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PubMed2001

Erosive potential of oral care products.

Seven oral care products and orange juice as a positive control were tested for the erosive potential by immersing each enamel specimen (10 per group) into solutions of the various products for 10 and 20 min. Before and after the experiment Knoop surface hardness (SMH) was measured. The enamel microstructure before and after immersion was assessed by scanning electron microscopy and confocal laser scanning microscopy. Orange juice produced the most marked losses of hardness after 10 and 20 min. Among the dental hygiene products only the fluoride-free toothpaste produced a significant reduction of hardness after 10 as well as after 20 min. With the exception of Elmex gel, all tested oral care products led to a significant (p < 0.05) increase of enamel hardness. The results of the hardness measurements corresponded with the microstructure findings. It may, therefore, be concluded that the tested fluoride-containing oral care products do not exhibit any erosive potential, which could be picked up with the methodologies under study.

Amines↗
PubMedDate not supplied

Fluoride is unable to reduce dental erosion from soft drinks.

The main aim of the present study was to compare the erosive capabilities of some fruit-flavoured drinks, fresh or saturated with CaF2, with their content of acids and with previous results from some carbonated soft drinks. The other aim was to measure and compare the rates of dissolution of CaF2 in some carbonated and non-carbonated drinks and water. Seven commercially available fruit-flavoured drinks were diluted for drinking. Two human molars, each with two approximately 4 x 4 mm windows, were exposed continuously to 500 ml of each drink with or without prior equilibration with CaF2 under gentle agitation for 48 h. The depths of the erosions were then measured on microradiographs made from sections. Dissolution rate of CaF2 was measured by suspending 0.5 g of the salt in 0.5 litre of the drinks for 2, 10 and 60 min followed by solution analysis. The pH of the drinks was 2.83-3.51. The amount of NaOH required to bring pH to 5.5 ranged from 12-42 mmol/l, which is more than the amount necessary for most carbonated soft drinks. Equilibration with CaF2 gave total fluoride concentrations of 3-8 ppm. The depths of the lesions induced by the drinks without added fluoride were 450-625 microm whilst those developed by the drinks equilibrated with CaF2 were 350-625 microm. The dissolution of CaF2 was faster in the carbonated drinks and in distilled water than in the non-carbonated drinks. In conclusion, non-carbonated fruit-flavoured drinks contain considerable amounts of acids which, in vitro, induce erosions in teeth similar to those induced by carbonated soft drinks. Saturation with CaF2 reduced the in vitro development of erosions by 28% induced by drinks with pH above 3; in drinks with pH below 3, erosions were not affected by pH, despite total fluoride concentrations of up to 20 ppm.

Beverages↗
PubMed2006

Effect of an iron mouthrinse on enamel and dentine erosion subjected or not to abrasion: an in situ/ex vivo study.

OBJECTIVES: This in situ/ex vivo study evaluated whether a rinse with an iron solution could reduce wear and the percentage of microhardness change of human enamel and dentine submitted to erosion followed by brushing after 1 or 30min. DESIGN: During 2 experimental 5-day crossover phases (wash-out period of 10 days), 10 volunteers wore intraoral palatal devices, with 12 specimens (6 of enamel and 6 of dentine) arranged in 3 horizontal rows (4 specimens each). In one phase, the volunteers immersed the device for 5min in 150mL of cola drink, 4 times a day. Immediately after immersion, no treatment was performed in one row. The other row was brushed after 1min using a fluoride dentifrice and the device was replaced into mouth. After 30min, the remaining row was brushed. In the other phase, the procedures were repeated, but after immersion the volunteers rinsed for 1min with 10mL of a 10mM ferrous sulphate solution. Changes in surface microhardness (%SMH) and wear (profilometry) of enamel and dentine were measured. Data were tested using ANOVA and Tukey's tests (p<0.05). RESULTS: The enamel presented more wear than dentine, under all experimental conditions. The iron solution caused a significant reduction on the %SMH in enamel, and a significant reduction on the wear in dentine, regardless the other conditions. CONCLUSIONS: Rinsing with an iron solution after an erosive attack, followed or not by an abrasive episode, may be a viable alternative to reduce the loss of dental structure.

Adult↗
PubMed2002

Comparison of factors potentially related to the occurrence of dental erosion in high- and low-erosion groups.

Soft drink intake, method of drinking, pH variations, plaque topography, and various salivary, microbial and clinical factors were compared in Saudi men with high (n = 10, mean = 20.5 yr) and low (n = 9, mean = 20.3 yr) dental erosion. pH-measurements were carried out with a microtouch electrode at six different intraoral locations after the subjects had consumed 330 ml of regular cola-type drink in their customary manner. The results showed that higher intake of cola-type drinks was more common in the high- (253 l yr(-1)) than in the low-erosion group (140 l yr(-1)). High erosion was associated with a method of drinking whereby the drink was kept in the mouth for a longer period (71 s vs. 40 s). pH after drinking did not differ between the groups for any of the six measuring sites. Plaque accumulation on the palatal surfaces of maxillary anterior teeth and urea concentration in unstimulated saliva were lower in high-erosion subjects. Aside from these, there were no differences in salivary and microbial factors between the groups. First molar cuppings, buccal cervical defects, and mouth breathing were more common in the high- than in the low-erosion group. In summary, consumption of cola-type drink, method of drinking, amount of palatal plaque on anterior teeth, and salivary urea concentration are factors associated with dental erosion.

Adult↗
PubMed1987

Esthetic management of perimolysis with porcelain laminate veneers.

This report deals with the dental manifestations of bulimia nervosa. Differential diagnosis of perimolysis was identified and compared with other manifestations of systemic or exogenous causal factors. Conservative cosmetic dental management of the dental erosion that occurred as a result of bulimia nervosa was described and discussed in comparison with other currently accepted treatment modalities.

Adult↗
PubMedDate not supplied

Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study.

PURPOSE: The aim of this study was to investigate the effects of gastroeophageal reflux disease (GERD) on: (1) erosion; (2) caries formation; (3) salivary function; and (4) salivary microbiological counts. METHODS: Thirty-eight GERD patients with a mean age of 6 1/2 years and 42 healthy children of the same age and gender and social background comprised the study group. All subjects answered a detailed frequency questionnaire related to acidic drinks, foods, and sugar consumption and participated in a clinical dental examination. The caries experience of the children was recorded according to World Health Organization criteria, and erosion was scored according to the Eccles and Jenkins grading scale. The children were also investigated for stimulated salivary flow rate, buffer capacity, and salivary mutans streptococci (MS), lactobacilli, and yeast colonization. RESULTS: The prevalence of dental erosion and the salivary yeast and MS colonization in GERD children was found to be significantly higher than for healthy subjects (P<.05). The caries experience, salivary flow rate, buffering capacities of the children, and frequency of acidic drinks, foods, and sugar consumption were found to be similar in both groups. CONCLUSION: This current investigation has shown that GERD children were at an increased risk of developing erosion and caries compared with healthy subjects.

Candida albicans↗
PubMed2001

Investigation of an index to measure tooth wear in primary teeth.

UNLABELLED: Tooth wear, in particular erosion, has been reported to be widespread in children in the UK. Wear may affect either dentition, but epidemiological measurement has proved difficult. OBJECTIVES: The objectives of this study were: (a) to investigate use of a simple index of wear in primary teeth; and (b) to compare findings from visual examination and from photographs with those at histological examination of the same teeth. SAMPLE AND METHODS: Forty-one exfoliated or extracted primary anterior teeth were assessed visually and using photographs. Ground sections of the teeth were prepared and examined using polarised light microscopy. RESULTS: On visual examination, 31 of the 41 teeth had evidence of wear. In 14 teeth, tissue loss was confined to enamel and in 17 it extended into dentine. Findings on photographs were very similar to those on visual examination. Of the 10 teeth without erosion visually, two had evidence of loss on histological examination. Of the 14 with visual evidence of erosion confined to enamel, dentine was exposed in 11 cases. Diffuse demineralisation was evident histologically in 11 of the 31 teeth with evidence of erosion. CONCLUSIONS: It was concluded that clinical assessment of erosion may underestimate the extent of the condition. Under the conditions of the study, photographs gave results similar to those on visual examination.

Child↗
PubMed1998

A method to measure clinical erosion: the effect of orange juice consumption on erosion of enamel.

OBJECTIVE: Acidic soft drinks are frequently implicated in dental erosion, but there are limited supporting data. Research is problematic due to the insidious nature of erosion and accuracy in assessing tissue loss. The aim of this study was to develop and validate, using a negative control, a model to accurately measure erosion in situ due to a single aetiological agent over a relatively short time period. METHODS: An intra-oral appliance capable of retaining an enamel sample was designed in order to assess the effect of orange juice consumption on enamel. The study was a single centre, randomized, placebo controlled, blind, crossover design. RESULTS: Ten subjects, each consuming 11 of orange juice per day for 15 days, showed significantly more erosion on the enamel specimens than the same subjects consuming 11 of water per day over the same time period, measurements undertaken with surfometry. The same investigation was performed in vitro. Again, orange juice was significantly more erosive; indeed, it was in the order of 10 times that produced in situ. Surface microhardness testing in situ and in vitro demonstrated statistically significant differences between exposed and unexposed areas after orange juice treatment. CONCLUSIONS: Changes produced by water either in situ or in vitro were always well within the baseline measurement parameters (+/- 0.3 micron) set down for the method and hence validated the clinical model in terms of reproducibility and accuracy in measurement. It is concluded that this method has confirmed the erosive potential of orange juice in situ. The method could have many applications to study dental erosion under highly controlled conditions and over realistic time periods.

Adult↗
PubMed2002

Gastroesophageal reflux disease and dental erosion in children.

Recurrent exposure to gastric acid as in children with bulimia and gastroesophageal reflux disease (GERD) may contribute to dental erosion. We performed a prospective study to evaluate the presence of GERD and dental erosions in children with primary and permanent dentition. Children undergoing elective endoscopy for possible GERD (n = 37) underwent evaluation of their teeth for the presence, severity, and pattern of erosion and stage of dentition: 24 patients had GERD. Dental erosions were identified in 20; all had GERD. Erosion patterns showed more involvement of the posterior teeth. Many affected patients had primary dentition.

Adolescent↗
PubMed2005

Relationship between enamel erosion and liquid flow rate.

The association of severe erosion with certain habits of consuming soft drinks prompted a study of erosion in relation to fluid flow. In the main experiments, citric acid solution (pH 3.2) was directed at polished enamel surfaces at flow rates of 26, 67 or 126 ml min(-1) through outlets of diameters 1.0, 2.6 or 5.0 mm for up to 20 min. Erosion depth increased with time of exposure and total volume of solution, with increasing flow rate and with decreasing outlet diameter. Scanning electron microscopy of acid-treated surfaces and of the subsurface enamel indicated that the clearance of dissolution products, rather than the mechanical dislodgement of partly dissolved crystal bundles, was the main process involved. For an exposure time of 20 min, erosion increased with (liquid velocity)(1/4). In a secondary experiment, it was found that the erosive potential of a low-erosive drink did not increase with increasing liquid velocity. The rapid increase in the rate of erosion caused by citric acid at low liquid velocities shows that reproducible stirring is essential for precision and intercomparison of in vitro studies. It also accounts for the rapid erosion seen when erosive drinks are consumed from a straw placed labial to the anterior teeth, or are "swished" between the teeth.

Carbonated Beverages↗
PubMed1994

Aetiological, predisposing and environmental factors in dentine hypersensitivity.

If the hydrodynamic theory of stimulus transmission across dentine is valid, sensitive dentine has tubules open at the surface and patent to the pulp. Direct and indirect evidence supports this supposition. Factors that result in dentine exposure remove the covering enamel or periodontal tissues (gingival recession). Epidemiological and clinical data for the distribution of exposed cervical dentine indicate that chronic trauma from physical and chemical factors is the most significant aetiological factor. Brushing with a toothpaste may not open dentinal tubules. It is more likely that toothpaste ingredients, when brushed on dentine, would create a smear layer. Exposure of tubules by erosion is probably the major initiator of sensitivity. An increase in our understanding of the aetiological factors involved in dentine hypersensitivity is essential if a sound approach to its management is to evolve. Such information could emanate from epidemiological studies, clinical investigations and laboratory experiments.

Beverages↗
PubMed1984

Dental management of the chronic vomiting patient.

A review of dental erosion secondary to medical or psychologic causes (or both) has been presented. Clinical signs and symptoms and appropriate restorative therapy have been discussed. Diagnosis and stabilization of the chronic vomiting patient must precede definitive restorative procedures.

Chronic Disease↗
PubMed2002

[Dental mask of gastroesophageal reflux disease].

In the last few years the interest of extraesophageal symptoms of gastroesophageal reflux disease is getting greater and greater. Because of it is often appearance, this disease is noticed not only by gastroenterologists, but also other doctors and dentists. They think that pathological, backward reflux of esophagus in many cases can be responsible for dental organ disease. Clinical research proofs that often pouring the sour mixture from the stomach into the esophagus and then to mouth can cause a diminution in the teeth such as: erosion and decay. The background agum and tounque can be gastroesophageal reflux disease. acquantance with this facts among the dentists can help to make a diagnosis and treat well patients with a pathological reflux of esophagus.

Dental Caries↗
PubMed1999

Development and evaluation of a low erosive blackcurrant juice drink in vitro and in situ. 1. Comparison with orange juice.

OBJECTIVE: The aim of this study was to determine whether an experimental blackcurrant juice drink with added calcium was less erosive to enamel both in vitro and in situ compared with a proprietary orange juice product. METHODS: The study was a single centre, blind, randomised, placebo controlled three cell crossover design. An intra oral appliance capable of retaining one enamel sample in situ was constructed and worn by 12 volunteers. The drinks under test were orange juice, the experimental blackcurrant juice drink with calcium and water. Drinks were consumed as 250 ml volumes four times during the working day under supervision for 15 days. The same methodology was modelled in vitro. Measurements of enamel loss were made by profilometry. RESULTS: Water, the experimental blackcurrant juice drink and orange juice produced 0.19, 0.41 and 2.54 microns loss of enamel respectively in situ and 0.0, 5.2 and 22.18 microns loss of enamel respectively in vitro. All differences between pairs of drinks in situ and in vitro were statistically significant. CONCLUSIONS: Data using this model in situ were only available for orange juice and this was therefore considered as a positive control with water a placebo control. The results have demonstrated that the experimental blackcurrant juice drink with calcium is markedly less erosive than orange juice, particularly and importantly in situ. The experimental blackcurrant juice drink has limited erosive potential to teeth and deserves further comparative investigation and development as a low pH fruit drink for public consumption.

Adult↗
PubMed2006

Effect of salivary stimulation on erosion of human and bovine enamel subjected or not to subsequent abrasion: an in situ/ex vivo study.

This in situ/ex vivo study evaluated whether saliva stimulated by chewing gum could prevent or reduce the wear and the percent change in microhardness (%SMH) of bovine and human enamel submitted to erosion followed by brushing abrasion immediately or after 1 h. During 2 experimental 7-day crossover phases, 9 previously selected volunteers wore intraoral palatal devices, with 12 enamel specimens (6 human and 6 bovine). In the first phase, the volunteers immersed the device for 5 min in 150 ml of cola drink, 4 times per day (at 8, 12, 16 and 20 h). Immediately after the immersions, no treatment was performed in 4 specimens, 4 other specimens were immediately brushed (0 min) using a fluoride dentifrice, and the device was replaced into the mouth. After 60 min, the remaining 4 specimens were brushed. In the second phase, the procedures were repeated, but after the immersions, the volunteers stimulated the salivary flow rate by chewing a sugar-free gum for 30 min. Changes in wear and %SMH were measured. ANOVA and Tukey's test showed statistical differences (p<0.05) for the following comparisons. The chewing gum promoted less wear and %SMH. A decreasing %SMH and an increasing enamel wear were observed in the following conditions: erosion only, 60 min and 0 min. The human enamel presented greater %SMH and less wear compared to bovine enamel. The data suggest that the salivary stimulation after an erosive or erosive/abrasive attack can reduce the dental wear and the %SMH.

Adult↗
PubMed1988

Dental erosion and upper gastrointestinal disorders.

The orodental status, particularly dental erosions, of 109 patients with upper gastrointestinal symptoms was examined. In 44 patients, the underlying pathosis was associated with increased acid output in the stomach (reflux esophagitis or duodenal ulcer), while in 48 patients who underwent cholecystectomy, the duodenogastric reflux was alkaline. In 17 patients with gastric ulcer, the gastric secretion was usually normal. The diagnoses were made with gastroscopy. Seven patients with dental erosion were found, and they all came from the group of 35 dental patients with reflux esophagitis or duodenal ulcer. No erosions were seen in the other diagnostic groups (F = 0.02). Thus, gastrointestinal disorders with increased output of gastric acid may be linked with dental erosions. The finding emphasizes the need for accurate diagnosis and appropriate treatment of patients with upper gastrointestinal symptoms in order to avoid irreversible lesions in the teeth.

Adult↗
PubMedDate not supplied

The pH and titratable acidity of a range of diluting drinks and their potential effect on dental erosion.

OBJECTIVES: To investigate, in vitro, the potential dental effects of diluting juices by measuring their acidity levels and to examine the effect dilution has on the potential erosive properties of the drinks. METHODS: Four commonly available diluting drinks were assessed for both pH and titratable acidity at a variety of dilutions, reflecting the range of concentrations over which such drinks may be consumed. Predetermined dilutions of citric acid and hydrochloric acid, with similar pH values to those of the drinks, were used as positive control acidic solutions. The pH measurements throughout the study were made using a pH electrode connected to an Orion EA940 IonAnalyser. RESULTS: All four drinks demonstrated a high degree of resistance to a rise in pH, indicating high intrinsic buffering capacity. The measured pH changed very little with increasing dilution ratio when compared to the citric and hydrochloric acid controls, even when considered extremely dilute. In contrast, the titratable acidity of each of the drinks reduced proportionally with increasing dilution, thereby reducing considerably its erosive potential. CONCLUSIONS: While dilution had very little effect on the measured pH values, the titratable acidity reduced as the drink became more dilute. Since there appears to be a direct relationship between dilution and titratable acidity, the erosive potential of diluting juices may be reduced substantially by the addition of water. It remains unlikely, however, that the drinks would ever be consumed at a 'safe' level of dilution due to diminished taste and colour.

Beverages↗