Dental erosion is a very common problem among all. Erosion is the loss of dental hard tissue as a result of chemical process not involving bacteria. Therefore, any action taken by the individuals that may lend itself to an acidic oral environment can potentially erode teeth. An important step towards prevention of dental erosion should be the identification of those individuals who are at risk of dental erosion. Certain factors, classified as either extrinsic or intrinsic, have been identified as the predictors of susceptibility to dental erosion.
An example of extrinsic factors that can cause dental erosion are dietary sources of acids such as: citrus fruits and fruit juices, other acidic fruits/juices, carbonated beverages, acidic sports drinks, acidic fruit-flavored candies, wine, cider, salad dressing, vinegar conserves and acidic herbal tea. It has been shown that the frequency of consumption of acidic food stuff can have a profound effect on the resultant erosive tooth wear. Therefore, the most basic and practical advice that should be given to the patient is to reduce the intake frequency of that particular erosive element of the diet. The temperature of an acidic drink influences its erosive potential; taking the drink ice-cold reduces its erosive effect. In addition, the use of a straw has been shown to reduce the contact time of acid with the tooth tissue, as long as the straw is held in place towards the back of the mouth. Use of a straw in this fashion should not be used as an alternative to a preventive regime which involves reduction of frequency of intake of acidic beverages.
In addition, the use of acidic medicaments when prescribed for frequent use over a long period of time, predispose teeth to dental erosion. An example of acidic medicaments which might have erosive potential is vitamin C, aspirin, and iron tonics. Interestingly, occupation might have a role in this regard. Dental erosion has been reported among individuals who are directly exposed to acid fumes or aerosols in their place of work. This includes workers in battery factories, galvanizing factories and fertilizer industries. Furthermore, competitive swimmers in poorly maintained gas-chlorinated swimming pools have also been associated with dental erosion. Frequent tooth brushing with abrasive dentifrice as practiced by some aesthetic conscious individuals may render the tooth surface more susceptible to erosion due to its effect or removing the more protective highly mineralized outer layer of the teeth.
Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth, and acting regularly on the dental hard tissues over a period of several years. This may be the result of chronic vomiting, persistent regurgitation. Some patients may not be aware of their underlying medical condition, but in search of treatment for deteriorating condition of their teeth, the dentist may be the first healthcare personnel to observe the underlying medical disorder. Others may not recognize their condition as a disorder, especially with anorexia/bulimia patients, and hence would not seek medical attention until it starts affecting the aesthetics, function or comfort of their teeth. An appropriate referral to the relevant physician should be considered in these cases.
It is a common practice among individuals to refresh their mouth by tooth brushing with dentifrice after an acidic challenge, such vomiting or regurgitation, as is the case with an eating disorder. The hazard of brushing immediately following an acidic challenge should be stressed. The patient highly advised to use “time-delay technique” such as allowing at least 30 minutes before brushing.
Dental erosion is a very common problem among all. Erosion is the loss of dental hard tissue as a result of chemical process not involving bacteria. Therefore, any action taken by the individuals that may lend itself to an acidic oral environment can potentially erode teeth.
Unfortunately, patient can barely detect early enamel erosion due to its smooth and shiny appearance. Even when detected they rarely seek treatment until it gets to an advanced stage, when it either becomes sensitive or affects the esthetics of early detection and treatment therefore falls on dental professionals. Regular dental examinations would enable early detection of dental erosion and appropriate management could be instituted immediately. Helpful methods include: periodic professional application of fluoride varnish or gel can increase the resistance of the teeth to further erosive attack.
High-risk individuals may be urged to change their oral hygiene procedure; using a low abrasion toothbrush with a high fluoride or bicarbonate containing but low-abrasive toothpaste. Regular use of rematerializing agent (eg, fluoride mouth rinses, fluoride lozenge) should be recommended for all individuals susceptible to dental erosion. The practice of continuous or bedtime baby bottle feeding with baby fruit juices as a means of comforting a child should be discouraged. Furthermore, the intake of acidic foods or drinks as the last thing before bed should be avoided.