Dental Erosion and Therapeutic Options

Tooth wear is a common, multifactorial non-carious dental hard tissue disease, and it may lead to a range of problems such as hypersensitivity, occlusal dysfunction, and aesthetic defects, significantly impacting patients’ oral health and quality of life. This article aims to systematically review the clinical assessment, diagnostic methods, pathophysiology, and etiological classification of tooth wear, with a focus on discussing evidence-based restorative and pharmacological management strategies, thereby providing a theoretical basis and practical guidance for clinical practice. This review provides an overview of the fundamental concepts and classification of tooth wear, encompassing both mechanical and chemical forms. With regard to clinical assessment, it outlines fundamental examination methods such as visual inspection and history taking, and reviews the application and development of standardized indices, including the Basic Erosive Wear Examination (BEWE) and the Tooth Wear Index (TWI), as well as adjunctive tools like intraoral photographs. In terms of etiology, it analyzes the interaction mechanisms of mechanical wear (attrition and abrasion), chemical wear (erosion), and biomechanical fatigue, and further classifies etiological factors according to typical location and morphological characteristics. Regarding treatment, this review emphasizes etiological intervention and risk factor management, and evaluates the performance and indications of restorative materials such as composite resin, ceramic, and CAD/CAM resin matrix composites. It also discusses key techniques for achieving durable long-term bonding, as well as the value and future prospects of integrating digital workflows, such as intraoral scanning and digital smile design (DSD), into diagnosis, treatment planning, and clinical management. In addition, it reviews pharmacological strategies for tooth wear, especially topical remineralizing agents, from the perspective of therapeutic targets and mechanisms of action. The modern management of tooth wear depends on early identification and accurate etiological diagnosis, appropriate selection of restorative materials based on long-term performance, and the synergistic application of minimally invasive adhesive techniques, digital technologies, adjuvant pharmacological therapies, and individualized risk control throughout the treatment process.