Influence of the relative enamel abrasivity of toothpastes (REA value) on the wear of eroded enamel

Zoe S. Moser; Blend Hamza; Florian J. Wegehaupt

doi:10.61872/sdj-2025-02-03

Authors

Zoe S. Moser Clinic for conservative and preventive dentistry, University of Zurich, Zurich, Switzerland
Blend Hamza Clinic for orthodontics and pediatric dentistry, University of Zurich, Zurich, Switzerland
Florian J. Wegehaupt Clinic for conservative and preventive dentistry, University of Zurich, Zurich, Switzerland

DOI:

https://doi.org/10.61872/sdj-2025-02-03

PMID:

40231776

Keywords:

Erosion , Abrasion, Toothpaste, Tooth wear

Abstract

Eroded enamel is more susceptible to abrasion than healthy one. The present study aims to determine the impact of toothpaste abrasiveness (REA-value) and brushing force on enamel wear after erosion. 140 enamel samples from bovine teeth were divided into seven groups (N = 20). Each group was assigned a different toothpaste with varying levels of abrasiveness (groups 1+2: Candida Parodin (REA 2), groups 3+4: Candida Multicare (REA 9), and groups 5+6: Candida White Micro Crystals (REA 19)). The samples were first exposed to a citric acid solution (pH 2.60; 2 min) to simulate an erosive attack and then subjected to brushing with the assigned toothpaste using an automatic brushing machine at 1- and 2-N brushing force. Samples of group 7 were left unbrushed and served as the control group. The erosive/abrasive cycling was repeated 10 times. Enamel wear was measured profilometrically. Higher erosive/abrasive wear was observed in all toothpaste groups compared to the control. In all toothpaste groups, erosive/abrasive wear was significantly higher at 2-N brushing force than 1 N (P < 0.05). At 1-N and 2-N force, Candida Parodin showed lower enamel wear than Candida Multicare and Candida White Micro Crystals. The results showed that toothpastes with higher REA values result in greater abrasion of eroded enamel, but only up to a certain value. Eroded tooth structure is more prone to abrasion at higher contact pressure, but REA value has a greater influence. Patients with erosion should use toothpaste with low REA value and avoid excessive contact pressure.

References

1. Menghini G, Steiner M, Thomet E, Rath C, Marthaler T, Imfeld T. Weiterer Kariesrück-gang bei Schweizer Rekruten von 1996 bis 2006. Schweiz Monatsschrift Für Zahnmed SMfZ. 2010;120:596–600.

2. Steiner M, Menghini G, Marthaler TM, Imfeld T. Kariesverlauf über 45 Jahre bei Zürcher Schülern. Schweiz Monatsschrift Für Zahnmed SMfZ. Dezember 2010;120:1095–104.

3. Menghini G, Steiner M, Marthaler T et al. Kari-esprävalenz von Schülern in 16 Zürcher Land-gemeinden in den Jahren 1992 bis 2000. Schweiz Monatsschrift Für Zahnmed SMfZ. März 2003;113:267–77.

4. Stehr C. Prävention zeigt Erfolg: Verbesserung in allen Altersgruppen. Freie Zahnarzt. 1. Sep-tember 2016;60:9–9.

5. Schlueter N, Luka B. Erosive tooth wear–a review on global prevalence and on its preva-lence in risk groups. Br Dent J. 2018;224:364–70.

6. Hara A, Lussi A, Zero D. Biological Factors. Monogr Oral Sci. 1. Februar 2006;20:88–99.

7. Franzò D, Philpotts CJ, Cox TF, Joiner A. The effect of toothpaste concentration on enamel and dentine wear in vitro. J Dent. Dezember 2010;38:974–9.

8. Wiegand A, Burkhard JPM, Eggmann F, Attin T. Brushing force of manual and sonic toothbrush-es affects dental hard tissue abrasion. Clin Oral Investig. 2013;17:815–22.

9. Hellwig E, Schäfer E, Klimek J, Attin T. Einfüh-rung in die Zahnerhaltung: Prüfungswissen Ka-riologie, Endodontologie und Parodontologie: mit 235 Abbildungen in ca. 300 Einzeldarstel-lungen und 68 Tabellen. 7. überarbeitete Auf-lage. Köln: Deutscher Zahnärzte Verlag; 2018. 699 S, pp 64.

10. Lippert F. An Introduction to Toothpaste - Its Purpose, History and Ingredients. In: Van Lo-veren C, Herausgeber. Monographs in Oral Science [Internet]. S. Karger AG; 2013 [zitiert 25. November 2024]. pp. 1–14. Verfügbar un-ter: https://karger.com/books/book/242/chapter/5167219

11. Hamza B, Attin T, Cucuzza C, Gubler A, Wege-haupt FJ. RDA and REA Values of Commercially Available Toothpastes Utilising Diamond Pow-der and Traditional Abrasives. Oral Health Prev Dent. 4. September 2020;18:807–14.

12. Wiegand A, Köwing L, Attin T. Impact of brush-ing force on abrasion of acid-softened and sound enamel. Arch Oral Biol. 1. November 2007;52:1043–7.

13. Hamza B, Martinola L, Körner P, Gubler A, Attin T, Wegehaupt FJ. Effect of brushing force on the abrasive dentin wear using slurries with dif-ferent abrasivity values. Int J Dent Hyg. Febru-ar 2023;21:172–7.

14. Steiger-Ronay V, Tektas S, Attin T et al. Com-parison of Profilometric and Microindentation Analyses for Determining the Impact of Saliva on the Abrasion of Initially Eroded Enamel. Car-ies Res. 2019;53:33–40.

15. Klimek J, Hellwig E, Ahrens G. Fluoride Taken Up by Plaque, by the Underlying Enamel and by Clean Enamel from Three Fluoride Compounds in vitro. Caries Res. 17. November 2009;16:156–61.

16. Wiegand A, Schwerzmann M, Sener B et al. Impact of toothpaste slurry abrasivity and toothbrush filament stiffness on abrasion of eroded enamel - an in vitro study. Acta Odontol Scand. August 2008;66:231–5.

17. Wegehaupt FJ, Högger VGM, Attin T. Abrasion of eroded and sound enamel by a dentifrice containing diamond abrasive particles. SWISS Dent J SSO – Sci Clin Top. 24. Juli 2017;127:634–9.

18. Attin T, Wegehaupt F, Gries D, Wiegand A. The potential of deciduous and permanent bovine enamel as substitute for deciduous and perma-nent human enamel: Erosion–abrasion experi-ments. J Dent. 1. Oktober 2007;35:773–7.

19. Attin T, Becker K, Roos M, Attin R, Paqué F. Impact of storage conditions on profilometry of eroded dental hard tissue. Clin Oral Investig. Dezember 2009;13:473–8.

20. Rios D, Honório HM, Magalhães AC et al. Influ-ence of toothbrushing on enamel softening and abrasive wear of eroded bovine enamel: an in situ study. Braz Oral Res. April 2006;20:148–54.

21. Rios D, Honório HM, Magalhães AC et al. Effect of Salivary Stimulation on Erosion of Human and Bovine Enamel Subjected or Not to Subse-quent Abrasion: An in situ/ex vivo Study. Caries Res. 19. Mai 2006;40:218–23.

22. Tawakoli PN, Becker K, Attin T. Abrasive effects of diamond dentifrices on dentine and enamel. SWISS Dent J SSO – Sci Clin Top. 17. Januar 2018;128:14–9.

23. Tawakoli PN, Sener B, Attin T. Mechanical ef-fects of different Swiss market-leading denti-frices on dentin. Evaluation of cleaning poten-tial, relative dentin abrasion and surface roughening. SWISS Dent J SSO – Sci Clin Top. 16. November 2015;125:1210–9.

24. Wegehaupt FJ, Schleich J, Hamza B, Wiedemei-er D, Attin T. Performance of a newly devel-oped mineral gel system on erosive and ero-sive/abrasive enamel loss An in vitro study. 10. September 2018 [zitiert 25. Juni 2024]; Verfüg-bar unter: https://www.zora.uzh.ch/id/eprint/158144

25. Wiegand A, Attin T. Design of Erosion/Abrasion Studies – Insights and Rational Concepts. Caries Res. 2011;45:53–9.

26. Ganss C, Schlueter N, Preiss S, Klimek J. Tooth brushing habits in uninstructed adults – fre-quency, technique, duration and force. Clin Oral Investig. Juni 2009;13:203–8.

Influence of the relative enamel abrasivity of toothpastes (REA value) on the wear of eroded enamel

Authors

DOI:

PMID:

Keywords:

Abstract

References

Downloads

Published

How to Cite

Issue

Section

License

How to Cite

Make a Submission

sdj_editors

Latest publications