signs of erosion are finely shiny or dull areas on the tooth surface, which makes diagnosis difficult at this early stage. Often only when there are small ones on the chewing surfaces Dents and hollows or steps on the crown edge have formed, the teeth are more sensitive to temperature differences, discolour or become shorter, patients consult their dentist. If even dental fillings, e.g. made of plastic or amalgam, are already protruding from the neighboring tooth substance or a typical, remaining enamel bar is visible on the gumline, it is an advanced tooth erosion that must be treated.

 

Erosion process in the entire upper jaw: massive loss of tooth
enamel with removal of the enamel cusps.
Image source: © CP GABA GmbH.


In addition to erosions and caries, other defects in the hard tooth substance can also occur next to each other or overlap, such as Attritions, Fractions and Abrasionswhich the dentist must clarify and treat accordingly.
 

Superimposition of erosion and abrasion

In contrast to erosions, attritions and abrasions are caused mechanically and have sharply delineated defects. However, previous damage caused by erosion softens the tooth substance and can thus accelerate mechanical damage caused by abrasion. Even incorrect toothbrushing techniques can intensify abrasions and make real "cleaning grooves" visible.

 

Superposition of erosion and abrasion:
Enamel ridges on the gumline and severely shortened, abraded teeth.
Image source: © GZFA

 

If the erosion process continues with high chewing pressure due to teeth grinding, the teeth lose more and more of their substance, especially their height. This vertical loss of teeth leads to the training of a horizontal chewing pattern - similar to a ruminant. As a result, there is no longer any physiological canine guidance, massive muscle tension and TMJ stress as well as other CMD symptoms occur.

Patient case: tooth damage due to erosion

In a patient with tooth damage due to erosion and abrasion due to bulimic disease, chewing function and dental aesthetics were restored.

Using conceptual diagnostics and a standardized procedure based on the DROS®Therapy concept, the patient received a successful prosthetic fitting. The splint therapy, which took place in two phases, led to the desired neuromuscularly guided physiological centric of the temporomandibular joints after 10 weeks. This centric could be reproduced on the basis of centric registrations and thus allowed the prosthetic implementation not from the centric occlusion, but from the centric relation. The functional and aesthetic restoration with dentures, which ensured stable anterior and canine guidance as well as protection against renewed craniomandibular dysfunctions (CMD), was carried out via a wax-up.

The full Technical article in the "DZW Kompakt" read here:
https://www.gzfa.de/uploads/media/GZFA-V__DZW-EBAbraham_2011-06.pdf
 

Therapy options and preventive measures

Erosion should be recognized and treated as early as possible. If erosion processes are already present in the deciduous dentition, there is a high risk of it developing in the permanent dentition. In addition, the process progresses faster with age.
 

Protection of the tooth substance

The basis of any treatment for dental erosions is to protect and preserve as much of the hard tooth substance as possible. To do this, the destruction process must first be stopped, and only then can lost tooth substance be rebuilt using minimally invasive methods.

Is in the Initial stage only the tooth enamel is slightly damaged by erosion and the teeth are not yet sensitive to hot or cold, a Sealing of the tooth surfaces help, which, however, has to be repeated every 6-9 months. Further preventive measures depend on the cause of the erosion. This includes changing eating habits, such as avoiding acidic drinks and meals, learning the correct teeth brushing technique with fluoride toothpaste and a soft brush, and treating stomach problems and eating disorders.
The addition of calcium and phosphate to beverages and meals protects against acidic effects, so the consumption of foods with a naturally high content, such as dairy products, is harmless.

in the advanced stageIf dents / hollows are already visible on the tooth surface or the edges of tooth fillings protrude, then the loss of tooth substance must be compensated for. On the posterior teeth, the defects are filled with composite fillings, and in the event of a large loss of substance with crowns, overlays / onlays / inlays made of composite or ceramic.

The dentist can treat erosions on the front teeth functionally and aesthetically perfectly with veneers, adhesively bonded ceramic veneers.

If there are abrasion and erosion processes in the patient's dentition at the same time, usually associated with a massive loss of the vertical dimension of the tooth substance, only complete reconstructions (KFR) made of all-ceramic can achieve a functional and aesthetic restoration of the chewing function.
Splint therapy (DROS®Splint) in the run-up to the restoration supports the dentist and dental technician in determining the dimensions of the loss of hard tooth substance and in reconstructing the original, physiological bite height.

Here you can find dentists for aesthetic dentistry in your area

The DROS concept: Further information on the treatment of teeth grinding, bruxism and CMD.

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