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Gastric erosion — Clinical Guidelines

Overview

Gastric erosion, often discussed in the context of dental erosion, refers to the chemical wear of tooth enamel caused by acids from intrinsic sources (e.g., gastroesophageal reflux disease) or extrinsic sources (e.g., acidic foods and beverages). 1 3

Diagnosis

Screen for intrinsic causes: Anorexia nervosa, bulimia nervosa, rumination syndrome, gastroesophageal reflux disease. 1

Assess extrinsic factors: Dietary history focusing on acidic foods and beverages, habits like prolonged exposure (holding/swishing). 1 6

Clinical examination: Evaluate tooth structure loss and correlate with patient history. 3 6

Photographic documentation: Use color photographs to document erosion patterns and progression. 6

Management

Dietary modifications: Reduce intake of acidic foods and beverages; counsel on proper oral hygiene practices. 1 6

Restorative options: Use direct composite restorations for reversible repair of eroded tooth surfaces. 2

Behavioral changes: Advise against habits that prolong acid exposure on teeth. 1

Special Populations

No specific guidelines: Abstracts do not provide detailed management for pregnancy, pediatrics, elderly, or specific comorbidities related to gastric erosion. 1 2 3 6

Key Recommendations

Screen patients with dental erosion for underlying medical conditions such as gastroesophageal reflux disease, eating disorders, and habits that prolong acid exposure. (Evidence: Strong 1)

Implement dietary counseling to minimize exposure to acidic substances and modify behaviors that exacerbate erosion. (Evidence: Moderate 1 6)

Consider restorative treatments like direct composite restorations for managing dental erosion effectively. (Evidence: Weak 2)

References

1 Marshall TA. Dietary assessment and counseling for dental erosion. Journal of the American Dental Association (1939) 2018. link 2 Milosevic A. Acid Erosion: An Increasingly Relevant Dental Problem. Risk Factors, Management and Restoration. Primary dental journal 2017. link 3 Shipley S, Taylor K, Mitchell W. Identifying causes of dental erosion. General dentistry 2005. link 4 Chu P, Crosthwaite GL. Gastric foreign bodies: no longer a cross to bear. The Australian and New Zealand journal of surgery 1999. link 5 Liu C, Buckley R. The role of the therapeutic contact lens in the management of recurrent corneal erosions: a review of treatment strategies. The CLAO journal : official publication of the Contact Lens Association of Ophthalmologists, Inc 1996. link 6 Eccles JD. Dental erosion of nonindustrial origin. A clinical survey and classification. The Journal of prosthetic dentistry 1979. link90196-3)

Gastric erosion