Surface enamel wear due to tooth erosion and abrasion are highly prevalent among adults in the United States. In fact, 96 percent of dentists surveyed see surface enamel wear in their patients, but only one-third discuss the topic during a routine examination.  Patients, not surprisingly, are even less adept at raising the issue.

The pathology of erosion- and abrasion-related surface enamel wear is not completely understood. With erosion, it is believed, acids in the diet tend to weaken surface enamel, leaving uneven crevices where plaque and stains can collect. Common dietary causes of erosion that can significantly reduce gloss and increase roughness include soda, orange juice, and many sport drinks.  Abrasion is typically caused by improper brushing technique or excessively abrasive dentifrices.

Just before the kickoff of the recent 29th Yankee Dental Congress, a distinguished faculty gathered in Boston for a roundtable discussion of these and other topics of importance to primary care dental professionals nationwide.

"All of us have some degree of surface enamel wear due to erosion and abrasion," said Gerard Kugel, DMD, MS, associate dean for research at Tufts University School of Dental Medicine. "We believe dentists and, especially, dental hygienists should be telling their patients about the common causes and potentially important aesthetic consequences of surface dental erosion and abrasion."

The faculty convened to discuss how the responsibilities of primary care dentistry have changed in recent years, including the enormous increase in cosmetic procedures, as well as the ways in which the field might evolve in the years ahead. Presentation topics included a review of fluoride and its clinical implications; diagnosis and management of dental erosion; the emergence of cosmetic dentistry; and a look at the possible future of primary care dentistry.

Dr. Kugel, who specializes in clinical research and cosmetic dentistry, chaired a distinguished four-member faculty, which included Dr. Sebastian G. Ciancio, chair of the department of periodontics and endodontics and distinguished service professor at the School of Dental Medicine of the State University of New York at Buffalo; Dr. John J. Hefferren, research professor at the Higuchi Biosciences Center at the University of Kansas at Lawrence; and Dr. Robert A. Uchin, dean of the College of Dental Medicine at Nova Southeastern University. The discussion was supported by an unrestricted educational grant from Church and Dwight Co., Inc., makers of ARM & HAMMER® dental products.

"Although surface enamel wear is very common in the United States," Dr. Kugel explained, "we are hopeful that clinicians will begin to educate patients about this important, but underappreciated, cosmetic issue as part of a comprehensive oral care program."