Treatment of dental abrasion

It may be stated that modern dentistry knows how to effectively manage the “eternal” disease of the oral cavity, i.e. decay. Fluorine products, proper personal and regular professional oral hygiene, culture of nutrition provide actual possibilities to retain teeth in the course of the entire lifetime. Although we know how to fight “dirty” diseases, at the same time pathological conditions determined by the “achievements of civilisation” become evident. The lifestyle of a great number of people is changing radically. Speed, abundance of information, constant decision making, i.e. constant stress or anxiety, have become our daily routine. Today, dentists observe that a group of oral diseases is becoming increasingly more frequent and what is worse younger, i.e. pathological dental abrasion (faster than typical for a certain age). Dental abrasion is characteristic of 97 per cent of population, including 7 per cent requiring treatment so that dental structure is not entirely decomposed by this pathological condition.

Natural (determined by age) dental abrasion accelerates due to three major causes: frequent presence of acids in the mouth (erosion), teeth grinding (see Prevention of Consequences Caused by Teeth Grinding) and incorrect cleaning of teeth or their abrasion by other objects (smoking pipe, fishing rod lines, needles, etc.) (see Prevention of Oral Diseases). One cause is predominant. Teeth are most affected by food or gastric acids. When dental tissues soften due to acids, it is much easier to rub them off with a toothbrush or when grinding teeth. Dental tissue starts decomposing if saliva pH drops below 5.5 (normal salivary pH is around 7). Acidity of some food products is provided in the table below.







2.9 - 3.5




3.3 - 4.5


2.4 - 3.3


3.1 - 4.2


4.2 - 5.0


3.4 - 4.7


2.3 - 3.8


2.8 - 4.6




1.8 - 2.4


2.4 - 2.7


3.0 - 4.0




3.2 - 4.7


3.8 - 4.2


3.0 - 4.2

Distilled water



At the moment, there is sufficient evidence that gastric acid causes dental erosion. Compared to food acids the effect of which can be easily eliminated by getting into the habit to rinse the mouth with water immediately after each meal, gastric acid (pH 1-2) causes the deepest damage to teeth. Gastric acid comes up to the mouth from the stomach when vomiting (in case of anorexia nervosa, bulimia, alcoholism, oncologic diseases, pregnancy, etc.) or due to gastro-oesophageal reflux (GER) caused by abnormal relaxation of lower oesophageal sphincter.

The effect of gastric acid can be reduced considerably if after vomiting teeth are in no way brushed with a toothbrush and toothpaste, and the mouth is immediately rinsed with water or alkaline liquid, e.g. milk.

Chronic coming up of the gastric contents is far more difficult to avoid in case of reflux. Apart from the major symptom of the disease, i.e. heartburn, other symptoms may be present as well. Typical and untypical symptoms are presented in the figure below.



The following is the tactics of treating pathological dental abrasion caused by the coming up of gastric acid into the mouth: the patient is referred to a gastroenterologist or another specialist of general pathology for a consultation and a complex of dentistry measures, i.e. restoration of damaged teeth by fillings or dentures and prevention (explanation how to behave, mineral restoring therapy, protective mouth guards).

Thus, differently from decay which is a local problem of the oral cavity, pathological causes for dental abrasion are often related not only to the oral cavity, it is a multidisciplinary pathology. Appointments to dentists are usually more frequent than to doctors of other areas. Therefore, a competent dentist can identify the cause for dental abrasion from its specific pattern, perform the required procedures in the mouth and refer the patient to a respective specialist for consultation.


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