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Monographs in Oral Science 2013Dental erosion develops from the chronic exposure to non-bacterial acids resulting in bulk mineral loss with a partly demineralised surface of reduced micro-hardness.... (Review)
Review
Dental erosion develops from the chronic exposure to non-bacterial acids resulting in bulk mineral loss with a partly demineralised surface of reduced micro-hardness. Clinical features are loss of surface structures with shallow lesions on smooth surfaces and cupping and flattening of cusps; already in early stages, coronal dentine often is exposed. Not only enamel, but also dentine is therefore an important target tissue for anti-erosion strategies. The main goal of active ingredients against erosion is to increase the acid resistance of tooth surfaces or pellicles. The challenge with toothpastes is that abrasives, otherwise beneficial in terms of cleaning properties, may counteract the effects of active ingredients. Fluoride toothpastes offer a degree of protection, but in order to design more effective formulations, active ingredients in addition to, or other than, fluorides have been suggested. Polyvalent metal cations, Ca/P salts in nano-form, phosphates, proteins, and various biopolymers, e.g. chitosan, are substances under study. The complex combined action of active ingredients and abrasives on the dental hard tissues, and the role of excipients of complex toothpaste formulations are not yet fully understood. Current evidence is flawed by the diversity of experimental designs, and there is no knowledge from clinical studies with patients so far. However, research results indicate that there is potential to develop effective toothpastes in this field. As the prevalence of initial erosive lesions particularly in younger age groups is high in some countries, such strategies would be of great importance for maintaining oral health.
Topics: Cariostatic Agents; Chemistry, Pharmaceutical; Dental Enamel; Dentin; Fluorides; Humans; Tooth Erosion; Toothpastes
PubMed: 23817062
DOI: 10.1159/000350475 -
Journal of Clinical Medicine Sep 2023Both eating disorders and dental erosion are increasingly affecting adolescents and young adults. Thus, our systematic review was designed to answer the question: "Is... (Review)
Review
Both eating disorders and dental erosion are increasingly affecting adolescents and young adults. Thus, our systematic review was designed to answer the question: "Is there a relationship between dental erosion and eating disorders?" Following the inclusion and exclusion criteria, 31 studies were included in this systematic review (according to the PRISMA statement guidelines). Based on the meta-analysis, 54.4% of patients with bulimia nervosa and 26.7% with anorexia nervosa experienced tooth erosion. For the whole group of 1699 patients with eating disorders, erosive lesions were observed in 42.1% of patients. Bulimics were more than 10 times more likely to experience dental erosion compared to healthy individuals (OR = 10.383 [95%CI: 4.882-22.086]). Similarly, more than 16 times increased odds of tooth erosion were found in patients with self-induced vomiting (OR = 16.176 [95%CI: 1.438-181.918]). In conclusion, eating disorders are associated with an increased risk of developing erosive lesions, especially in patients with bulimia nervosa.
PubMed: 37834805
DOI: 10.3390/jcm12196161 -
Clinical Oral Investigations Mar 2008Dental erosion is a multifactorial condition: The interplay of chemical, biological and behavioural factors is crucial and helps explain why some individuals exhibit... (Review)
Review
Dental erosion is a multifactorial condition: The interplay of chemical, biological and behavioural factors is crucial and helps explain why some individuals exhibit more erosion than others. The erosive potential of erosive agents like acidic drinks or foodstuffs depends on chemical factors, e.g. pH, titratable acidity, mineral content, clearance on tooth surface and on its calcium-chelation properties. Biological factors such as saliva, acquired pellicle, tooth structure and positioning in relation to soft tissues and tongue are related to the pathogenesis of dental erosion. Furthermore, behavioural factors like eating and drinking habits, regular exercise with dehydration and decrease of salivary flow, excessive oral hygiene and, on the other side, an unhealthy lifestyle, e.g. chronic alcoholism, are predisposing factors for dental erosion. There is some evidence that dental erosion is growing steadily. To prevent further progression, it is important to detect this condition as early as possible. Dentists have to know the clinical appearance and possible signs of progression of erosive lesions and their causes such that adequate preventive and, if necessary, therapeutic measures can be initiated. The clinical examination has to be done systematically, and a comprehensive case history should be undertaken such that all risk factors will be revealed.
Topics: Acids; Adolescent; Adult; Aged; Aged, 80 and over; Child; Dental Enamel Solubility; Dental Pellicle; Diet; Diet, Cariogenic; Humans; Middle Aged; Odontometry; Risk Factors; Tooth Abrasion; Tooth Erosion
PubMed: 18228059
DOI: 10.1007/s00784-007-0179-z -
Monographs in Oral Science 2011Dental erosion develops through chronic exposure to extrinsic/intrinsic acids with a low pH. Enamel erosion is characterized by a centripetal dissolution leaving a small... (Review)
Review
Dental erosion develops through chronic exposure to extrinsic/intrinsic acids with a low pH. Enamel erosion is characterized by a centripetal dissolution leaving a small demineralized zone behind. In contrast, erosive demineralization in dentin is more complex as the acid-induced mineral dissolution leads to the exposure of collagenous organic matrix, which hampers ion diffusion and, thus, reduces further progression of the lesion. Topical fluoridation inducing the formation of a protective layer on dental hard tissue, which is composed of CaF(2) (in case of conventional fluorides like amine fluoride or sodium fluoride) or of metal-rich surface precipitates (in case of titanium tetrafluoride or tin-containing fluoride products), appears to be most effective on enamel. In dentin, the preventive effect of fluorides is highly dependent on the presence of the organic matrix. In situ studies have shown a higher protective potential of fluoride in enamel compared to dentin, probably as the organic matrix is affected by enzymatical and chemical degradation as well as by abrasive influences in the clinical situation. There is convincing evidence that fluoride, in general, can strengthen teeth against erosive acid damage, and high-concentration fluoride agents and/or frequent applications are considered potentially effective approaches in preventing dental erosion. The use of tin-containing fluoride products might provide the best approach for effective prevention of dental erosion. Further properly designed in situ or clinical studies are recommended in order to better understand the relative differences in performance of the various fluoride agents and formulations.
Topics: Calcium Fluoride; Cariostatic Agents; Dental Enamel; Dental Enamel Solubility; Dentin; Fluorides; Humans; Tooth Erosion
PubMed: 21701198
DOI: 10.1159/000325167 -
Monographs in Oral Science 2014There is evidence that the presence of erosion is growing steadily. Due to different scoring systems, samples and examiners, it is difficult to compare the different... (Review)
Review
There is evidence that the presence of erosion is growing steadily. Due to different scoring systems, samples and examiners, it is difficult to compare the different studies. Preschool children from 2 to 5 years showed erosion on deciduous teeth in 1 to 79% of the subjects. Schoolchildren (aged from 5 to 9 years) already had erosive lesions on permanent teeth in 14% of the cases. In the adolescent group (aged between 9 and 20 years), 7 to 100% of the persons examined showed signs of erosion. Incidence data (the increase in the number of subjects presenting signs of dental erosion) was evaluated in four of these studies and presented average annual values between 3.5 and 18%, depending on the initial age of the examined sample. In adults (aged from 18 to 88 years) prevalence data ranged between 4 and 100%. Incidence data are scarce in this age group, and only one study was found analysing the increase of affected surfaces, showing an incidence of 5% for the younger and 18% for older age groups. In general, males present more erosive tooth wear than females. The distribution showed a predominance of affected occlusal surfaces (mandibular first molars) followed by facial surfaces (anterior maxillary teeth). Oral erosion was frequently found on maxillary incisors and canines. Overall, prevalence data are not homogeneous. Nevertheless, there is a trend towards a more pronounced rate of erosion in younger age groups. Furthermore, a tendency was found for more erosive lesions with increasing age and these erosions progressed with age.
Topics: Age Factors; Disease Progression; Disease Susceptibility; Global Health; Humans; Incidence; Prevalence; Tooth Erosion
PubMed: 24993258
DOI: 10.1159/000360973 -
Caries Research 2011The advantages, limitations and potential applications of available methods for studying erosion of enamel and dentine are reviewed. Special emphasis is placed on the... (Review)
Review
The advantages, limitations and potential applications of available methods for studying erosion of enamel and dentine are reviewed. Special emphasis is placed on the influence of histological differences between the dental hard tissue and the stage of the erosive lesion. No method is suitable for all stages of the lesion. Factors determining the applicability of the methods are: surface condition of the specimen, type of the experimental model, nature of the lesion, need for longitudinal measurements and type of outcome. The most suitable and most widely used methods are: chemical analyses of mineral release and enamel surface hardness for early erosion, and surface profilometry and microradiography for advanced erosion. Morphological changes in eroded dental tissue have usually been characterised by scanning electron microscopy. Novel methods have also been used, but little is known of their potential and limitations. Therefore, there is a need for their further development, evaluation, consolidation and, in particular, validation.
Topics: Calcium; Dental Enamel; Dentin; Hardness; Humans; Microradiography; Microscopy, Atomic Force; Microscopy, Electron, Scanning; Phosphates; Tooth Erosion
PubMed: 21625129
DOI: 10.1159/000326819 -
Monographs in Oral Science 2014Dental erosion is caused by repeated short episodes of exposure to acids. Dental minerals are calcium-deficient, carbonated hydroxyapatites containing impurity ions such... (Review)
Review
Dental erosion is caused by repeated short episodes of exposure to acids. Dental minerals are calcium-deficient, carbonated hydroxyapatites containing impurity ions such as Na(+), Mg(2+) and Cl(-). The rate of dissolution, which is crucial to the progression of erosion, is influenced by solubility and also by other factors. After outlining principles of solubility and acid dissolution, this chapter describes the factors related to the dental tissues on the one hand and to the erosive solution on the other. The impurities in the dental mineral introduce crystal strain and increase solubility, so dentine mineral is more soluble than enamel mineral and both are more soluble than hydroxyapatite. The considerable differences in structure and porosity between dentine and enamel influence interactions of the tissues with acid solutions, so the relative rates of dissolution do not necessarily reflect the respective solubilities. The rate of dissolution is further influenced strongly by physical factors (temperature, flow rate) and chemical factors (degree of saturation, presence of inhibitors, buffering, pH, fluoride). Temperature and flow rate, as determined by the method of consumption of a product, strongly influence erosion in vivo. The net effect of the solution factors determines the overall erosive potential of different products. Prospects for remineralization of erosive lesions are evaluated.
Topics: Buffers; Chemical Phenomena; Dental Enamel Solubility; Dentin Solubility; Durapatite; Humans; Hydrogen-Ion Concentration; Porosity; Rheology; Temperature; Tooth; Tooth Erosion; Tooth Remineralization
PubMed: 24993265
DOI: 10.1159/000359943 -
Journal of Dentistry Sep 2023This study compared the surface change on natural and polished enamel exposed to a joint mechanical and chemical wear regimen. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
This study compared the surface change on natural and polished enamel exposed to a joint mechanical and chemical wear regimen.
METHODS
Human enamel samples were randomly assigned to natural (n = 30) or polished (n = 30) groups, subjected to erosion (n = 10, 0.3% citric acid, 5 min), abrasion (n = 10, 30 s), or a combination (n = 10). Wear in the form of step height was measured with a non-contact profilometer, and surface changes were inspected with SEM on selected sections. Data was normalised and underwent repeated measures MANOVA, accounting for substrate and erosive challenge as independent variables, with Bonferroni correction for significant post hoc interactions.
RESULTS
After four cycles, polished samples had mean step heights of 3.08 (0.40) μm after erosion and 4.08 (0.37) μm after erosion/abrasion. For natural samples, these measurements were 1.52 (0.22) μm and 3.62 (0.39) μm, respectively. Natural surfaces displayed less wear than polished surfaces under erosion-only conditions (p<0.0001), but the difference disappeared with added abrasion. SEM revealed a shallow subsurface layer for polished surfaces and natural ones undergoing only erosion. However, natural surfaces exposed to both erosion and abrasion showed deeper subsurface changes up to 50 µm.
CONCLUSION
Natural enamel, when exposed to erosion alone, showed less wear and minimal subsurface alterations. But with added abrasion, natural enamel surfaces saw increased wear and notable subsurface changes compared to polished ones.
CLINICAL SIGNIFICANCE
The pronounced subsurface lesions observed on eroded/abraded natural enamel surfaces highlight how combined wear challenges may accelerate tooth tissue loss.
Topics: Humans; Tooth Abrasion; Tooth Attrition; Tooth Erosion; Tooth Wear; Toothbrushing
PubMed: 37544352
DOI: 10.1016/j.jdent.2023.104652 -
Dentistry Journal Jun 2017This paper reviews the surface ablation of early hominin teeth by attrition, abrasion, and erosive dental wear. The occurrence of these lesions is explored in a sample... (Review)
Review
This paper reviews the surface ablation of early hominin teeth by attrition, abrasion, and erosive dental wear. The occurrence of these lesions is explored in a sample of South African fossil australopithecine dentitions revealing excessive wear. Interpretation of the nature of the dietary components causing such wear in the absence of carious erosion provides insight into the ecology of the Plio-pleistocene epoch (1-2 million years ago). Fossil teeth inform much of the living past by their retained evidence after death. Tooth wear is the ultimate forensic dental evidence of lives lived.
PubMed: 29563425
DOI: 10.3390/dj5020019 -
JDR Clinical and Translational Research Oct 2022The aim of this study is to examine the effect of diet drinks on dental erosion among a representative sample of US adults.
OBJECTIVE
The aim of this study is to examine the effect of diet drinks on dental erosion among a representative sample of US adults.
METHODS
Adult dietary and dental data were analyzed from the 2003-2004 cycle of the National Health and Nutrition Examination Survey. Erosion was measured with a modified tooth wear index and was analyzed as a dichotomous variable. Cluster analysis was performed, and the cluster number was based on having a separate diet drink cluster and the values. Survey procedure and sample weights were used.
RESULTS
Most of the population (80%) had some form of dental erosive lesions. When compared with the total sample, people with erosion were more likely to be male (52.5%) and older. People with no erosive lesions were younger (42.3%) and non-Hispanic Black (21.2%). Cluster analysis resulted in 4 distinct clusters: high water, high diet drinks, high coffee/tea, and high soda. The respective percentage of individuals in each cluster who had erosion was 78.9%, 85%, 83.9%, and 76.2%, where the "high diet drinks" cluster showed the highest erosion ( = 0.28). Logistic regression modeling showed that the "high diet drinks" cluster had increased odds of erosion (odds ratio = 1.27; 95% CI = 0.58 to 2.77) when compared with the "high water" cluster, but the relationship was not statistically significant.
CONCLUSION
High diet drinks consumption slightly increased the odds of dental erosion among US adults, although this relationship was not statistically significant. It is thus not yet clear that dentists should recommend diet drinks, as they might be linked to systemic diseases. Further research is needed to explore more about risk factors of erosion.
KNOWLEDGE TRANSFER STATEMENT
The findings of this study are suggestive, though not significantly, that diet drinks may increase risk for dental erosion. While further research is needed, it is not clear that dentists should recommend these drinks as healthy substitutes for sugary drinks.
Topics: Adult; Artificially Sweetened Beverages; Beverages; Coffee; Dentition, Permanent; Female; Humans; Male; Nutrition Surveys; Tea; Water
PubMed: 34622687
DOI: 10.1177/23800844211048478