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Tooth wear in children is a multifactorial process that can be due to either physiological or pathological processes. The most frequent type of tooth wear in children is erosion, and its contribution to overall tooth wear is explained. The prevalence, aetiology, presentation and management of tooth wear, especially erosion, are discussed in this article, with practical clinical advice for the treating clinician and families. The challenges to giving practical preventive advice, and the complexities involved in overcoming dietary and lifestyle changes in an environment of powerful advertising, peer pressure and social media influencers are discussed in detail.
CPD/Clinical Relevance: Erosive tooth wear is common in children, so understanding the aetiology and giving families practical and relevant preventive advice is important.
Article
Tooth wear in children is multifactorial and can be due to either physiological or pathological processes. The different types of tooth wear (erosion, attrition and abrasion) can occur separately or together, and often act synergistically. Erosion is the most frequently seen type of tooth wear in children in both the primary and permanent dentition. Physiological attrition is commonly seen in later stages of the primary dentition and is often accelerated by erosion.1
The prevalence of tooth wear in children is high, with the 2013 Child Dental Health Survey finding more than 50% of 5 year olds had signs of tooth wear and nearly 40% of 15 year olds.2 Around 4% of 15 year olds had tooth wear extending into dentine or pulp on lingual surfaces of the incisors, and 3% extending into dentine or pulp on the occlusal surfaces of molars.2 While low proportions of children were affected by tooth wear into dentine or pulp, this is very substantial damage to have at the age of 15 years. This prevalence level has been validated in a previous systematic review that estimated an overall worldwide prevalence of tooth erosion of 30% in the permanent dentition of children and adolescents aged 8–19 years.3
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