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PubMed1986

Evaluation of materials and techniques for restoration of erosion areas.

The data indicate that the two dentin bonding agents, used in conjunction with enamel acid etching, provided a superior seal of the cavity compared to the respective resins alone or with either the dentin bond agent or acid etching used alone. The seal of resin restorations placed with the total system (acid etch and dentin bond agent) were comparable to the seal of the glass ionomer cement restorations. Compared with the 2-week specimens, there was no increase in leakage of the 6-month resin restorations when inserted with dentin bond agents and acid etch. The sealing ability of the resin restorations in conservatively prepared cavities was superior to comparable resin restorations in cavities that had not been prepared. This did not appear to be true for glass ionomer cement restorations. Data obtained to compare the bond strength of resins as used in the study with that of glass ionomer cements do not indicate a precise correlation between bond strength and sealing ability. The exact role of dentin bonding agents await further evaluation of their stability over a prolonged period of time, particularly in clinical investigations.

Acid Etching, Dental↗
PubMed2005

The ability of fruit teas to remove the smear layer: an in vitro study of tubule patency.

OBJECTIVES: Fruit teas are know to have an erosive effect on enamel, but the effects on dentine are unknown. Lesions of dentine hypersensitivity have numerous patent dentinal tubules and the aim of this paper was to examine the ability of various fruit teas to remove the smear layer. METHODS: The erosive potential of a variety of fruit teas was assessed in the laboratory by measuring their pH and neutralisable acidity. Smeared dentine specimens were prepared from extracted teeth and the ability of each tea to remove the smear layer was assessed by measuring the diameter and area of the opened tubules and counting the number of patent tubules seen in a unit area using scanning electron microscopy. A 0.2% citric acid solution was used as a positive control. RESULTS: The pH of the fruit teas ranged from 2.98 to 3.95 and the neutralisable acidity ranged from 10.63 to 33.0 ml of 0.1 M NaOH. All the fruit teas tested were able to remove the smear layer. The mean diameter of the tubules ranged from 0.61 to 1.14 microm and the mean area ranged from 0.31 to 1.03 microm2. The number of patent tubules per specimen ranged from 13 to 121. CONCLUSION: All the fruit teas tested were found to be highly acidic and able to remove the smear layer.

Dental Enamel↗
PubMed1998

In vitro quantitative assessment of enamel microhardness after exposure to eroding immersion in a cola drink.

Studies assessing the erosive potential of soft drinks have employed long time intervals of immersion that may not accurately depict the impact of frequent soft drink consumption on enamel. This in vitro study assessed the effect of a cola drink on enamel, replicating an actual drinking pattern. Six groups of 4 human enamel slabs were immersed (5 min each bath) in fresh cola drink, with immersions taking place with or without agitation, and under 3 regimes of frequency intake (low intake, 1 immersion/day; medium, 5/day; high, 10/day). Quantitative assessments of surface erosion were done over an 8-day interval using surface microhardness testing (Vickers). Results showed a sharp decrease from baseline (mean value 352.1 Vickers Hardness Number, SD 32.5) to day 1 (269.3, SD 41.0) and then continued decreasing throughout the assay, although less markedly, to reach 204.5, SD 45.4 on day 8. Microhardness decreased regardless of frequency regime, except on day 8, on which slabs from the low intake group were harder (233.2, SD 25.0) than slabs from the high intake group (169.8, SD 49.5; p < 0.05). Results from the ANOVA on the factorial experiment indicated that the role of agitation was statistically significant (d.f. = 1, F = 7.2, p = 0.020) while the level of intake was of borderline significance (d.f. = 2, F = 3.2, p = 0.075). The main effect resulting from the joint roles of agitation and intake indicated that there was an important interaction between the two variables (d.f. = 3, F = 4.5, p = 0.023).

Analysis of Variance↗
PubMed1988

Buffering effect of antacids in the mouth--a new treatment of dental erosion?

Antacids are drugs of choice in the treatment of reflux esophagitis and peptic ulcer disease, where acid regurgitation may cause dental erosion. Since there are no specific preventive measures or effective treatment for erosions, the present study was made to assess whether the keeping of antacids in the mouth before swallowing would be beneficial with regard to their effect on mouth pH, after acidic challenge. Five healthy subjects formed the test panel. After measuring the acid binding capacity of all the antacid preparations in the Finnish market, the two most effective were selected for testing, one in emulsion form (Novaluzid), the other a tablet (Link). Acid regurgitation was mimicked by consuming a low-pH (3.2) drink immediately before the antacid. Control series were made with the acidic drink only. Both the antacids were found to counteract totally the pH fall caused by the drink, when measured as changes in the tongue surface pH. The Novaluzid preparation was more effective than the Link preparation but the difference was not significant. It may be anticipated that patients suffering from acid regurgitations would benefit if they are counseled to keep their antacids in the mouth for a while before swallowing.

Acids↗
PubMedDate not supplied

Erosion and attrition of human enamel in vitro part II: influence of time and loading.

OBJECTIVES: To determine the influence of load and time on enamel wear by attrition under neutral and acid environments in vitro. METHODS: Groups of 10 enamel cusp and smooth surface specimens obtained from unerupted third molars were opposed in a wear machine under loads of 200, 400 and 600 g in citric acid at pH 3.2 and in physiological saline at 35 degrees C for 30 min (2280 wear cycles). The experiment was repeated with a load of 600 g for 10 and 20 min accompanied by 10 taped specimens to measure erosion only. Erosion and attrition of smooth surface specimens was determined by profilometry. RESULTS: At a load of 600 g attrition in saline increased with time from 7.9 microm (SD 3.7 microm) at 10 min, 10.2 microm (SD 4.8 microm) at 20-25.5 microm (SD 9.1 microm) after 30 min and combined attrition/erosion in citric acid from 1.5 microm (SD 0.4 microm) to 2.5 microm (SD 0.9 microm) to 6.0 microm (SD 3.7 microm). At a fixed time of 30 min, attrition in saline was 5.2 microm (SD 3.6 microm) at 200 g and 8.1 microm (SD 1.5 microm) at 400 g and combined attrition/erosion in citric acid 2.8 microm (SD 1.2 microm) and 3.6 microm (SD 0.7 microm). Comparison between both environments revealed significant differences at fixed load at all time points (p < 0.01) and at fixed time between 400 and 600 g (p < 0.01). CONCLUSIONS: Load and time significantly influence enamel wear both in acid and neutral conditions but the effects were not linear.

Adolescent↗
PubMed1990

The effect of cavity pretreatment procedures on dentin bonding: a four-year clinical evaluation.

Cervical abrasion and erosion lesions were restored with composite resin restorations bonded with four different dentin-bonding resins, an enamel-bonding resin, or restorations of a glass ionomer cement. The long-term clinical retention of the restorations were evaluated during a 4-year period. The surrounding enamel was not acid-etched. Four cleaning methods for dentin pretreatment were used to study their effects on the bonding between dentin and the restorative materials. The dentin was treated with either (1) etching for 60 seconds or (2) 15 seconds with 37% phosphoric acid, (3) cleaning with 5% sodium hypochlorite (NaOCL) for 20 seconds, or (4) cleaning with Tubulicid etchant for 60 seconds. None of the composite resin restorations, regardless of pretreatment or bonding method, showed acceptable restorations. All glass ionomer cement restorations were retained after pretreatment with Tubulicid etchant and 5% NaOCL after a 6-month period. Full acceptance, in other words, 3 year retention, was reached only after pretreatment with NaOCL.

Acid Etching, Dental↗
PubMed1996

Three-year clinical effectiveness of four total-etch dentinal adhesive systems in cervical lesions.

A 3-year follow-up clinical trial of two experimental Bayer total-etch adhesive systems and two commercial total-etch systems. Clearfil Liner Bond System and Scotchbond Multi-Purpose, was conducted to evaluate their clinical effectiveness in Class V cervical lesions. Four hundred twenty abrasion-erosion lesions were restored randomly using the four adhesive systems. There were two experimental cavity designs, in which the adjacent enamel margins either were or were not beveled and acid etched. Clearfil Liner Bond System and Scotchbond Multi-Purpose demonstrated high retention rates in both types of cavity design at 3 years. The two experimental Bayer systems scored much lower retention rates in both cavity designs at 3 years. None of the systems guaranteed margins free of microleakage for a long time. At 3 years, superficial, localized marginal discolorations were observed, the least for Clearfil Liner Bond System, followed by Scotchbond Multi-Purpose and the two experimental systems. Small marginal defects were recorded at the cervical dentin and the incisal enamel margin. Retention of Clearfil Liner Bond and Scotchbond Multi-Purpose appears to be clearly improved over earlier systems, but marginal sealing remains problematic. The two Bayer systems were found to be clinically unreliable.

Acid Etching, Dental↗
PubMed2003

[Influence of the buffer capacity of amine fluoride-containing toothpastes and gels in enamel erosion].

The aim of the study was to evaluate the abrasion resistance of eroded enamel brushed with experimental toothpastes and fluoride gels of varying buffering capacities. 50 Specimens were prepared from extracted human molars and cycled through three alternating de- and remineralizations including brushing abrasion in a brushing machine. Demineralization was accomplished by immersing the samples in 1% citric acid (5 min), remineralization occurred during immersing the samples in artificial saliva (1 min). Groups of ten samples were brushed with either one of the toothpaste (A-C) or one of the fluoridated gels (D-E). Toothpastes and gels were produced on the basis of elmex toothpaste or elmex-gelée (GABA International AG, Switzerland). Amount of titrable acid was defined as amount (mg) of 1 N KOH needed for neutralization of 1 g toothpaste or gel (A: 6 mg, B: 12 mg, C: 24 mg, D: 3.1 mg, E: 10 mg KOH). The following abrasion values (mean + S.D. [micron]) were obtained profilometrically: A: 6.76 +/- 2.05, B: 6.84 +/- 1.19, C: 8.28 +/- 2.89, D: 4.19 +/- 1.09 and E: 0.83 +/- 0.61. No significant difference in abrasion between the toothpastes was found. The fluoride gel with the higher buffering capacity (E) exhibited significantly less abrasion than the gel with the lower buffering capacity (D). It is concluded that in eroded enamel buffering capacity of the tested fluoridated toothpastes has no effect on abrasion, whereas use of fluoride gel with a higher buffering capacity leads to reduced abrasion values.

Amines↗
PubMed1995

Site specificity of citric acid retention after an oral rinse.

Erosion of the buccal incisor enamel, most frequent in the upper jaw, has been associated with excessive oral exposure to citric acid-containing foodstuffs. The aim of the study was to determine the retention of citric acid at different sites in the mouth after a standardized exposure. Thirty-four normal subjects rinsed with 95.2 mmol/l (2%) citric acid, pH 2.1, for 5 s. At 1 min 55 s after the rinse a preweighed cotton pellet was used to collect saliva samples from upper labial incisor surfaces (UB), lower labial incisor surfaces (LB) and sublingually (SL). The citric acid concentration was determined enzymatically. The concentrations were (mean +/- SD): 32.12 +/- 19.50, 11.90 +/- 8.60 and 1.52 +/- 1.90 mmol/l in the saliva collected from the UB, LB and SL sites, respectively. Analysis of variance revealed that the citric acid concentration in the upper incisor site differed significantly from that of the lower incisor site (p < 0.001) and the sublingual site (p < 0.001), and that the lower incisor site differed significantly from the sublingual site (p < 0.001). The individuals differed significantly with respect to citric acid retention (p < 0.05). A significant correlation was found between UB and LB sites (r = 0.61, p < 0.05).

Adult↗
PubMed1999

Buffering capacities of soft drinks: the potential influence on dental erosion.

The pH of fruit juices and carbonated drinks are known to be low and have, therefore, been implicated in the increasing incidence of erosion. The ability of a drink to resist pH changes brought about by salivary buffering may play an important part in the erosion process. The aims of this study were to measure the initial pH of several widely available soft drinks and determine their buffering capacities. As part of a larger study, the following groups of drinks were tested: pure fruit juices, non-fruit-based carbonated drinks, fruit-based carbonated drinks, flavoured spring waters, and plain carbonated mineral waters as positive controls with still water as the negative control. The measurement of pH was carried out using a pH electrode connected to an Orion EA940 Ionanalyser. One hundred millilitres of each drink was then titrated with 1 M sodium hydroxide, added in 0.5 mL increments, until the pH reached 10. Each titration was repeated three times. The average initial pH was lowest for the non-fruit-based drinks (2.81+/-0.274) and highest for plain mineral water (7.4+/-0.1002). The buffering capacities can be ordered as follows: fruit juices>fruit-based carbonated drinks and flavoured mineral waters>non-fruit-based carbonated drinks>sparkling mineral waters>still mineral water. It is concluded that fruit juices and fruit-based carbonated beverages, with their increased buffering capacities, may induce a prolonged drop in oral pH.

Beverages↗
PubMed2006

Effect of stannous fluoride toothpaste on erosion-like lesions: an in vivo study.

It has recently been shown that stannous fluoride (SnF(2)), in the form of aqueous solutions and as toothpaste, can reduce the dissolution of enamel in erosive acids in vitro and in situ. The aim of this study was to compare the effect of toothpastes containing SnF(2) or NaF on enamel dissolution using an in vivo model. Four healthy anterior teeth in each subject (n = 20) were exposed to diluted citric acid (100 mmol l(-1) or 10 mmol l(-1)) applied using a peristaltic pump (5 ml @7 ml min(-1)) and the acid was collected in a test tube before and after application of the respective toothpastes (etch I and etch II). Toothpaste was applied to the labial surfaces with a soft brush (four applications, each of 1-min duration), with gentle water rinsing between applications. Each subject had one pair of teeth treated with each of the test toothpastes. Enamel dissolution was examined by assessment of calcium content in the citric acid applied before and after the treatment with toothpaste. The results indicate that the SnF(2) toothpaste markedly reduced the dissolution of teeth in vivo (etch II < etch I), whereas the NaF toothpaste provided no protection (etch II > etch I). Toothpaste appears to be an acceptable vehicle for SnF(2) and maintains the dissolution-reducing effect exhibited by aqueous solutions of this fluoride salt.

Adult↗
PubMed1996

Effect of citric acid clearance on the saturation with respect to hydroxyapatite in saliva.

Citric acid contained in beverages and foods is one of the main causes of enamel erosion. It was hypothesized that the clearance of citric acid from saliva would influence the degree of salivary saturation with respect to hydroxyapatite (OHAp). Ten subjects rinsed with 2% citric acid, pH 2.1, for 5s. Before and at 1,2, 5, 10 and 15 min after the rinse, a small saliva sample was collected. The sample pH, ionic strength and the concentrations of ionized calcium, inorganic phosphate and citric acid were determined. The pH of the saliva decreased from 7.21 + or - 0.40 (mean + or - SD) at time zero to a minimum of 6.46 + or - 0.88 at 1 min after the rinse. It was back to baseline value after 15 min. The saliva was supersaturated with respect to OHAp at time zero. After the rinse with the citric acid the saturation level shifted to undersaturation in all individuals except one. At 1 and 2 min after the rinse the saliva was, on average, undersaturated. After 5 min the average saturation level was back to supersaturation. The individual differences were large. The correlations between the rate of clearance of citric acid during the 1 minute and the minimum degree of saturation with respect to OHAp at 1,2 and 5 min after the rinse were significant (r 0.84, r 0.76 and r 0.79, respectively). In conclusion, rinsing with citric acid will cause a decrease in the saturation level with respect to OHAp in a highly individual pattern.

Adult↗
PubMed2004

Diet, nutrition and the prevention of dental diseases.

Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is <15-20 kg/yr ( approximately 6-10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

Carbonated Beverages↗
PubMed1998

Human dental microwear caused by calcium oxalate phytoliths in prehistoric diet of the lower Pecos region, Texas.

Recent research demonstrates that silica phytoliths of dietary origin are associated with microwear of human teeth. Previous research has shown that severe enamel microwear and dental wear characterizes Archaic hunter-gatherers in the lower Pecos region of west Texas. Calcium oxalate crystals are especially common in Archaic coprolites. The vast majority are derived from prickly pear and agave, which were the dietary staples in west Texas for 6,000 years. The calcium oxalate phytoliths are harder than enamel. Therefore, calcium oxalate crystals are the most likely source of previously documented dental microwear and wear in the lower Pecos region.

Calcium Oxalate↗
PubMed2000

Tooth wear and compensatory modification of the anterior dentoalveolar complex in humans.

In populations living in environments where teeth wear severely, some compensatory modification of the dentoalveolar complex is thought to occur during life whereby functional occlusion is maintained as tooth substance is lost by wear. This study investigates one aspect of this modification process: Changes in the anterior dentoalveolar complex that are accompanied with wear were examined in a series of Japanese skeletal samples. In the prehistoric Japanese hunter-gatherer population heavy wear occurs over the entire dentition. The following changes were demonstrated to have occurred in the anterior segment of the dentition accompanied by wear on the anterior teeth: The anterior teeth tip lingually with wear up to a nearly upright position to fill in interproximal spaces that would have been generated by wear, and to maintain contact relations between adjacent teeth. At the same time, the anterior surface of the maxillary alveolar process also inclines lingually to a certain extent. The amount of lingual tipping is greater in the maxillary anterior teeth than in their mandibular antagonists. It is because of this discrepancy that, with age, the horizontal component of the overlap between maxillary and mandibular anterior teeth decreases, and their bite form changes from scissor bite to edge-to-edge bite. Lesser degrees of lingual tipping of the anterior teeth were also detected in the prehistoric agriculturists and historic Japanese populations. The variation in the degree of lingual tipping observed among the samples is explained by inter-population variation in severity and pattern of tooth wear. This and other evidence suggests that mechanisms that compensate for wear in the anterior dentition may be characteristic of all living human populations, independently of the degree of wear severity endured in their environments.

Adolescent↗
PubMed1993

Oral and dental complications in dieting disorders.

This study investigated the oral status and dental complications in patients with both anorexia and bulimia nervosa. Results revealed that prolonged periods of dietary restraint in anorexic patients did not result in changes to bacteria associated in dental caries. Furthermore, patients did not have lower decay rates or salivary flow but did have more acidic saliva. Moreover, both groups of patients revealed changes indicative of gingivitis and gingival recession but not necessarily of periodontitis when compared to control subjects.

Adolescent↗