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PubMed2005

The role of erosion in tooth wear: aetiology, prevention and management.

Tooth wear is a universal experience. The cause is usually a combination of erosion, attrition and abrasion. Attrition usually presents with flattened incisal and occlusal tooth surfaces which accurately inter-digitate. Erosion from dietary or gastric acids forms smooth lesions which typically appear as cupped occlusal/incisal and concave buccal/facial surfaces. When combined with attrition or abrasion, acids have the potential to cause significant wear. Wear reduces the thickness of enamel exposing the underlying dentine and changing the colour from the white of enamel to yellow of dentine. Acids causing erosion originate from the stomach or from the diet. Gastric acid is associated with reflux disease and eating disorders. The frequency of acidic foods and drinks and how they are consumed is important in dietary erosion. The progression of tooth wear is recognised to be slow with periods of activity and inactivity. Although restorations can be indicated, prevention and monitoring remain important strategies in maintaining the life of the teeth.

Beverages↗
PubMed1996

Tooth wear--dental erosion.

This article aims to address the issues arising out of the increasing concern by general dental practitioners of erosion-related tooth wear. The prevalence, common presentation, differential diagnosis, likely aetiology, prevention and management of suspected cases of this form of tooth wear are considered.

Adolescent↗
PubMed1991

[Acid erosions of tooth surface. 1. Influence of saliva, medicaments, fruit acids and mechanical stress].

The clinical aspects, etiology, pathogenesis and classification of dental erosions are reviewed. Individual susceptibility or resistance to erosive damage has been attributed to variations in the quality and quantity of saliva. A lot of medicaments reduce the salivary secretion. Under the influence of acids, in particular of fruit acids, the peripheral tooth surface are demineralized in the absence of dental plaque. The citrus juices showed potentially the worst dental properties. Abrasive brushing techniques and functional influences wear down the already damaged layer of tooth surfaces.

Acids↗
PubMed2005

The effect of socio-economic status and ethnicity on the comparative oral health of Asian and White Caucasian 12-year-old children.

OBJECTIVE: To investigate the oral health of 12-year-old children of different deprivation but similar fluoridation status from South Asian and White Caucasian ethnic groups. DESIGN: An epidemiological survey of 12-year-old children using BASCD criteria, with additional tooth erosion, ethnic classification and postcode data. CLINICAL SETTING: Examinations were completed in schools in Leicestershire and Rutland, England, UK. Participants A random sample of 1,753 12-year-old children from all schools in the study area. MAIN OUTCOME MEASURES: Caries experience was measured using the DMFT index diagnosed at the caries into dentine (D3) threshold, and tooth erosion using the index employed in the Children's Dental Health UK study reported in 1993. RESULTS: The overall prevalence of caries was greater in White than Asian children, but varied at different levels of deprivation and amongst different Asian religious groups. There was a significant positive association between caries and deprivation for White children, but the reverse was true for non-Muslim Asians. White Low Deprivation children had significantly less tooth erosion, but erosion experience increased with decreasing deprivation in non-Muslim Asians. CONCLUSIONS: Oral health is associated with ethnicity and linked to deprivation on an ethnic basis. The intra-Asian dental health disadvantage found in the primary dentition of Muslim children is perpetuated into the permanent dentition.

Asian People↗
PubMed1994

Case report: the use of indirect composite for the management of extensive erosion.

Erosive tooth surface loss due to acidic soft-drinks has been well documented. Unfortunately, the erosive danger, especially to young patients, of low calorie beverages seems less well appreciated. A clinical case is reported to highlight the problems that can occur with excessive exposure to such beverages. A method of restoring the damaged dentition using indirect composite is described. It is concluded that indirect composite may be particularly suited for the restoration of eroded dentitions, especially in young patients where aesthetics and repairability are important. Further clinical studies are necessary to assess the performance of these and other materials currently used in the management of erosive tooth wear.

Adolescent↗
PubMed2006

Occupation and sports.

In rare cases the occupation - be it at work or during professional and strenuous sports activities - may give a clue to a patient's risk factors for dental erosion. However, no detrimental effects were described on a population level. Frequent contact to inorganic or organic acids at work could increase the occurrence and progression of erosion. In some studies, acid workers had significantly more teeth with erosive tooth wear than the controls. Clinical findings showed erosion mainly on upper anterior teeth and dentine hypersensitivity. Occupation groups at risk would mostly be found in the chemical industry, but also others like wine tasters may have dental erosion. A few case reports and studies have reported an association between sports activities and erosive tooth wear. The cause could be direct acid exposure or strenuous exercise, which may increase gastroesophageal reflux. Risk groups are swimmers exercising in water with low pH and athletes consuming frequently erosive sport drinks. It has to be kept in mind that sports drinks and occupation can be for some patients a cofactor in the development or in the increase of dental erosion. However, it is unlikely that one or two isolated factors will be responsible for this multifactorial condition.

Acids↗
PubMed2006

Dental erosion in children.

Erosive tooth wear in children is a common condition. The overlapping of erosion with mechanical forces like attrition or abrasion is probably in deciduous teeth more pronounced than in permanent teeth. Early erosive damage to the permanent teeth may compromise the dentition for the entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of the condition and adequate preventive measures are of importance. Knowledge of the etiological factors for erosive tooth wear is a prerequisite for such measures. In children and adolescents (like in adults) extrinsic and intrinsic factors or a combination of them are possible reasons for the condition. Such factors are frequent and extensive consumption of erosive foodstuffs and drinks, the intake of medicaments (asthma), gastro-esophageal reflux (a case history is discussed) or vomiting. But also behavioral factors like unusual eating and drinking habits, the consumption of designer drugs and socio-economic aspects are of importance.

Adolescent↗
PubMed1996

Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system for assessing erosive anterior tooth wear.

The aim of the study was to investigate some aspects of the oral health of male Saudi military inductees with special reference to soft-drink consumption, dental erosion, caries and fluorosis prevalences; a second aim of the study was to develop a system for assessing dental erosion. The material comprised a random selection of 95 individuals with a mean age of 20.9 years (range, 19-25 years). A questionnaire survey was made of each individual's dietary and oral hygiene habits and general and oral health, in addition to clinical, study cast, radiographic, and photographic examinations. The results showed that soft-drink consumption in the sample (x = 247 1/year) far exceeded that found in Western populations and that professional and self-administered dental care were generally scant. Twenty-eight percent of the maxillary anterior teeth showed pronounced dental erosion. Fluorosis was a common finding, and the number of untreated carious cavities was high. DMFT (mean = 10.0; DT = 7.7; MT = 0.5; FT = 1.8) and DMFS (mean = 18.3; DS = 12.6; MS = 2.5; FS = 3.2) were higher than those of comparable Western populations and showed an approximately threefold increase over a period of about 18 years as compared with that previously reported in a similar Saudi sample. In view of the high frequencies of dental erosion, untreated carious cavities, and fluorosis reported here and the strong indication of an increasing caries prevalence, the need for serious recognition of the implications in the planning of future dental health care program is stressed.

Adult↗
PubMed2006

Definition of erosion and links to tooth wear.

Erosive tissue loss is part of the physiological wear of teeth. Clinical features are an initial loss of tooth shine or luster, followed by flattening of convex structures, and, with continuing acid exposure, concavities form on smooth surfaces, or grooving and cupping occur on incisal/occlusal surfaces. Dental erosion must be distinguished from other forms of wear, but can also contribute to general tissue loss by surface softening, thus enhancing physical wear processes. The determination of dental erosion as a condition or pathology is relatively easy in the case of pain or endodontic complications, but is ambiguous in terms of function or aesthetics. The impact of dental erosion on oral health is discussed. However, it can be concluded that in most cases dental erosion is best described as a condition, with the acid being of nonpathological origin.

Dental Occlusion↗
PubMed1991

[Acid erosions of tooth surface. 2. Oral complications in patients with psychogenic eating disorders].

The increasing morbidity of the psychosomatical eating disorders demands more attention by the general practioners. The origin of the anorexia nervosa and bulimia nervosa and the clinical picture are described. The consequences of the acid erosion at the teeth are shown with illustrations. The cooperation between the psychotherapist and the dentist has a positive influence on the long therapy of the patients.

Acids↗
PubMed2006

Behavioral factors.

During and after an erosive challenge, behavioral factors play a role in modifying the extent of erosive tooth wear. The manner that dietary acids are introduced into the mouth (gulping, sipping, use of a straw) will affect how long the teeth are in contact with the erosive challenge. The frequency and duration of exposure to an erosive agent is of paramount importance. Night-time exposure (e.g. baby bottle-feeding) to erosive agents may be particularly destructive because of the absence of salivary flow. Health-conscious individuals tend to ingest acidic drinks and juices more frequently and tend to have higher than average oral hygiene. While good oral hygiene is of proven value in the prevention of periodontal disease and dental caries, frequent toothbrushing with abrasive oral hygiene products may enhance erosive tooth wear. Unhealthy lifestyles such as consumption of designer drugs, alcopops and alcohol abuse are other important behavioral factors.

Acids↗
PubMedDate not supplied

Erosion of tooth enamel surfaces among battery chargers and automobile mechanics in Ibadan: a comparative study.

A cross sectional comparative survey was conducted among battery chargers and automobile mechanics in Ibadan to determine the effect of exposure of acid in form of solution or fumes on tooth enamel wear one hundred and five subjects were recruited and examined for erosion. This number comprised 67 automechanics and apprentices and 38 battery chargers and their apprentices. Other groups of automobile workers sharing the workshops were excluded from the study. All respondents aged between 11 and 68 years of age. Verbal informed consent was taken from all the subjects. One thousand and one hundred teeth were examined using the upper and lower central sextants. One hundred and sixty teeth were found to be missing. The teeth examined comprised 712 teeth of automechanics (88.55%) and 388 teeth of battery chargers (85.08%). Out of the 712 teeth of automechanics, only 23 teeth (3.2%) showed evidence of tooth wear whereas in the battery chargers group, 159 teeth out of 388 teeth (41%) had tooth wear. (P < 0.05). The battery charger group also showed a higher percentage of missing teeth, (14.9%) as against 11.44% of the automechanic group (P > 0.05). This study has shown that battery chargers are subjected to occupational hazard of exposure to highly erosive acids and fumes. Prevention through oral health education targeted at this group of subjects and early diagnosis are very important.

Adolescent↗
PubMed2004

Oral and dental health among inpatients in treatment for alcohol use disorders: a pilot study.

UNLABELLED: Individuals undergoing treatment for alcohol use disorders exhibit increased risk for impaired oral health. We conducted a study to assess oral health and demographic characteristics of inpatients under treatment for alcohol use disorders. MATERIALS AND METHODS: Thirty-four inpatients, 24 male and 10 female, with diverse ethnicity, were recruited in a rehabilitation center for alcohol use disorders in Buffalo, NY. Before undergoing oral examination, subjects completed a questionnaire on dental hygiene, associated behaviors, and demographic characteristics. Information regarding patients' oral health was collected using plaque, gingival, and decayed, missing or filled teeth (DMF) indices, and by examining soft tissue and evaluating signs of abrasion, erosion, and attrition. Statistical analysis determined prevalence and descriptive characteristics. RESULTS: Alcohol intake for the population was, on average, 45.7 drinks/week, and 61.8% had smoked cigarettes within the past month. Patients were missing 15.1% of their teeth. Of teeth examined, 13.5% had dental caries. Prevalence of soft tissue abnormalities was 35.3%, prevalence of tooth erosion was 47.1%, and prevalence of moderate/severe gingival inflammation was 82.3%. Although study participants reported brushing at least once a day, 70.6% of subjects presented with heavy dental plaque accumulation. Most participants (85.3%) described the condition of their mouth and teeth as fair or poor. Finally, we observed a satisfactory participation rate among those who qualified for the study. CONCLUSION: Oral examination showed significant levels of dental caries, gingival inflammation, soft tissue abnormalities, and tooth erosion. In addition, this study indicates that patients undergoing treatment for alcohol use disorders evidence poor oral health, and are at heightened risk for the development of periodontal disease.

Adult↗
PubMed1999

Oral status of 81 subjects with eating disorders.

The aim was to explore possible correlations between the oral status of patients undergoing treatment at a special outpatient psychiatric clinic for eating disorders and such variables as psychiatric diagnosis and duration of illness, oral hygiene habits, salivary function, and dietary habits. Healthy volunteers of a similar age were recruited for comparison. The material comprised 100 consecutive referrals, of whom 79 were women and 2 were men (age range 17 to 47, median 25 yr) participated. The eating disorders were diagnosed according to the American Psychiatric Association's DSM III-R criteria. The clinical and radiographic examinations were supplemented by standardized intraoral photographs, study models and salivary analysis. The decayed, missing, filled surfaces (DMFS) index was 15.3+/-10.9, a significantly higher caries frequency than for the reference group. More than half the subjects had erosive tooth wear involving the dentine, and about one-third had very low unstimulated salivary flow rates and very high counts of mutans streptococci and lactobacilli. Erosive tooth wear was significantly correlated to the number of years of binge-eating. Compared to age-matched individuals, subjects with diagnosed eating disorders are more susceptible to both dental caries and erosion. They should be encouraged to adopt appropriately tailored preventive programmes and to have regular dental check-ups.

Adolescent↗
PubMed1991

[Studies concerning the effect of sport drinks on hydroxyapatite dissolution].

The purpose of this study was to evaluate the erosive properties of sport drinks and to clarify the facts which effect these properties. We analysed the contents of 3 kinds of sport drinks and measured their capacity to dissolve hydroxyapatite in vitro under several duration times. The following results were obtained: 1) The pH Values of the sport drinks ranged from 2.91 to 4.07. 2) The total sugar concentration of the sport drinks ranged from 3.24 to 5.95%. The sugar were consisted mainly to sucrose, glucose and fructose, but their proportion in the sport drinks had different values respectively. 3) After stirring for 1 and 5 minutes, there was a negative correlation (Spearmann's rank correlation coefficient test) between the pH values of the sport drinks and the amounts of Ca2+ released into them. And after stirring for 10 and 20 minutes, there was a negative correlation between the Ca concentrations of the sport drinks and the amounts of Ca2+ released into them. 4) The addition of sugar to the sport drinks showed no effect on their capacity to dissolve hydroxyapatite. The results suggested that tooth erosion depends on the pH value of the sport drink at the early stage when the tooth contacted it, and also tooth erosion depends on the Ca concentration of the sport drink when the tooth is in contact with it for a long time.

Calcium↗