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PubMed2006

Erosive effect of an antihistamine-containing syrup on primary enamel and its reduction by fluoride dentifrice.

AIM: This study evaluated the action of an antihistamine-containing syrup (Claritin D) on enamel that was subsequently submitted or not to applications of fluoride dentifrice. METHODS; Two hundred sixty-four slices (n=44 per subgroup) prepared from exfoliated primary molars were evaluated in hardness tests. Six subgroups were submitted to different treatments for 10 days. The controls underwent pH cycling with (positive control) or without (negative control) three daily immersions in fluoride dentifrice/distilled water slurry. The test subgroups related to daytime use of the antihistamine syrup underwent pH cycling and two 5-min applications of Claritin D, coupled or not to the three daily immersions in the fluoride slurry. The subgroups related to nocturnal use of the syrup were submitted to the same procedures of daytime subgroups, respectively, but with one of the applications of Claritin D lasting for 8 h. RESULTS: The median hardness values obtained after use of the syrup were significantly lower than the initial ones. Equivalent values for subgroups submitted to fluoride applications in addition to treatment with the syrup were significantly higher. CONCLUSION: It was concluded that the antihistamine-containing syrup reduced the hardness of primary enamel and that, in this experiment, the use of fluoride dentifrice was able to diminish this erosive effect.

Cariostatic Agents↗

PubMedDate not supplied

Preliminary in vitro assessment of erosive potential using the ultra-micro-indentation system.

The aim of this study was to measure the change in hardness and modulus of elasticity of enamel and dentine in primary teeth using the ultra-micro-indentation system (UMIS) after exposure to potentially erosive beverages and to relate the changes to the chemical composition of the test beverages. Primary molar teeth were sectioned and polished. Indentations were made in enamel and dentine prior to and then after exposure to one of four beverages: distilled water (control), orange juice, Orange Cordial, Fanta((R)) and a 'toothfriendly' Tropical Orange Cordial (Ribena((R))). Each beverage was then analysed. Fanta and Orange Cordial were the only test beverages to show a statistically significant reduction in the enamel hardness in comparison to the control and only Fanta showed a significant reduction in dentine hardness. None of the test beverages significantly reduced the modulus of elasticity of either enamel or dentine. Statistically the pH, phosphate and fluoride concentrations of the beverages were correlated with softening of enamel. Calcium concentration and titratable acidity were correlated with softening of dentine. The UMIS offers another method of measuring the basic mechanical properties of enamel and dentine. This is useful in predicting the erosive potential of substrates. It is likely that the pH, titratable acidity, fluoride, phosphate and calcium content of beverages are all important in determining the potential erosiveness of beverages.

Acids↗

PubMed1999

Techniques for the production of dental eroded lesions in vitro.

This project firstly demonstrated an in vitro technique for the production of eroded lesions which simulates the in vivo conditions, and secondly evaluated the influence of salivary parameters on the degree of erosion in vitro. Teeth were sectioned sagitally into three equal portions. The portions were randomly assigned to one of three experimental groups (A, B and C). Lesions were produced by cycling the teeth between orange juice and either artificial saliva (A) or water (B) for a total period of 12 h, or by a single 12 h immersion in orange juice (C). Sections were prepared from each specimen and mineral loss was quantified using transverse microradiography. Mineral loss was significantly lower in group A compared with B and C. Greatest mineral loss was observed in B though not significant when compared with C. The present technique mimics the in vivo conditions with the saliva reducing the degree of erosion and possibly remineralizing the lesions.

Animals↗

PubMed1998

[Investigation on the positions and relevant factors of wedge-shaped defects in the elderly].

OBJECTIVE: To investigate the position and relevant factors of wedge-shaped defects in elderly. METHODS: 462 elderly were examined. RESULTS: The occurrence rate of wedge-shaped defects was 99.1%, all had at least labial or buccal defects, with premolars the most frequent. However, 15.2% of them had lingual defects, most frequently in molars. No significant association were found between wedge-shaped defect position and tooth brushing or erosion factors in the group. In tooth with defect, the occlusal surface wear was more severe, the denture abutment teeth were more in number, and the functional mobility was increased; in teeth with lingual defect, these phenomena were more obvious. CONCLUSION: The wedgeshaped defects, besides tooth brushing and erosion factors, occlusal force and its accumulation plays a role as well, lingual lesions are more related to traumatic occlusal force.

Aged↗

PubMedDate not supplied

A study in vitro of the abrasive effect of the tongue on enamel and dentine softened by acid erosion.

The palatal aspect of upper anterior teeth appears to be one site of predilection for erosion. This raises the question of whether abrasion of softened enamel and dentine by the tongue has a role in this process. The aim of this study in vitro was to determine whether enamel and dentine specimens licked by the tongue after exposure to acid lost more tissue than when exposed to acid alone. Flat enamel and dentine specimens were prepared from human third molars and taped to expose a window of tissue. Three groups of specimens were exposed to citric acid for 10 min followed by 60 s tongue licking, ultrasonication or immersion in water. Two further groups of enamel specimens were placed in a low erosive drink for 10 min with or without licking. At the end of 5, 10 and 15 treatment cycles tissue loss was measured by profilometry. Enamel loss was significantly greater with licking and ultrasonication compared to water immersion. Dentine loss was greater with licking and ultrasonication compared to water immersion, but differences only reached significance for ultrasonication. The low erosive drink produced one third of the citric acid erosion and licking had no effect. The results suggest that the tongue could exert an abrasive effect on dental tissues softened by erosion, thereby increasing the overall loss of tooth substance.

Adolescent↗

PubMed2000

A comparison of the erosive potential of different beverages in primary and permanent teeth using an in vitro model.

The aim of this study was to compare the erosive potential of different beverages and foodstuffs in primary and permanent teeth. Sixty primary and 60 permanent human teeth were immersed for 3 min in the solution under study (5 teeth per treatment group). Surface microhardness was measured before and after exposure. Initial (baseline) surface microhardness was lower for primary teeth than for permanent teeth. In both primary and permanent teeth, Sprite showed the highest decrease in surface microhardness, whereas yogurt showed an increase in surface microhardness in the primary teeth. Overall decrease was 27.2 +/- 17.5 KHN (mean +/- SD) for primary and 25.9 +/- 15.6 KHN for permanent teeth. The comparison of the erosive susceptibility in this in vitro model showed that primary teeth were not more susceptible to erosion compared to permanent teeth.

Beverages↗

PubMed2004

Susceptibility of deciduous and permanent enamel to dietary acid-induced erosion studied with atomic force microscopy nanoindentation.

The initial stages of dental enamel demineralization by dietary acids are of particular clinical relevance. Some authors have reported a difference in the susceptibility of deciduous and permanent enamel to erosion, although other studies could not confirm these findings. The aim of the present study was therefore to investigate whether there are differences in the susceptibility of deciduous and permanent enamel to dietary acid induced erosion (demineralization). Nanoindentation combined with atomic force microscopy was used to investigate the erosive effect of four different drinks (cola, lemonade, juice drink, and water) on enamel at early stages in vitro. Surface nanohardness and reduced elastic modulus were obtained for the soft drink-treated enamel samples as a function of the exposure time. The results obtained showed that the four drinks had widely differing erosive effects due to their diverse compositions. Water did not show statistically significant changes in nanomechanical properties for all exposure times compared with untreated enamel. Exposure of enamel to cola, lemonade and the juice drink led to a statistically significant surface softening of the enamel with cola and the lemonade having a much stronger softening effect than the juice drink. For longer exposure times enamel softening increased for cola and lemonade and stayed unchanged for the juice drink. Deciduous enamel was not found to be more susceptible to erosion than permanent enamel under the conditions of the present study.

Acids↗

PubMedDate not supplied

Effects of two fluoridation measures on erosion progression in human enamel and dentine in situ.

The aim of the present study was to evaluate the effects of fluoride on erosive mineral loss in human enamel and dentine using a cyclic de- and remineralisation model in situ. The study was a three-treatment (5 days each) crossover design involving 4 (enamel) or 6 (dentine) healthy volunteers. Samples were recessed in palatal mouth appliances and worn day and night except during meals and were demineralised extraorally with 0.05 M citric acid (pH 2.3) for 6 x 5 min daily. Fluoridation was performed with toothpaste (SnF2/Olaflur; 0.14% F-) for 3 x 5 min daily (toothpaste fluoridation) or with toothpaste in combination with a mouthrinse (SnF2/Olaflur; 0.025% F-) for 3 x 5 min daily and with a gel (NaF/Olaflur, 1.25% F-) on days 1 and 3 instead of the toothpaste (intensive fluoridation). In the control group no fluoridation was performed. Mineral loss (microm) was determined with the use of longitudinal microradiography. In enamel, mineral loss was 40.7 +/- 15.1 microm in the control group, 18.3 +/- 12.4 microm after toothpaste fluoridation and 5.0 +/- 12.2 microm after intensive fluoridation. The respective values for dentine were 49.0 +/- 15.4, 35.0 +/- 15.5 and 19.8 +/- 12.0 microm. All differences were statistically significant (p < or = 0.001). The results indicate that intensive fluoridation is effective in preventing enamel and dentine from mineral loss even under severely erosive conditions.

Amines↗

PubMed1996

In vitro study of enamel erosion caused by soft drinks and lemon juice in deciduous teeth analysed by stereomicroscopy and scanning electron microscopy.

The erosion caused in vitro by cola-type and guaraná-type beverages (the latter is a soft drink sold in Brazil), and a canned lemon juice on the enamel of human deciduous teeth was analyzed. Morphological analysis of affected enamel was done using stereomicroscopy and scanning electron microscopy (SEM). The harmful effect of all test products on deciduous enamel was clearly demonstrated. Stereomicroscopy showed loss of gloss and an alteration in normal color of enamel, with irregular loss of dental tissue in variable degrees. Such a loss became more serious as the time of incubation increased. Different degrees of solubilization of enamel prisms were demonstrated by SEM, affecting initially the sheaths and the heads of prisms and later their tails. Areas of erosion increased in proportion to the time of incubation. All the products showed a great erosive potential on human deciduous dental enamel.

Beverages↗

PubMedDate not supplied

Influence of the organic matrix on root dentine erosion by citric acid.

This investigation was conducted in an attempt to clarify the role of the organic matrix in bovine dentine demineralisation by 1% citric acid. Dentine slabs (n = 15) were treated for 2 min with 10% sodium hypochlorite (NaOCl, a strong protein solvent), 2% glutaraldehyde (GDA, a protein fixative) or deionised water (DIW, as negative control) prior to each of 5 demineralisation periods of 30 min. The mineral loss (DeltaZ), lesion depth (LD) and surface loss (SL) were determined after each period of demineralisation, by transverse microradiography. The NaOCl-treated group showed higher DeltaZ and LD than the GDA- and DIW-treated groups. No differences between GDA and DIW groups were found. The DeltaZ and LD profiles were explained by quadratic fits (r(2) >0.80; p = 0.001) in all groups. SL was detected only in the NaOCl-treated group. The data suggested that the maintenance of the organic matrix in the lesion might be important to reduce the erosion progression rate.

Animals↗

PubMedDate not supplied

Use of a visible light cured elastomeric resin to stabilize cervical matrix in restoration of Class V erosion lesion.

Effective moisture control and gingival retraction are essential prerequisites for success in the restoration of Class V bonded restorations. Various techniques exist for cervical isolation and moisture control in Class V restorations. This case report details a modified technique in which a visible light cured elastomeric resin was utilized to stabilize a cervical matrix in restoration of a Class V erosion lesion. The resultant customized matrix provides effective isolation, moisture control, and gingival retraction when used in conjunction with Class V restorations.

Dental Cavity Preparation↗

PubMedDate not supplied

Oral manifestations of a child with chronic vomiting.

Perimolysis is a type of intrinsic erosion--an irreversible dental demineralization linked to chronic regurgitation--which causes teeth to be more susceptible to dental caries. The purpose of this case report was to study a 35-month-old chronic vomiting child who visited the Department of Pediatric Dentistry in Yonsei Dental Hospital, Seoul, South Korea, for an evaluation of and treatment for the loss of tooth structure of his primary teeth. To prevent further destruction of the teeth and maintain occlusal height, all the posterior teeth were restored with stainless steel crowns and all the anterior teeth were restored with resin veneer crowns after pulpal treatment under general anesthesia. Therefore, when a child suffering from chronic vomiting visits a pediatric dental clinic, it is prudent to: (1) perform all possible dental treatment to control vomiting's adverse influences on the oral structures; and (2) refer the patient to a pediatrician to determine the cause of vomiting.

Child, Preschool↗

PubMed2006

Minimal intervention dentistry: part 2. Strategies for addressing restorative challenges in older patients.

Minimal intervention dentistry (MID), a modern, evidence-based approach to caries management in dentate patients, uses a medical model whereby disease is controlled by the "oral physician" and an affiliated dental team. Geriatric MID helps clinicians to address the ever-increasing restorative challenges presented by older patients, including erosion, abrasion, demineralization, rampant coronal and root caries, retained roots, recurrent caries (necessitating crowns and other repairs), subgingival caries, "wet" oral environments, salivary dysfunction, disruptive behaviours, poor compliance with preventive care, high plaque levels, and financial and other restrictions on care options. The main components of a geriatric approach to MID are assessment of the risk of disease, with a focus on early detection and prevention; external and internal remineralization; use of a range of restorations, dental materials, and equipment; and surgical intervention only when required and only after disease has been controlled. This second in a series of 2 articles describes direct restorative strategies to address the challenges of geriatric caries management, including choice of material, placement of glass ionomers, sandwich technique, techniques for the management of erosion and abrasion, tunnel and slot preparations, techniques for "wet" subgingival environments, vital pulp therapy and geriatric atraumatic restorative technique.

Aged↗

PubMed2003

Dental erosion in gastroesophageal reflux disease.

Dentists are often the first health care professionals to diagnose dental erosion in patients with gastroesophageal reflux disease (GERD). Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus, and GERD is defined as symptoms or complications of GER. Twenty-four-hour monitoring of esophageal pH is helpful in diagnosing GERD. Treatment of dental erosion resulting from GERD involves a multidisciplinary approach among family physician, dentist, prosthodontist, orthodontist and gastroenterologist. When possible, dental erosion should be treated with minimal intervention, and such treatment should include control of microflora, remineralization, adhesive restorations and use of biomimetic materials.

Dental Restoration, Permanent↗

PubMed2006

Evaluation of a desensitizing test dentifrice using an in situ erosion remineralization model.

OBJECTIVE: To evaluate, in an in situ remineralization model, the ability of a low abrasion fluoride dentifrice containing potassium nitrate to enhance the remineralization of enamel that was previously subjected to an in vitro dietary erosion challenge. METHODOLOGY: Thirteen subjects completed a single-blind (to specimen analyst) crossover design study with four randomly assigned dentifrice treatments: placebo dentifrice (0 ppm F; PD); dose response control dentifrice (250 ppm F; DD); clinically tested fluoride dentifrice (1100 ppm F; FD); and test dentifrice (1150 ppm F + 5% KNO3; TD). Each subject wore a palatal appliance holding eight bovine enamel blocks that were previously exposed for 25 minutes to an in vitro erosive challenge with grapefruit juice. Surface microhardness (SMH) was determined prior to the erosive challenge (baseline), after the in vitro erosive challenge, after in situ remineralization, and after a second in vitro erosive challenge. Statistical analyses included ANOVA and pair-wise comparisons between treatments, testing at a 5% significance level. RESULTS: The mean percent SMH recovery (SD) was 20.4 (7.7)a for PD; 27.4 (5.9)b for DD; 29.5 (8.9)bc for FD; 33.4 (6.7)c for TD. The mean percent net erosion resistance (SD) was -57.7 (10.8)a for PD; -41.3 (11.6)b for DD; -28.7 (9.7)c for FD; -23.6 (7.3)c for TD. Different superscript letters following the means imply statistically significant differences between groups for each response. CONCLUSION: The test dentifrice was shown to significantly enhance the remineralization of enamel previously subjected to an erosion challenge.

Adult↗

PubMed2006

In vitro microhardness studies on a new anti-erosion desensitizing toothpaste.

OBJECTIVE: To evaluate in vitro the efficacy of a new anti-erosion desensitizing toothpaste to inhibit enamel surface softening by a dietary acid, and promote re-hardening of artificial erosive lesions. METHODOLOGY: The ability of the toothpaste to inhibit formation and promote repair of erosive lesions in human enamel has been investigated. In an enamel surface softening study, sound human enamel was pre-treated with one of four toothpaste slurries for two minutes, before exposure to 1.0% citric acid, pH 3.8, for a total of 30 minutes. The surface microhardness (SMH) of the specimens was determined at baseline and at 10-minute intervals using a Struers Duramin-1 microindentor. In an enamel re-hardening study, the erosive lesions were prepared by exposure of the specimens to 1.0% citric acid, pH 3.8, for 30 minutes. After two minutes treatment with a toothpaste slurry, lesion repair was monitored by SMH after 4, 24, and 48 hours incubation in artificial saliva. This remineralizing phase was modified by the addition of an aliquot of the relevant toothpaste slurry, to mimic in vivo carryover of the formulation. RESULTS: The new test formulation, Elmex Sensitive, and Colgate Sensitive exhibited statistically significant inhibition of citric acid-mediated enamel surface softening versus a fluoride-free placebo at all time points. The test toothpaste gave statistically superior protection against the erosive challenge compared to Elmex Sensitive and Colgate Sensitive after 20- and 30-minute exposures. In the remineralization studies, erosive lesions treated with the test toothpaste exhibited statistically superior re-hardening versus lesions treated with Elmex Sensitive and Colgate Sensitive after 24- and 48-hour incubation in the artificial saliva. Lesions treated with Elmex Sensitive re-hardened to a statistically significant extent versus the fluoride-free placebo toothpaste. A re-hardening study, in which a series of the new toothpaste-base formulations containing increasing concentrations of NaF were evaluated, showed a clear fluoride dose response. CONCLUSION: The present microhardness studies show that treatment with fluoride-containing toothpastes helps protect sound enamel from acid-mediated surface softening, and promotes re-hardening of erosive lesions. The new test toothpaste exhibited statistically superior efficacy to Elmex Sensitive and Colgate Sensitive in both in vitro models.

Analysis of Variance↗

PubMed2002

Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.

OBJECTIVES: The objective of this study was to determine the prevalence of dental erosion in preschool children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children. METHODS: A sample of 987 children (2-5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries was defined as caries affecting the smooth surfaces of two or more maxillary incisors. RESULTS: Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to enamel but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). The mean dmft for the 987 children was 4.80 (+/-4.87). Of the 384 children who had caries but not rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out of 267 who were clinically caries free (SND=2.61, P<0.01). Of the 336 with rampant caries, 96 (29%) also had evidence of erosion. CONCLUSIONS: The level of erosion was similar to that seen in children of an equivalent age in the UK. Caries was a risk factor for erosion in this group of children.

Age Factors↗

PubMed2003

Dental erosion in 5-year-old Irish school children and associated factors: a pilot study.

OBJECTIVE: To determine the prevalence of dental erosion in a stratified sample of 5-year-old children and to investigate whether demographic and dietary factors were associated. DESIGN: Cross sectional study in Cork City and County. METHODS: A sample of 202 5-year-old children stratified on fluoridation status was selected. Measurement of erosion used a scoring system and criteria based on those used in the UK. Wear on the palatal and labial surfaces of primary maxillary teeth considered to be predominantly erosive was assessed. Demographic and dietary details were collected via a parental questionnaire. Statistical analysis was stepwise logistic regression. RESULTS: In lifetime residents of fluoridated areas (n = 114) 47% had evidence of erosion; in 21% erosion had progressed to the dentine or pulp. The corresponding figures in non-fluoridated areas (n = 76) were 43% and 21% respectively. The variables significantly associated with erosion to dentine or pulp were low socio-economic status, measured by low family income and the frequency of fruit squash and carbonated drink consumption. CONCLUSION: The prevalence of dental erosion overall was 47%, in 21% erosion affected the dentine or pulp. Levels in fluoridated and non-fluoridated areas were similar. Low socio-economic status and frequency of fruit squash and carbonated drink consumption were associated with erosion extending to dentine or pulp.

Beverages↗