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PubMed1994

The etiology and treatment of cervical erosion.

Erosion lesions are probably caused by a number of factors in combination. Symptomatic treatment is most indicated for lesions too shallow to restore. For the restoration of erosion, glass ionomer materials, because they eliminate the risk of secondary caries, remain the material of choice, although dentin-adhesive resins have been continuously improved. Recent light-cured glass ionomer restorative materials can be placed without most of the inconvenience inherent in earlier chemically cured materials, and like their chemically cured predecessors, can be veneered with composite resin to improve the esthetics of highly visible restorations.

Composite Resins↗

PubMed1998

Young adult patients with established dental erosion--what should be done?

This clinical paper discusses the problem of managing established erosion in the young patient. For a significant number of these patients it is not possible to establish conclusively the erosive source. Intermediate composite restorations, in addition to the use of normal preventive measures, can be used to protect eroded teeth from further damage. The main goal of such restorations is to protect the viability of the worst-affected teeth until such time as the aetiological factors can be identified and controlled. They can also improve overall aesthetics and create interocclusal space.

Adolescent↗

PubMed2002

Dental erosion caused by silent gastroesophageal reflux disease.

BACKGROUND: Gastroesophageal reflux disease, or GERD, is a relatively common condition, in which stomach acid may be refluxed up through the esophagus and into the oral cavity, resulting in enamel erosion. Symptoms such as belching, unexplained sour taste and heartburn usually alert the patient to the condition. In silent GERD, however, these symptoms do not occur, and enamel erosion of the posterior dentition may be the first indication of GERD. CASE DESCRIPTION: A 30-year-old man came to a dental clinic with enamel erosion on the occlusal surfaces of his posterior teeth and the palatal surfaces of his maxillary anterior teeth. He reported no history of gastrointestinal disease or heartburn. CLINICAL IMPLICATIONS: Enamel erosion may be a clinical sign of silent GERD that allows the dentist to make the initial diagnosis. Referral to a physician or gastroenterologist is necessary to define the diagnosis; however, dental expertise may be essential in distinguishing between differential diagnoses such as bulimia, attrition and abrasion. Successful treatment of this medical condition is necessary before dental rehabilitation can be initiated successfully.

Adult↗

PubMed2002

Dietary advice in dental practice.

This paper aims to provide dental health professionals with practical advice to pass on to patients about diet and dental health. Sugars are the most important dietary factor contributing to dental caries. Different foods carry different dental health risks; those containing non-milk, extrinsic sugars are potentially the most damaging. In the UK, sugared soft drinks and confectionery contribute approximately 50% to total intake of non-milk extrinsic sugars. Patients should be encouraged to reduce the frequency of intake of sugary foods. Intake of acidic foods and drinks contributes to dental erosion and consumption of such foods should also be limited. Dietary advice to dental patients should be positive and personalized if possible and can be in line with dietary recommendations for general health. These are to increase the consumption of starchy staple foods (eg bread, potatoes and unsweetened cereals), vegetables and fruit and to reduce the consumption of sugary and fatty foods.

Acids↗

PubMed2003

Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using focus groups of schoolchildren. A preliminary study.

OBJECTIVES: This qualitative study was designed to record the perception by Newcastle children of the influences on their choice of drinks and their knowledge of the dental health problems caused by acidic drinks. METHODS: Four focus groups, each involving 8 Newcastle schoolchildren (4 boys and 4 girls) formed the basis of the study. Two age groups, 13-14-year-olds and 8-9-year-olds, and two socio-economic groups were investigated, using state schools in Newcastle upon Tyne. A moderator guided the children to discuss their choice of drink and its dental effects amongst themselves. RESULTS: In total, 32 children participated in the focus groups and the results suggested that 8-9-year-olds preferred still, fruit-flavoured drinks whilst 13-14-year-olds preferred carbonated drinks. Taste was the most important influence on drink choice in all age groups. Parents and friends were more influential in younger children, whilst cost, availability and thirst were more important to older children. Younger children did not believe advertisements whilst older children thought they might work if seen enough times. Dental knowledge was confused in all age groups and only the 13-14-year-old-high socio-economic groups knew that acidic drinks were bad for the teeth. Different methods for addressing the problem of erosion were suggested by different age groups. There was very little difference between the socio-economic groups in the areas discussed. CONCLUSIONS: The children's knowledge of dental diseases and the effect of drinks on the teeth were confused. The factors that influence drink choice appear to change with age, rather than socio-economic status.

Adolescent↗

PubMed1995

Subvertical grooves of interproximal facets in Neandertal posterior teeth.

Subvertical grooves, located on the interproximal facets of most Neandertal posterior teeth, are less frequently noted on the teeth of other hominids, including modern humans. These grooves, 0.1-0.5 mm in width, are strictly localized within the facet area. Scanning electron microscopic (SEM) examination of grooves present on Neandertal teeth from Caverna delle Fate (Liguria, Italy) and Genay (Côte d'Or, France) demonstrated that they were produced during the life of these individuals. Characteristics of the groove surface suggest an erosion-abrasion mechanism of formation. These grooves, which developed in parts of the dentition exposed to marked stress, originated in areas characterized by changes in the orientation of enamel prism bundles (i.e., Hunter-Schreger bands). Observations carried out on modern human molars showed a subvertical disposition of these bands near interproximal ridges facilitating subvertical microfractures. Possible correlations between enamel structure, masticatory stress, and interproximal groove formation in Neandertals are discussed.

Animals↗

PubMedDate not supplied

Salivary factors affecting dental erosion in children.

Dental erosion is becoming a major dental problem in both children and adults. The aim of this study was to measure the salivary flow rates, buffering capacity and mutans streptococci counts in children with erosion, and compare them to age- and sex-matched caries-free and caries-active individuals to establish which factors may be important in erosion. The study was conducted as a case-control study with standard methods of salivary and mutans streptococci measurement. The results showed significant differences for mutans streptococci counts (p = 0.05), unstimulated and stimulated salivary pH and buffering capacity (p = 0.001). These results suggest that although individuals with erosion have caries experience similar to a caries-free individual, their salivary characteristics more closely match those of a caries-active subject. The tests described are simple to carry out and may be useful in explaining individual patient susceptibility.

Adolescent↗

PubMed1996

Erosion-abrasion lesions revisited.

Oral-hygiene-related abrasion lesions usually occur in patients over 30 years of age. Although abrasions and idiopathic erosions are different regressive alterations of the teeth, the clinical diagnosis is not always evident. Abuse of oral-hygiene devices and abrasive dentifrices can cause dental and gingival abrasions, but their role in the etiology of these lesions should be established clearly before a precise diagnosis is made. This largely influences treatment implications and expectations. This article clarifies the definitions, etiology, pathogenesis, clinical aspects, and treatment of abrasions and similar clinical lesions.

Adolescent↗

PubMed1989

[Analytic measurement of the solubility of the enamel surface exposed to acid and morphometric study of the resulting erosion in rat incisors treated with aluminum].

Their method of examination is based on the area analytical examination of scanning electromicroscopic photographs made of the enamel surfaces corroded with acid. By means of their method the area distribution of the enamel surfaces has been determined on which no detectable changes were formed after the acid action. The results obtained that way have also been compared with the results of analytical measurements. Their examinations were performed on uppar incisors of rats treated with aluminium.

Acid Etching, Dental↗

PubMed2005

Soft drinks and dental health: a review of the current literature.

In recent years there has been increased interest in the role of commercial soft drinks in dental diseases namely as dental caries and erosion. The objective of this paper has been to review the past and current literature to determine the present knowledge on this subject. The literature related to dental caries, erosion, drinks, soft drinks and fruit juices was reviewed. The literature shows efforts have been taken to modify soft drinks by either adding or deleting certain components so as to reduce their harmful effects on teeth. A rational protocol to encourage the sensible use of drinks and the modification of drinks to render them less harmful would be advisable.

Age Factors↗

PubMed2003

[Dental wear as a stomatologic manifestation of bulimia nervosa--a clinical case].

The number of patients with anorexia and bulimia nervosa is increasing nowadays. The typical oral feature of these eating disorders is the dental erosion which causes sensitivity of the teeth and esthetic problems for the involved patients. This phenomenon is a characteristic feature in these cases and it may be the first sign of the mentioned disorders. The purpose of the study was to describe the generally the most characteristic oral findings of bulimia nervosa and anorexia nervosa because the dentists play a significant role in recognizing the basic problem of the patients, and they can send them for medical treatment of the serious general problems.

Adult↗

PubMed1983

Oral tissue alterations associated with the use of smokeless tobacco by teen-agers. Part I. Clinical findings.

The use of smokeless tobacco appears to be finding its way onto middle school, high school and college campuses as a socially acceptable and popular habit. Numerous reports in the literature have described the oral changes that appear to be associated with the use of smokeless tobacco in adults. Such information is unavailable for the lower age groups. A study was therefore undertaken to determine the prevalence and frequency of oral hard- and soft-tissue alterations associated with the use of smokeless tobacco in a teen-age population. High school students in grades 9 to 12 were evaluated on a random basis. From a total sample of 1,119 students, 117 users of smokeless tobacco were identified. Four distinct lesions associated with smokeless tobacco use were identified clinically: (1) hyperkeratotic or erythroplakic lesions of the oral mucosa, (2) gingival or periodontal inflammation, (3) a combination of oral mucosal lesions and periodontal inflammation, and (4) cervical erosion of the teeth. Among the smokeless tobacco users, 113 were boys and 4 were girls. Fifty-seven (48.7 percent) of the users had soft-tissue lesions and/or periodontal inflammation or erosion of dental hard tissues. Ninety-nine of the 117 users were Caucasian, 6 were Hispanic, 1 was black, 1 was Asian, 1 was an American Indian, and 6 failed to identify an ethnic origin. Use ranged from one to twenty "dips" per day, with an average time per dip of 30 minutes. Most users had been dipping for an average of 2 years, and twelve different tobacco brands were identified.

Adolescent↗

PubMed1990

A 3-year evaluation of Gluma and Gluma/Scotchbond for restoration of cervical erosions.

Gluma and Gluma/Scotchbond were used in cervical abrasion/erosion lesions mediating a bond between a resinous restorative material and dentin. The lesions were restored without acid etching of enamel and without use of an intermediary layer of an enamel bonding agent. 142 restorations were placed. The restorations were evaluated clinically using the USPHS-system at the baseline and every half year during a 3-yr period. After 36 months the Gluma and Gluma/Scotchbond restorations showed a 14.3% and 7.4% cumulative loss of retention respectively. No secondary caries was observed during the evaluation period.

Adult↗

PubMedDate not supplied

Dental care for children fed by tube: a critical review.

No guidelines for the oral care of children fed by tube have been published. Poor oral health (unrestored caries lesions, poor oral hygiene, dependence for oral care) and tube-feeding are associated with the development of aspiration pneumonia. Children fed by tube have abundant calculus, and low caries activity. The potential for dental erosion related to gastro-esophageal reflux and oral hypersensitivity is high. To optimize oral health and reduce the risk of aspiration pneumonia, this population should receive dental care at more frequent intervals than children fed orally. Modifications to dental procedures are suggested to minimize the risks associated with dental treatment. Evidence-based treatment guidelines are indicated to optimize dental care for children fed by tube.

Animals↗

PubMed1998

Clinical evaluation of different adhesive systems for restoring teeth with erosion lesions.

This investigation evaluated the performance of a resin-modified glass ionomer, a compomer, and a bonding system/composite combination for the restoration of cervical erosion lesions without cavity preparation. Forty-eight lesions (11 patients) were restored with a bonding agent/composite combination [Prime & Bond 2.1/PrismaTPH (P & B/TPH); DeTrey/Dentsply], a compomer (Dyract; DeTrey/Dentsply), or a light-curing glass ionomer (Fuji II LC; Fuji). The materials were randomly assigned to the patients in triplets. No cavity preparation was performed. The procedures strictly followed the manufacturers' instructions. The restorations were evaluated clinically, using modified USPHS criteria, and by quantitative scanning electron microscope (SEM) analysis, at baseline and 12 months. The clinical data were statistically evaluated with the Pearson chi-square test, the SEM data (criterion gap formation) were analyzed with the Mann-Whitney U-test and error rates method. Clinically, two restorations could not be evaluated. One Dyract restoration failed. With respect to marginal discoloration, recurrent caries and contour, no significant differences could be found between the materials. The surface texture of P & B/TPH and Dyract was significantly better than that of Fuji II LC at baseline and 12 months. Compared to P & B/TPH and Fuji II LC, Dyract revealed a significant decrease in marginal integrity between baseline and 12 months. In SEM analysis, gap formation was determined as follows: baseline, enamel interface: 4% Dyract= 4% Fuji >2% P & B/TPH and dentin interface: 11% Dyract >9% P & B/TPH >2% Fuji; 12 months, enamel interface: 15% Dyract >4% Fuji >3% P & B/TPH and dentin interface: 11% P & B/TPH >6% Fuji >5% Dyract. The error rates method revealed no significant differences, in general, between the three materials with regard to gap formation. In conclusion, the restorations of erosion lesions with different classes of adhesive materials were well retained after 12 months. None of the materials studied revealed superiority over the other materials. All materials revealed shortcomings with respect to either surface texture, marginal integrity or color stability clinically and for all materials gap formation was recorded in the SEM evaluation.

Acetone↗

PubMed2004

A methodology for testing the erosive potential of sports drinks.

OBJECTIVES: The aim of the study was to develop and test a methodology in situ, which simulated the consumption of sports drinks. A secondary aim was to assess the acceptability of the method to sedentary participants. METHODS: To select the sports drink for the study in situ, five commercially available sports drinks were examined for erosive potential in vitro. The study in situ was a single centre, 2-period, 2-treatment crossover study to compare the erosive effect of a commercially available sports drink (Test), with that of mineral water (Control), over 10 day periods on 10 healthy volunteers. Subjects wore upper removable appliances containing two human enamel specimens from 9 a.m. to 5 p.m. The regimen of intake of the drinks was 350 ml in 10, 5-min rest, 650 ml in 25, 5-min rest, 500 ml in 10 and 5-min rest. Measurements of enamel loss were made on samples after 5 and 10 days by profilometry. RESULTS: The in situ study showed a statistically significant difference in erosive potential between the test and control beverages. No specimen exposed to the control beverage displayed appreciable erosion. Erosion occurred with the test drink, but to a variable degree between subjects. The subjects unanimously found the drinking regimen unpleasant. CONCLUSIONS: The sports drink caused significantly more erosion in situ than water and as seen in other studies, there was marked variation in susceptibility to erosion between subjects. The new drinking regimen was designed to simulate pre, during and post-exercise intake. Although all the sedentary subjects participating in this study reported that they found the volume of fluids consumed over a short period of time excessive it is unlikely that this would prove problematic in the exercise environment.

Adult↗

PubMed1996

Lessening dental erosive potential by product modification.

Current interest in dental erosion has led to increasing attention to ways in which potentially erosive products might be modified. Information on how this could be achieved has been hard to gather, and has focused chiefly on possibilities in reformulating soft drinks. The bulk of the work published on this relates to calcium and phosphate supplementation, ranging from early experimentation on saturation of a demineralising medium with tricalcium phosphate, through tests of more soluble phosphates and other calcium salts providing various levels of Ca2+ and PO4(3-), to a calcium citrate malate additive specially formulated to curb erosion by soft drinks. Opinions on the effectiveness of citrate, the practicability of reducing the acidity levels of soft drinks, and the possible applications of fluoride, bicarbonates and certain constituents of milk products are also included. Finally, an attempt has been made to summarize some of the advantages and shortcomings of the different methods, but it is clear that much further work will be needed before firm guidelines on the best routes to product improvement can be laid down.

Acids↗

PubMed2005

Toothbrush abrasions and noncarious cervical lesions: evolving concepts.

Toothbrush abrasion at the cervical areas of teeth is generally thought to be a result of frequent or forceful toothbrushing, faulty or vigorous technique, filament stiffness or design, dominant hand dexterity, or abrasive dentifrices. However, a review of the evidence-based literature cannot conclusively establish any one factor as the primary etiology of cervical abrasions because of inherent methodological limitations and conflicting results. Rather, a variety of factors related to toothbrushing may act in concert with dental erosion and, possibly, occlusal loading in the creation of noncarious cervical lesions. Individual variation also may make some individuals more susceptible to development and may modify the progression of those lesions. Individual variations may involve oral and dental anatomy, periodontal status or phenotype, and periodontal disease history and treatment. Further research is needed to clearly assess the interaction of all those factors in the development of cervical lesions. Therefore, awareness of a multifactorial etiology in noncarious cervical lesions may help the clinician to formulate an appropriate treatment plan for the patient.

Acids↗