How to Diagnose and Monitor Erosive Tooth Wear and When Is It an Oral Disease?

Erosive tooth wear, characterized by the impact of non-bacterial acids as the predominant primary causal factor, has become a growing concern in dentistry. This review explores the diagnostic challenges associated with erosive tooth wear, its distinction from other forms of tooth wear such as attrition and abrasion and the need for early detection to prevent severe damage. The morphological features of erosive wear, the clinical assessment methods, including the use of indices like the Basic Erosive Wear Examination, and modern technological advancements, such as intraoral scanners, for monitoring wear progression are outlined. What also is addressed is the ongoing debate over whether erosive tooth wear constitutes an oral disease, suggesting that while it may be considered pathological when accompanied by symptoms like pain or functional impairment, minor wear may be a normal ageing process. Further research and discussion are needed to refine diagnostic criteria and determine the threshold at which erosive tooth wear becomes pathological in order to avoid medicalization, wish-fulfilling dentistry and disease mongering.