The role of toothpastes and toothbrushes in the aetiology of tooth wear

Abstract

Objectives: To review current knowledge with respect to the epidemiology of abrasive lesions and the evidence for the role of toothpastes and toothbrushes in their aetiology. Materials and methods: 'Medline' databases for the period 1966 to the present day were searched electronically, while the dental literature prior to 1966 was searched manually. In both cases, the key words: tooth abrasion, toothpaste and toothbrush were used. Conclusions: Studies in vitro demonstrate that tooth brushing with abrasive toothpastes produces wear to dentine. Extrapolation of these data to effects in vivo is difficult, but suggests that, under normal use, tooth brushing with toothpaste will cause limited wear of dentine in a lifetime's use. Negligible damage to dentine occurs with a toothbrush alone. Most toothpastes have low relative enamel abrasivity values and, alone, have little or no effect on enamel. Abuse and/or interaction with erosion can increase wear of dentine to pathological levels. Enamel softened by erosive agents is easily removed by any mechanical action.