gastro-oesophageal reflux.10.4.3 Management
Immediate
The most important aspect of the management of tooth surface loss is early diagnosis.
While it is important to treat any dental sensitivity resulting from the tooth surface
loss it is essential to establish the aetiology and, where possible, to eliminate the
cause. This may not always be possible⎯the existence of an underlying eating
disorder cannot be resolved quickly or simply. Indeed, as with all forms of behaviour
modification, the elimination of dietary causes of erosion will often be difficult,
particularly in young adolescents who are no longer under parental control and who
often find it hard to adjust to alternative life-styles and dietary habits. Ideally, the
cause of the tooth surface loss should be eliminated before restorative treatment is
started. In order to achieve this, all patients and parents should be given dietary
counselling which should be personal, practical, and positive. It is important not to
simply advise against all carbonated drinks but to offer positive alternatives, and to
suggest that such drinks may be taken as a treat occasionally and that intake should be
limited to meal times. 574HTable 10.7 gives some practical suggestions that may be made
to patients depending on the aetiology of the problem.
In young patients dental sensitivity may be a problem. Erosive tooth loss may be
rapid and with the large pulp chambers pulpal inflammation is common and
secondary dentine does not have time to form. The use of glass ionomer cements or
resin-based composites as temporary coverage may resolve the sensitivity and also act
as a diagnostic aid.