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Aplasia of the parotid gland in Down syndrome.

Salivary gland aplasia has not to our knowledge been previously reported in association with Down syndrome. We present a case of bilateral parotid aplasia in a patient with Down syndrome. Clinically he had aplasia of the major salivary glands and symptoms of xerostomia. Thirteen other family members over three generations were examined, and all had functional parotid glands. We reviewed publications about Down syndrome and salivary aplasia, together with the data regarding his other clinical problems and family background. His oral problems were inadequate plaque control, dental caries, and erosion of the teeth.

Adult↗

Intrinsic causes of erosion.

Gastric juice entering the mouth causes dental erosion. Common causes for the migration of gastric juice through the lower and upper oesophageal sphincters are reflux disease, eating disorders, chronic alcoholism and pregnancy. Gastro-oesophageal reflux is a common condition affecting up to 65% of the western population at some point in their lifetime. A typical clinical sign of acidic gastric juice entering the mouth is palatal dental erosion. As the condition becomes more chronic it becomes more widespread. There have been relatively few randomised studies investigating the aetiology of acids causing erosion. Of the few that have reported their findings, it appears that gastric acids are equally likely to induce moderate-to- severe erosion as in dietary acids. This literature review reports the conditions associated with the movement of gastric juice and dental erosion using medical and dental sources.

Alcoholism↗

An in vitro assessment of the erosive potential of some designer drinks.

The aim of this study was to establish the amount of surface enamel lost following immersion in a number of designer drinks using surface profilometry. Orange juice was used as a positive control. Twenty four designer drinks were tested and it was found that 18 out of 24 of these drinks produced surface enamel loss that was significantly greater by between two and six times than the orange juice control. It was concluded that many of the commercially available designer drinks had considerable erosive potential.

Alcoholic Beverages↗

Comparative study of wear of enamel induced by alternating and simultaneous combinations of abrasion and erosion in vitro.

Two types of interaction of erosive and abrasive forces with human enamel were analysed in an in vitro study. To simulate toothbrushing or chewing after an acidic challenge, enamel specimens were eroded in 0.3% citric acid (pH 3.2), then brushed with or without silica abrasive. To simulate simultaneous erosion and abrasion, as would occur during chewing of abrasive acidic food, enamel specimens were abraded in a toothbrushing machine, with and without silica abrasive, while immersed in citric acid. Enamel wear was measured by profilometry. In both experiments the combination of erosion and abrasion resulted in significantly greater wear than erosion alone, but no significant differences in wear after brushing with or without abrasive were found. Simultaneous erosion and abrasion resulted in about 50% more wear than alternating erosion and abrasion. It is concluded that softened enamel is highly unstable and potentially easily removed by short and relatively gentle physical action. Chewing of acidic foods with some abrasive properties might cause enhanced tooth wear.

Citric Acid↗

Cocaine-associated rapid gingival recession and dental erosion. A case report.

This case report chronicles the clinical presentation and unusual response to treatment of a patient with rapid gingival recession and dental erosion secondary to local cocaine application. The initial clinical diagnosis was necrotizing ulcerative periodontitis; only after several years of therapy did the patient voluntarily inform one of the therapists that cocaine had been regularly applied to the affected gingival sites. This case illustrates the importance of including cocaine application to gingival tissues in a differential diagnosis in cases of rapid gingival recession and dental erosion of unknown etiology.

Administration, Topical↗

Nutrition, diet and dental public health.

Nutrition and diet can affect teeth in three ways: by affecting the structure of teeth (and thus appearance), by causing dental caries and by eroding teeth. The importance of dietary sugars in causing dental caries is clearly established and a reduction in consumption of non-milk extrinsic sugars recommended by government. The Health Education Authority has played a major role in promoting this aspect of dietary advice. The structure of teeth is influenced by nutrition; much of the evidence for this being published by Mellanby and colleagues in this country. Interest in this topic has increased recently and it seems probable that malnutrition enhances susceptibility to dental caries, and possible that it increases susceptibility to enamel defects especially in areas with moderate to high levels of fluoride ingestion. The prevalence and severity of dental erosion is likely to be increasing in Britain. Preliminary studies indicated that fluoride helps to protect teeth against erosion, but more research is needed.

Dental Caries↗

Two-year clinical effectiveness of a resin-modified glass-ionomer adhesive.

PURPOSE: To evaluate the clinical effectiveness of a resin-modified glass-ionomer adhesive FujiBond LC (GC) in non-carious Class V cervical lesions. METHODS: 28 patients and 52 abrasion-erosion lesions were restored using FujiBond LC and a microfilled resin composite in a cavity design with the adjacent enamel margins beveled. Clinical parameters as retention, marginal integrity, clinical microleakage, caries recurrence, esthetics, gingival response, tooth vitality and post-operative sensitivity were evaluated at 6 months, 1 and 2 years. RESULTS: A 100% retention rate was recorded after 2 years of clinical service. However, only 15% of the restorations showed a perfect marginal adaptation. All marginal defects were small, either located at the incisal or at the cervical margin. The percentage of small marginal defects was obviously higher at the incisal enamel margin than at the cervical dentin margin. At the 2-year recall, half of the restorations exhibited a superficial, localized discoloration at the restoration margin, however none of the restorations showed deep, generalized discoloration. Remaining criteria of clinical effectiveness were rated as excellent.

Adult↗

Impact of modified acidic soft drinks on enamel erosion.

OBJECTIVE: To evaluate the enamel erosive potential of modified acidic soft drinks under controlled conditions in an artificial mouth. MATERIALS AND METHODS: From each of 144 bovine incisors one enamel sample was prepared. Labial surfaces of the samples were ground flat, polished and covered with adhesive tape, leaving an exposed area. The samples were distributed among four (A-D) groups for treatment with A: Coca-Cola, B: Sprite; C: Sprite light, D: orange juice. Either 1.0 mmol l(-1) calcium (Ca) or a combination (comb.) of 0.5 mmol l(-1) calcium plus 0.5 mmol l(-1) phosphate plus 0.031 mmol l(-1) fluoride was added to the beverages. Samples of each group were subdivided into three subgroups (-original; -Ca and -comb.) for treatment with original and modified drinks. De- and remineralization cycles were based on a standard protocol described earlier. Surface loss of the specimens was determined using profilometry after test procedure. RESULTS: In all subgroups, loss of enamel was observed. The enamel loss recorded for the samples rinsed with original Sprite and original orange juice was significantly higher compared with all other solutions (P = 0.001). Lowest enamel loss was recorded for the original Coca-Cola group (P = 0.001). With the exception of Coca-Cola, demineralization with the modified beverages led to significantly lower losses compared with the respective original solutions. CONCLUSION: Modification of the test soft drinks with low concentrations of calcium or a combination of calcium, phosphate and fluoride may exert a significant protective potential with respect to dental erosion.

Animals↗

Fruit yogurt: any erosive potential regarding teeth?

OBJECTIVE: The capability of drinks and foods to resist pH changes brought about by salivary buffering may play an important role in the dental erosion process in children. The aim of the present study was to test fruit yogurt, a popular snack for children, and the degrees of saturation (pK-pl) with respect to hydroxyapatite and fluorapatite to determine their erosive potential. METHOD AND MATERIALS: A variety of fruit yogurt was tested. To test the pH, 8 readings were taken with a pH electrode for each yogurt. Calcium content was detected by atomic absorption spectrophotometer, phosphorus by the inductively coupled plasma method, and fluoride content by ion chromatography. The degrees of saturation of hydroxyapatite and fluorapatite were calculated by use of a computer program. Statistical analysis was performed using 2-tailed analysis of variance (P < .05) and a post hoc test (Tukey) to determine differences between groups. RESULTS: The pH of each fruit concentrate was significantly different, except for banana yogurt. Except for the phosphorus content of raspberry yogurt, the calcium and phosphorus content for each fruit concentrate were significantly different. Fluoride levels were the same for all yogurts tested, and the degrees of saturation of hydroxyapatite and fluorapatite was positive, indicating supersaturation. CONCLUSION: It could be stated that fruit yogurt has no erosive potential.

Analysis of Variance↗