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Objectives: Previous work has shown protection to eroded teeth offered by a resin-based adhesive lasted up to three months. The hypothesis investigated in this study was whether application of a fissure sealant would offer longer protection., Methods: Seventeen adult patients with palatal tooth wear were recruited and written consent obtained. Metal discs were cemented on the palatal surfaces of all upper anterior teeth following previously published techniques. Alternate teeth within each subject were randomly chosen and coated with a clear fissure sealant using previously published methods. The uncoated teeth were used as controls. Accurate impressions were taken in custom made trays and repeated at 3, 6, 9, 12 and 20 months and scanned using a non-contacting laser profilometer., Results: The mean (standard deviation) thickness of the fissure sealant was 290 μm (500) at the start and after 3 months a mean thickness of 120 μm (260) remained. At this point the control surfaces showed a mean 70 μm (113) of tooth wear. At 6 and 9 months the mean wear for control teeth was higher at 120 μm (114) and 110 μm (114) than sealed teeth at 50 μm (260) and 60 μm (440), respectively. A comparison of paired sites within subjects at their final visit indicated a statistically significant difference in wear between the sealed and control teeth (p=0.016)., Conclusions: The use of fissure sealant to protect palatal dentine surfaces may have a role in prevention of tooth wear for up to a period of nine months., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This study investigated the hypothesis that coating eroded teeth with a resin-based dentin bonding agent gave protection from tooth wear. Nineteen adults with palatal tooth wear exposing dentin were recruited, following referral by their general dental practitioner. Alternate teeth were coated with the resin adhesive, while the uncoated teeth acted as controls. Accurate impressions of the eroded teeth, onto which were cemented machined stainless steel discs to act as reference areas, were scanned with a non-contacting laser profilometer at 3, 6, 12 and 24 months. The mean thickness of resin at baseline application was 0.15 mm and, from 0 to 6 months, the rate of wear of the control teeth was higher than those covered with Seal & Protect. There was a statistically significant difference in "wear" measured between resin covered and control teeth at three months. The Inter Class Correlations (repeated measurements) for the step heights obtained for the original and repeat impressions was excellent at 0.99. This study shows that coating eroded teeth with a resin-based adhesive has the potential to prevent further tooth wear.

Objectives: The role of fluoride in preventing erosion and abrasion on dentine remains unclear. The aim of this study was to investigate the effect of repeated applications of a 0.05% fluoride mouthwash and an adhesive on wear of dentine using stainless steel discs reference points and a laser profilometer., Methods: Small stainless steel discs were bonded to 60 caries free extracted molars which had previously been sectioned horizontally. The teeth were equally divided and subjected to four modalities in an erosion and abrasion laboratory model. Step heights were measured from the metal discs using a non-contacting laser profilometer at 100, 500, 1000, 2500 and 5000 cycles., Results: The results after 5000 cycles showed that dentine coated with a dentine adhesive (0.015 microm, S.D. 0.090) had statistically less wear than fluoride (0.127 microm, S.D. 0.150), abrasion and erosion (0.182 microm, S.D. 0.150) or abrasion only (0.096 microm, S.D. 0.090) (p<0.001)., Conclusion: In conclusion dentine surfaces coated with a resin-based adhesive provided more protection against erosion and abrasion than a fluoride mouthrinse. There were no statistical differences between the modalities for cycles less than 5000.

Purpose: To compare a developmental indirect resin composite with an established, microfilled directly placed resin composite used to restore severely worn teeth. The cause of the tooth wear was a combination of erosion and attrition., Materials and Methods: Over a 3-year period, a total of 32 paired direct or indirect microfilled resin composite restorations were placed on premolars and molars in 16 patients (mean age: 43 years, range: 25 to 62) with severe tooth wear. A further 26 pairs of resin composite were placed in 13 controls (mean age: 39 years, range 28 to 65) without evidence of tooth wear. The material was randomly selected for placement in the left or right sides of the mouth., Results: Sixteen restorations were retained in the tooth wear group (7 indirect and 9 direct), 7 (22%) fractured (4 indirect and 3 direct), and 9 (28%) were completely lost (5 indirect and 4 direct). There was no statistically significant difference in failure rates between the materials in this group. The control group had 21 restorations (80%) that were retained (10 indirect and 12 direct), a significantly lower rate of failure than in the tooth wear patients (P = .027)., Conclusion: The results of this short-term study suggest that the use of direct and indirect resin composites for restoring worn posterior teeth is contraindicated.

Dentine bonding resins may play a role in protecting dentine against acids for patients with erosion. Therefore, it is important to try and understand what potential difficulties may ensue when bonding to worn dentine. This paper reviews the literature on the changes between normal and worn dentine and the effect of this on the bonding to composite resins. A medline search was undertaken using the terms erosion, tooth wear and dentine bonding up until the spring of 2003. Although there are changes on the surface of worn dentine, there is little evidence that this may affect the bond.

The preventative techniques suggested to bulimic patients are frequently undervalued and ignored in favour of restorative treatment, possibly because the dentist may not be aware of the eating disorder. Educating bulimic patients about fluoride application, the use of brushing techniques, antacids, cheese, xylitol chewing gum and the possible use of mouth guards may minimise the effect of acids. Together with attempts at improving patient compliance they can be a valuable adjunct to treatment of bulimic patients with dental problems. Monitoring the wear on teeth by comparing study casts is a good way to maintain control but there are circumstances when restorations are indicated, perhaps when further delay may result in the prognosis of the teeth being compromised. Following a brief introduction to causes of bulimia and the consequences to the dentition, this paper, based on a literature review, considers patient-orientated techniques for prevention and provisional management of erosion of dental hard tissues for patients with bulimia nervosa.