Treatment
Prevention — Eliminate the Causative Agent
Dietary modification and medical management
- • Reduce frequency and quantity of acidic beverage consumption
- • Use a straw for acidic drinks to minimize tooth contact
- • Rinse with water or fluoride mouthwash immediately after acid exposure; do NOT brush for 30-60 minutes
- • GERD management with proton pump inhibitors (PPIs), dietary changes, head-of-bed elevation
- • Refer patients with eating disorders to appropriate psychiatric/psychological care
- • Saliva substitutes for xerostomia patients
Remineralization — Fortify Remaining Tooth Structure
Fluoride therapy and casein phosphopeptide complexes
- • High-fluoride toothpaste (2800-5000 ppm) twice daily for adults
- • Fluoride varnish applications every 3 months
- • Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) products — MI Paste, Tooth Mousse
- • Potassium nitrate to occlude exposed dentinal tubules and reduce sensitivity
Restorative Treatment
Restore lost tooth structure when erosion is clinically significant
- • Composite resin: direct build-up of anterior teeth — conserve maximum tooth structure
- • Posterior composite or glass ionomer for cupping lesions on molars
- • Composite veneers for anterior palatal erosion
- • Removable or fixed occlusal splints to protect teeth from further loss and facilitate monitoring
- • Porcelain veneers or crowns for severe erosion with significant structure loss — usually deferred until erosion is controlled
- • Full-mouth rehabilitation for severe cases with loss of vertical dimension