Have you ever been in the process of doing a complete exam and see that there is more wear on the posterior teeth than the anterior teeth? Let's think about possible causes that could be causing this.
GERD or 'Coke swishing'
First of all, if you're seeing cupping and cratering just on the lower first molars, then we're thinking that the possibility here is GERD that has occurred in the patient maybe between the ages of 7 and 9 years old. This is where the stomach acid has come back up into the oral cavity. If you're seeing a more generalized cupping and cratering going on on the lower posterior teeth, again, you're thinking of GERD that could be happening that's breaking down the enamel. The second thing that you would consider is 'Coke swishing' where the patient is consuming soda, they're holding it in the oral cavity for a longer period of time before they go ahead and consume or swallow the soda itself.
Another type of wear you might see is if there's generalized wear on the lower posterior teeth as well as the upper posterior teeth. Then we're thinking about fruit mulling where the patient is consuming the fruit, chewing it for long periods of time, again, before they go ahead and swallow. And because of the acidity of the fruit, this is causing the breakdown of the enamel as well.
So the next time when you're doing your complete exam and evaluating the wear and you notice more posterior wear than the anterior wear, think about these possible causes which will lead you to the proper diagnosis, and ultimately, to the proper treatment.