Dental erosion: a complication of pervasive developmental disorder

A young teenage male presenting for a routine check-up reported no health problems. Initial clinical examination revealed some enamel loss on the palatal surfaces of the maxillary incisors. Erosion lesions were suspected. Similar lesions, however, were not found throughout the mixed dentition and radiographic findings were inconclusive. To confirm the diagnosis of these lesions and, more importantly, to disclose the etiology, a thorough and detailed clinical examination of these lesions was conducted. Study models were made, mounted in centric occluding position, and closely screened. In addition, the health history was revisited, by interviewing the patient and his legal guardian. The information gathered led to the conclusion that the lesions in question were erosion lesions with concomitant wear facets that resulted from attrition of the softened enamel surface. An ample light on the possible etiological factors was shed, which assisted in the planning phase for the course of management. It is not uncommon that dental health care providers encounter in daily practice cases of early erosion lesions similar to those reported here. In most of these instances, minor changes in tooth morphology that represent a slight departure from the norm could be overlooked and often ignored. If such lesions go undetected, the underlying causes may escape diagnosis. However, if action is taken to pursue investigation of the causative factor, the result could assist in understanding the overall complexity of the health condition of the patient. This would enable planning the proper course of management for the total well being of the patient.