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How valid are current diagnostic criteria for dental erosion?

Ganss C - Clin Oral Investig (2008)

Bottom Line: This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research.Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor.In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany. carolina.ganss@dentist.med.uni-giessen.de

ABSTRACT
In principle, there is agreement about the clinical diagnostic criteria for dental erosion, basically defined as cupping and grooving of the occlusal/incisal surfaces, shallow defects on smooth surfaces located coronal from the enamel-cementum junction with an intact cervical enamel rim and restorations rising above the adjacent tooth surface. This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research. Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor. Besides other aspects, this finding might be due to lack of validity with respect to diagnostic criteria. In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted. Knowledge about the validity of current diagnostic criteria of different forms of tooth wear is incomplete, therefore further research is needed.

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Effect of the continuous exposure of a human third molar to 10% citric acid. The amorphous, centripetal tissue loss is obvious (a unaffected tooth, b tissue loss after 4, c 8, and d 12 h immersion time)
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Fig1: Effect of the continuous exposure of a human third molar to 10% citric acid. The amorphous, centripetal tissue loss is obvious (a unaffected tooth, b tissue loss after 4, c 8, and d 12 h immersion time)

Mentions: From the chemical view, the aetiology of dental erosion can be defined as the chronic exposure of the teeth to extrinsic or intrinsic acids under the condition that the oral fluids are undersaturated with respect to tooth mineral [23, 26]. Under in vitro conditions without physical impact, teeth demineralise centripetally (Fig. 1), a feature of substance loss which is normally not observed in the mouth. In fact, the multitudes of physical and chemical assaults occurring during a lifetime result in a more or less characteristic pattern of tooth wear. The classification of wear is therefore made from morphological features which are frequently seen clinically. The tooth morphology as apparent after eruption is the idealised status, deviations of which, if not caries or trauma, are diagnosed as (erosive) tooth wear. Various forms of wear including dental erosion are listed in the International Classification of Diseases [52] thus defining them as a disease (for critical discussion of this notion see [12]).Fig. 1


How valid are current diagnostic criteria for dental erosion?

Ganss C - Clin Oral Investig (2008)

Effect of the continuous exposure of a human third molar to 10% citric acid. The amorphous, centripetal tissue loss is obvious (a unaffected tooth, b tissue loss after 4, c 8, and d 12 h immersion time)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2238791&req=5

Fig1: Effect of the continuous exposure of a human third molar to 10% citric acid. The amorphous, centripetal tissue loss is obvious (a unaffected tooth, b tissue loss after 4, c 8, and d 12 h immersion time)
Mentions: From the chemical view, the aetiology of dental erosion can be defined as the chronic exposure of the teeth to extrinsic or intrinsic acids under the condition that the oral fluids are undersaturated with respect to tooth mineral [23, 26]. Under in vitro conditions without physical impact, teeth demineralise centripetally (Fig. 1), a feature of substance loss which is normally not observed in the mouth. In fact, the multitudes of physical and chemical assaults occurring during a lifetime result in a more or less characteristic pattern of tooth wear. The classification of wear is therefore made from morphological features which are frequently seen clinically. The tooth morphology as apparent after eruption is the idealised status, deviations of which, if not caries or trauma, are diagnosed as (erosive) tooth wear. Various forms of wear including dental erosion are listed in the International Classification of Diseases [52] thus defining them as a disease (for critical discussion of this notion see [12]).Fig. 1

Bottom Line: This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research.Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor.In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany. carolina.ganss@dentist.med.uni-giessen.de

ABSTRACT
In principle, there is agreement about the clinical diagnostic criteria for dental erosion, basically defined as cupping and grooving of the occlusal/incisal surfaces, shallow defects on smooth surfaces located coronal from the enamel-cementum junction with an intact cervical enamel rim and restorations rising above the adjacent tooth surface. This lesion characteristic was established from clinical experience and from observations in a small group of subjects with known exposure to acids rather than from systematic research. Their prevalence is higher in risk groups for dental erosion compared to subjects not particularly exposed to acids, but analytical epidemiological studies on random or cluster samples often fail to find a relation between occurrence or severity of lesions and any aetiological factor. Besides other aspects, this finding might be due to lack of validity with respect to diagnostic criteria. In particular, cupping and grooving might be an effect of abrasion as well as of erosion and their value for the specific diagnosis of erosion must be doubted. Knowledge about the validity of current diagnostic criteria of different forms of tooth wear is incomplete, therefore further research is needed.

Show MeSH
Related in: MedlinePlus