Diet analysis and advice for patients with
tooth wear is potentially the most logical intervention to arrest attrition, erosion and abrasion. It is saliva that protects the teeth against corrosion by the
acids which soften enamel and make it susceptible to wear. Thus the lifestyles and diet of patients at risk need to be analysed for sources of
acid and reasons for lost salivary protection. Medical conditions which put patients at risk of
tooth wear are principally:
asthma,
bulimia nervosa,
caffeine addiction,
diabetes mellitus, exercise
dehydration, functional depression,
gastroesophageal reflux in
alcoholism,
hypertension and syndromes with salivary hypofunction. The sources of
acid are various, but loss of salivary protection is the common theme. In healthy young Australians, soft drinks are the main source of
acid, and exercise
dehydration the main reason for loss of salivary protection. In the medically compromised, diet
acids and
gastroesophageal reflux are the sources, but medications are the main reasons for lost salivary protection. Diet advice for patients with
tooth wear must: promote a healthy lifestyle and diet strategy that conserves the teeth by natural means of salivary stimulation; and address the specific needs of the patients' oral and medical conditions. Individualised, patient-empowering erosion WATCH strategies; on Water,
Acid, Taste,
Calcium and Health, are urgently required to combat the emerging epidemic of
tooth wear currently being experienced in westernised societies.