[Destructive and protective factors in the development of tooth-wear].

The experience of the past decade proves that tooth wear occurs in an increasing number of cases in general dental practice. Tooth wear may have physical (abrasion and attrition) and/or chemical (erosion) origin. The primary physical causes are inadequate dental hygienic activities, bad oral habits or occupational harm. As for dental erosion, it is accelerated by the highly erosive foods and drinks produced and sold in the past decades, and the number of cases is also boosted by the fact that bulimia, anorexia nervosa and gastro-oesophageal reflux disease prevalence have become more common. The most important defensive factor against tooth wear is saliva, which protects teeth from the effect of acids. Tertiary dentin formation plays an important role in the protection of the pulp. Ideally, destructive and protective factors are in balance. Both an increase in the destructive forces, and the insufficiency of defense factors result in the disturbance of the equilibrium. This results in tooth-wear, which means an irreversible loss of dental hard tissue. The rehabilitation of the lost tooth material is often very difficult, irrespectively of whether it is needed because of functional or esthetic causes. For that reason, the dentist should carry out primary and secondary dental care and prevention more often, i.e. dental recall is indispensable every 4-6 months.