Abstract
Dental erosion is a prevalent issue resulting from acid erosion of the tooth surface, leading to mineral loss. The protective properties of fluorides in preventing dental erosion and caries have been widely researched. In the initial article, a randomized, controlled, in-situ trial compared the effectiveness of a stannous-containing sodium fluoride dentifrice versus a potassium nitrate dentifrice and sodium fluoride in safeguarding enamel against erosive acid exposure. According to the study by Hooper et al. (2014), the stannous-containing dentifrice offered more substantial enamel protection than the potassium nitrate dentifrice and sodium fluoride.
The second article introduces the Basic Erosive Wear Examination (BEWE) as a new scoring system to simplify the assessment of tooth erosion severity in general practice. The aim is to develop a standardized and validated index that can compare results from previous studies. This would help establish consistency in the measurement of tooth erosion severity (Bartlett et al., 2008).
The third article provides a comprehensive literature review on the relations between tooth surfaces and fluoride. The study suggests that the incorporation of fluoride into teeth is minimal and may not offer significant protection against acid attacks, whether from acidic substances or bacteria that produce acid and cause cavities. (Epple et al., 2022).
Dental Erosion
Dental erosion is a growing concern in dentistry, with its prevalence increasing in recent years. Dental erosion refers to the loss of dental hard tissues caused by the action of acid on the tooth surface. According to Hooper et al. (2014), the erosive process is not only related to the consumption of acidic food and drinks but also to various intrinsic and extrinsic factors such as gastric reflux, eating disorders, and medications. Dental erosion can result in tooth sensitivity, tooth wear, and aesthetic problems, which can significantly impact the quality of life of the affected individuals. (Epple et al., 2022)
Bartlett et al. (2008) note that despite the increased awareness and knowledge about dental erosion, there still exists an unmet need for the prevention, diagnosis, and management of dental decay. This analysis outlines the current literature about dental erosion, focusing on identifying the gaps in knowledge and the unmet needs in the field.
The three articles selected for this review provide insights into different aspects of dental erosion, such as the impact of dietary factors, the analysis and prevention of loss of dental tissue, and the role of dental professionals in managing dental decay. (Bartlett et al., 2008) By examining these articles, we can better understand the existing state of knowledge on the loss of dental tissue and the areas where further research is needed to improve the prevention and management of this condition.
After reviewing the three articles, several overall trends and gaps in research about dental erosion emerge.
Firstly, dental erosion is an increasingly prevalent and concerning issue in modern dentistry. The articles note that various factors, including acidic drinks and foods, gastroesophageal reflux disease, and eating disorders can cause dental erosion. Additionally, dental erosion can lead to significant consequences, such as tooth sensitivity, enamel wear, and a heightened risk of cavities. (Bartlett et al., 2008)
Secondly, there needs to be more clarity regarding the terminology and diagnostic criteria for dental erosion. The articles use different definitions and measurement scales for dental decay, which makes it challenging to compare and synthesize findings across studies.
Thirdly, the articles point to gaps in research regarding the prevention and treatment of dental erosion. Although some interventions, such as fluoride varnishes, show promise in slowing down or reversing the effects of dental decay, more studies are needed to determine the most effective treatment strategies.
Bartlett et al. (2008) presented a written work examining the efficiency of various toothpaste types in stopping tooth decay and dental erosion while introducing a novel evaluation system for measuring tooth wear. The writer’s point of view is likely to be one of the dental professionals looking for evidence-based recommendations for preventing and managing dental erosion and caries.
When analyzing and comparing literature, the writers may use criteria such as study design, sample size, outcome measures, and statistical analysis methods to determine the quality and validity of the research. They may also consider the relevance and applicability of the findings to their clinical practice or research question.
The organization of the review could vary, but it may include an introduction to the topic and research question, a description of the search strategy and inclusion/exclusion criteria, a summary of the studies reviewed, and a discussion of the findings and implications for practice.
Particular literature may only be included if it meets the inclusion criteria or is updated or relevant to the research question. The scope of the review may also be limited by factors such as language barriers, availability of full-text articles, and time constraints.
Discussion
Upon analyzing the three articles, it can be observed that they all focus on dental erosion and its prevention using fluoride-containing dentifrices. However, each piece uses a different approach and methodology to address this issue.
The first article, published in the International Dental Journal, presents a randomized in situ trial that compares the ability to prevent erosion by using a toothpaste that contains stannous and sodium fluoride dentifrice compared to a toothpaste containing potassium nitrate and sodium fluoride. The study uses a quantitative approach, using profilometry to measure the amount of tooth wear and calculate the erosion rate. The authors conclude that the stannous-containing dentifrice provides superior anti-erosive benefits compared to the potassium nitrate dentifrice/sodium fluoride. (Hooper et al., 2014)
The second article, published in the European Journal of Oral Sciences, introduces the Basic Erosive Wear Examination (BEWE) scoring system to evaluate and quantify dental erosion. This article employs a qualitative approach, providing a systematic framework for clinicians and researchers to assess the severity and extent of dental decay. The authors highlight the need for a standardized scoring system to help diagnose, inhibit, and manage dental erosion. (Bartlett et al., 2008)
The third article, published in the Dentistry Journal, critically discusses the physicochemical principles underlying the inhibition of dental caries and corrosion by fluoride. This article takes a theoretical approach, summarizing the current understanding of how fluoride ions interact with dental enamel and remineralize early caries lesions. The authors conclude that fluoride remains an operational and essential tool in preventing dental caries and erosion. However, its efficacy may vary depending on concentration, pH, and exposure time. (Epple et al., 2022)
When comparing and contrasting the findings among the three articles, it is clear that all authors agree on the importance of preventing dental erosion through the use of fluoride-containing dentifrices. However, each article takes a unique approach to address this issue. The first article compares two types of dentifrices and concludes that a stannous-containing sodium fluoride dentifrice provides superior anti-erosive benefits. The second article introduces a new scoring system to assess dental erosion, providing a standardized approach for clinicians and researchers. The third article provides a theoretical discussion of the physicochemical principles underlying the anticipation of dental decay by fluoride.
Individual Summaries
The first article is a randomized in situ trial that compares the anti-erosive properties of a stannous-containing sodium fluoride dentifrice and a potassium nitrate dentifrice /sodium fluoride. In the study, Hooper et al. (2014) urge that the stannous-containing sodium fluoride dentifrice provides better anti-erosive properties than the potassium nitrate dentifrice /sodium fluoride.
The second article proposes a new scoring system for assessing dental erosion called the Basic Erosive Wear Examination (BEWE). According to Bartlett et al. (2008), the BEWE is a simple, reliable, and effective recording system that can be used in both scientific and clinical settings to assess the severity of dental erosion.
The third article is a theoretical article that critically evaluates the effectiveness of fluorides in preventing dental erosion and caries. Epple et al. (2022) conclude that while fluorides effectively prevent dental decay and caries, their effectiveness varies depending on the type of fluoride used, the absorption, and the mode of supply.
In summary, each article significantly contributes to the literature on preventing dental erosion. The first article provides empirical proof for the effectiveness of a stannous-containing sodium fluoride dentifrice, the second introduces a valuable scoring system to evaluate dental decay, and the third summarizes the current understanding of the mechanisms by which fluoride prevents dental erosion.
Concluding paragraph
The three articles reviewed significantly contribute to understanding dental erosion prevention and management. One study uses an in situ model to compare the effectiveness of stannous-containing sodium fluoride dentifrice with sodium fluoride/potassium nitrate dentifrice in reducing erosive tooth wear. However, further investigation is needed to determine their long-term efficacy in preventing dental erosion.
Another article presents a new scoring system, BEWE, for measuring the severity of dental erosion, which can be helpful in research and clinical settings. Nonetheless, more research is necessary to establish standardized criteria for diagnosing and grading dental decay.
Lastly, a critical review of the mechanisms of fluoride therapy in preventing dental caries and erosion highlights the need for a personalized approach to fluoride therapy. Further research is needed to understand factors influencing fluoride efficacy, such as genetics, diet, and lifestyle.
Although inconsistencies in theory and findings are minimal across the reviewed articles, future studies should investigate the long-term effectiveness of stannous-containing sodium fluoride dentifrice, establish standardized criteria for diagnosing and grading dental erosion, and understand the individual factors that influence fluoride efficacy.
References
Hooper, S., Seong, J., Macdonald, E., Claydon, N., Hellin, N., Barker, M. L., He, T., & West, N. X. (2014). A randomisedin situtrial, measuring the anti-erosive properties of a stannous-containing sodium fluoride dentifrice compared with a sodium fluoride/potassium nitrate dentifrice. International Dental Journal, 64, 35–42. https://doi.org/10.1111/idj.12101
Bartlett, D., Ganss, C., & Lussi, A. (2008). Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clinical Oral Investigations, 12(S1), 65–68. https://doi.org/10.1007/s00784-007-0181-5
Epple, M., Enax, J., & Meyer, F. (2022). Prevention of Caries and Dental Erosion by Fluorides—A Critical Discussion Based on Physico-Chemical Data and Principles. Dentistry Journal, 10(1), 6. https://doi.org/10.3390/dj10010006
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