Topical Agents for Nonrestorative Management of Dental Erosion: A Narrative Review

Abstract

A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

Morphological and Elemental Evaluation of Investigative Mouthwashes to Repair Acid-Eroded Tooth Surface

“…The other three investigated mouthwash formulations that do not contain HWP were effective in depositing mineral layers that covered the eroded enamel surface, with strong bonding and biocompatibility between the new layer and the eroded enamel surface, such that the layers were not dislodged by ultrasonication. This finding agrees with the reports of previous studies, 19 , 27 and it is not surprising considering that all samples had a long exposure to remineralizing artificial saliva that contained all the major components of natural saliva (calcium, phosphate, magnesium, chloride, potassium, and hydroxyl ions), and its efficacy in remineralizing eroded lesion has been demonstrated. 19 …”

“…Fluoride compounds, HAP, CPP-ACP, CPP-ACP-F, and certain self-assembling peptides applied as toothpaste, mouthwash, brush-on liquid, varnish, or gel have been very effective in remineralizing the demineralized tissue but not the repair of the lost tissue. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Certain proteins have been successfully used to form scaffolds that modulate the mineralization of organized calcium phosphate crystallites and have shown great potential. [36][37][38][39][40] Thus, in the present study, we investigated the effectiveness of new mouthwash formulations containing varying concentrations of HWP in repairing eroded enamel tissue through the promotion of organized crystal growth on an acid-eroded enamel surface.…”

“… 26 CPP-ACP with fluoride (CPP-ACP-F) was found to be more effective at remineralizing eroded tooth surfaces than CPP-ACP without fluoride. 21 , 27 Another study comparing CPP-ACP-F paste and 0.2% sodium fluoride mouthwash found that both the mouthwash and the paste were effective; however, the 0.2% sodium fluoride mouthwash was more effective at preventing dental erosion. 28 Several studies have demonstrated the potential of synthetic HAP to remineralize eroded tooth surfaces by forming a protective layer that acts as an expendable shield that protects the tooth material from further acidic attacks.…”

The Effect of Epigallocatechin Gallate Extract on Dental Erosion an in Vitro Study

“…It is made up of K + and NO3 -, is thus a metal nitrate. It is commonly used to protect against tooth sensitivity (5). Nitrate decreases the flow of fluid through the tubules by obstructing them, decreases the activity of the dental sensory nerves, and prevents or reduces the sensory signals from reaching the brain (5).The action potential in the intradental nerves is blocked by potassium ions.…”

“…According to several reports, drinking green tea lowers your risk of developing ailments including heart disease and teeth decay There are four different types of polyphenols in tea: epigallocatechin-3-gallate (EGCG), epigallocatechin (EGC), epicatechin-3-gallate (ECG), and epicatechin (EC). The largest amount present is of EGCG, about 50% (5).…”