Erosion (dental) 1915187 223597093 2008-07-04T20:22:29Z 68.127.229.2 /* Signs */ '''Erosion''' is the loss of tooth structure due to chemical dissolution by acids not of [[bacteria|bacterial]] origin. Dental erosion is the most common chronic disease of children ages 5 -17. <ref>{{Citation | last = U.S. Department of Health and Human Services | title = Preventing Chronic Diseases: Investing Wisely in Health | publisher = National Center for Chronic Disease Prevention and Health Promotion | date = 8 August 2007 | accessdate = 2008-02-29}}</ref> Erosion is found initially in the [[tooth enamel|enamel]] and, if unchecked, may proceed to the underlying [[dentin]]. [[Image:PH scale.png|thumb|right|Frequently consumed foods and drinks below [[pH]] 5.0-5.7 may intitiate dental erosion.]] The most common cause of erosion is by acidic foods and drinks. In general, foods and drinks with a [[pH]] below 5.0-5.7 have been known to trigger dental erosion effects. <ref name="DentalErosionMandel">{{cite web |url=http://jada.ada.org/cgi/content/full/136/1/71 |title=Dental erosion due to wine consumption |accessdate=2008-01-03 |last=Mandel |first=Louis |publisher=American Dental Association}}</ref> Numerous clinical and laboratory reports link erosion to excessive consumption of soft drinks such as fruit drinks, fruit juices such as lemon juices with a high concentration of [[citric acid]] and carbonated drinks such as colas (in this case, the [[carbonic acid]] is not the cause of erosion, but citric and [[phosphoric acid]]). Additionally, [[wine]] has been shown to erode teeth, with the pH of wine as low as 3.0-3.8. <ref name="DentalErosionMandel" /> Other possible sources of erosive acids are from exposure to [[chlorine|chlorinated]] [[swimming pool]] water, and regurgitation of [[gastric acid]]s. ==Causes== One of the major causes of dental erosion is the types of drinks and foods consumed. Sugars consumed turn into acid and break down the protective enamel of teeth leaving teeth open to the possible chance of erosion. Drinks and foods that have a low pH level are known to be more acidic and therefore more harmful to teeth. <ref>{{Citation | last = Gandra | first = Beatrice Kay | last = Truelove | first = Edmond L. | title = Diagnosis and Management of Dental Erosion | publisher = The Journal of Contemporary Dental Practice | date = 15 November 1999 | url=http://www.thejcdp.com/issue001/gandara/gandara.htm | accessdate = 2008-03-01}}</ref> The most common types of food that cause dental erosion are dietary acids. Dietary acids include fruits such as lemons, limes, and pineapples. Drinks low in pH levels that cause dental erosion include fruit juices, sports drinks, and carbonated drinks. All of these causes are known as extrinsic causes, or causes outside of the body. <ref>{{Citation | last = Gandra | first = Beatrice Kay | last = Truelove | first = Edmond L. | title = Diagnosis and Management of Dental Erosion | publisher = The Journal of Contemporary Dental Practice | date = 15 November 1999 | url=http://www.thejcdp.com/issue001/gandara/gandara.htm | accessdate = 2008-03-01}}</ref> Other causes of dental erosion include intrinsic causes that occur inside the body. Intrinsic dental erosion, caused by gastric acid that comes in contact with the teeth, is known as perimolysis. <ref>{{Citation | last = Gandra | first = Beatrice Kay | last = Truelove | first = Edmond L. | title = Diagnosis and Management of Dental Erosion | publisher = The Journal of Contemporary Dental Practice | date = 15 November 1999 | url=http://www.thejcdp.com/issue001/gandara/gandara.htm | accessdate = 2008-03-01}}</ref> Diseases such as [[anorexia nervosa]], bulimia, and [[gastroesophageal reflux disease]] are causes of this. Gastro Esophageal Reflux Disease, also known as GERD, is commonly associated with dental erosion among adults. GERD is quite common and an average of 7% of adults experience it daily. <ref>{{Citation | last = Gandra | first = Beatrice Kay | last = Truelove | first = Edmond L. | title = Diagnosis and Management of Dental Erosion | publisher = The Journal of Contemporary Dental Practice | date = 15 November 1999 | url=http://www.thejcdp.com/issue001/gandara/gandara.htm | accessdate = 2008-03-01}}</ref> The main cause of GERD is increased acid production by the stomach. <ref>{{Citation | last = Gandra | first = Beatrice Kay | last = Truelove | first = Edmond L. | title = Diagnosis and Management of Dental Erosion | publisher = The Journal of Contemporary Dental Practice | date = 15 November 1999 | url=http://www.thejcdp.com/issue001/gandara/gandara.htm | accessdate = 2008-03-01}}</ref> ==Signs== There are many signs of dental erosion, including changes in appearance and sensitivity. One of the physical changes can be the color of teeth. There are two different colors teeth may turn if dental erosion is occurring, the first being a change of color that usually happens on the cutting edge of the central incisors. This causes the cutting edge of the tooth to become transparent. <ref>{{Citation | last = | first = | title = Acid Attack. | publisher = Academy of General Dentistry. | date = 6 February, 2008 | url=http://64.233.167.104/search?q=cache:YJ69EnrlwcUJ:www.agd.org/public/OralHealthFacts/files/pdfgenerator.aspx%3Fpdf%3DFS_ToothErosion.pdf+teeth+erosion&hl=en&ct=clnk&cd=7&gl=us | accessdate = 2008-03-09}}</ref> A second change of color in teeth that is a sign of dental erosion is a yellowish tint. This is caused when the white enamel is eroded away to show a yellowish middle layer of the tooth called dentin. <ref>{{Citation | last = | first = | title = Acid Attack. | publisher = Academy of General Dentistry. | date = 6 February, 2008 | url=http://64.233.167.104/search?q=cache:YJ69EnrlwcUJ:www.agd.org/public/OralHealthFacts/files/pdfgenerator.aspx%3Fpdf%3DFS_ToothErosion.pdf+teeth+erosion&hl=en&ct=clnk&cd=7&gl=us | accessdate = 2008-03-09}}</ref> A change in shape of the teeth can also be a sign of dental erosion. Teeth will begin to appear with a broad rounded concavity, and the gaps between teeth will become larger. There can be evidence of wear on surfaces of teeth not expected to be in contact with one another.<ref>{{Citation | last = | first = | title = Acid Attack. | publisher = Academy of General Dentistry. | date = 6 February, 2008 | url=http://64.233.167.104/search?q=cache:YJ69EnrlwcUJ:www.agd.org/public/OralHealthFacts/files/pdfgenerator.aspx%3Fpdf%3DFS_ToothErosion.pdf+teeth+erosion&hl=en&ct=clnk&cd=7&gl=us | accessdate = 2008-03-09}}</ref> If dental erosion occurs in children, a loss of enamel surface characteristics can occur. [[Amalgam]] restorations in the mouth may be clean and non-tarnished. Fillings may also appear to be rising out of the tooth, the appearance being caused when the tooth is eroded away leaving only the filling. The teeth may form divots on the chewing surfaces when dental erosion is occurring. This mainly happens on the first, second, and third molars. One of the most severe signs of dental erosion is cracking, <ref>{{Citation | last = | first = The Cleveland Clinic Department of Dentistry | title = Dental Health: Tooth Sensitivity | publisher = WebMD | date = | url=http://www.webmd.com/oral-health/tooth-sensitivity?page=2 | accessdate = 2008-03-09}}</ref> where teeth begin to crack off and have a very coarse feeling. <ref>{{Citation | last = | first = | title = Acid Attack. | publisher = Academy of General Dentistry. | date = 6 February, 2008 | url=http://64.233.167.104/search?q=cache:YJ69EnrlwcUJ:www.agd.org/public/OralHealthFacts/files/pdfgenerator.aspx%3Fpdf%3DFS_ToothErosion.pdf+teeth+erosion&hl=en&ct=clnk&cd=7&gl=us | accessdate = 2008-03-09}}</ref> A sign of dental erosion that is not a physical change of the teeth is pain when eating hot, cold, or sweet foods. This is caused when the enamel is eroded away exposing the dentin. The dentin is very sensitive making it painful eating these foods. <ref>{{Citation | last = Davenport | first = Tammy | title = Signs and Symptoms of Tooth Erosion. | publisher = About.com | date = 14 September 2007 | url=http://dentistry.about.com/od/toothmouthconditions/a/teetherosionsym.htm | accessdate = 2008-03-09}}</ref> [[Image:Tooth erosion 2.jpg|thumb|A mouth showing signs of tooth erosion]] ==Prevention== Seeing a dentist or an oral surgeon regularly for a routine checkup promotes healthy teeth. <ref>{{Citation | last = Chauhan | first = Pradeep | title = Dental Care Tips and Treatment for Kids. | publisher = American Chronicle | date = 26 February 2008 | url= http://www.americanchronicle.com/articles/53456 | accessdate = 2008-02-26}}</ref> Eating less sweet foods and more foods that provide vitamins and minerals also influences good oral hygiene. <ref>{{Citation | last = Chauhan | first = Pradeep | title = Dental Care Tips and Treatment for Kids. | publisher = American Chronicle | date = 26 February 2008 | url= http://www.americanchronicle.com/articles/53456 | accessdate = 2008-02-26}}</ref> Eating foods with high sugar content is unhealthy because the sugar destroys the enamel for about 20 minutes after contact. A way to help prevent the sugars and acids from attacking the tooth enamel is to rinse the mouth with water after eating sweet foods. Brushing directly after these sugar attacks could also be harmful as each brushstroke also takes away part of the tooth enamel. <ref>{{Citation | last = Goss | first = Lisa | title = How Does Fluoride Work? | publisher = | date = May 2005 | url= www.kidshealth.org/kid/feel_better/things/fluoride.html | accessdate = 2008-03-09}}</ref> Another way to help prevent dental erosion is using a straw when drinking unhealthy beverages. This pushes the liquid to the back of the mouth so it doesn’t touch the teeth. There is evidence that chewing sugarless gum may decrease the incidence of caries, better known as decay. <ref>{{Citation | last = | first = | title = Fluoride Facts | publisher = ADHA | date = 2005 | url= www.adha.org/oralhealth/fluoride_facts.htm | accessdate = 2008-03-09}}</ref> The most common way of preventing dental erosion is by brushing teeth, as removing plaque on a daily basis is vital to preventing dental erosion. The strength of teeth can be improved by brushing regularly after every meal and at night. Proper techniques, such as using a soft bristled brush and using a “pea-sized” amount of toothpaste should be followed. These also include brushing up on the front part of the bottom teeth and down on the front part of the top teeth. A back and forth motion should be used when brushing on the top surfaces of the teeth. <ref>{{Citation | last = Chauhan | first = Pradeep | title = Dental Care Tips and Treatment for Kids. | publisher = American Chronicle | date = 26 February 2008 | url= http://www.americanchronicle.com/articles/53456 | accessdate = 2008-02-26}}</ref> Brushing teeth twice a day for two to three minutes at a time is recommended. Flossing before brushing will also aid in better dental care. Many cavities start in the contact area between teeth, so flossing is a very important aspect to erosion prevention. <ref>{{Citation | last = Goss | first = Lisa | title = How Does Fluoride Work? | publisher = | date = May 2005 | url= www.kidshealth.org/kid/feel_better/things/fluoride.html | accessdate = 2008-03-09}}</ref> On a larger scale, communities are trying to prevent dental erosion among its youth through school programs that offer dental sealants. The sealants are offered to children who wouldn’t normally receive these benefits from a dentist because of the expense. Currently the programs are present in 29 states. In 1984, Ohio started the school based program. Today in Ohio, almost half of the counties have the program. Another one of the programs is in Wisconsin called ''Healthy Smiles for Wisconsin.'' The program started in the 2000-2001 school year and brought the sealant to forty communities. The program has shown the ability to reach children in high need of dental care that don’t have the money to pay for the expenses. ==Fluoride== To help prevent dental erosion from occurring, many communities adopted water fluoridation. Water fluoridation is the technique of adding fluoride to water compounds to reduce tooth decay and erosion. This has been used since the 1940’s after scientists noticed that children who consumed small amounts of fluoride had fewer cavities than children unexposed to it. Fluoride helps teeth during growth because it mixes with the tooth enamel, preventing tooth decay. <ref>{{Citation | last = Goss | first = Lisa | title = How Does Fluoride Work? | publisher = | date = May 2005 | url= www.kidshealth.org/kid/feel_better/things/fluoride.html | accessdate = 2008-03-09}}</ref> Fluoridated water is used by roughly sixty-six percent of Americans, costing a person 72 cents per year. Proponents state that this saves over $1.5 billion per year. ==See also== *[[Abrasion (dental)|Abrasion]] *[[Abfraction]] *[[Attrition (dental)|Attrition]] *[[Bruxism]] ==References== <references /> {{Reflist}} *[http://www.thejcdp.com/issue001/gandara/introgan.htm The Journal of Contemporary Dental Practice] *Summit, James B., J. William Robbins, and Richard S. Schwartz. "Fundamentals of Operative Dentistry: A Contemporary Approach." 2nd edition. Carol Stream, Illinois, Quintessence Publishing Co, Inc, 2001. ISBN 0-86715-382-2. [[Category:Dental disorders]] [[Category:Teeth]] {{dentistry-stub}} {{Oral pathology}} [[zh-min-nan:Chhùi-khí ê se̍k-sún]] [[de:Erosion (Zahnmedizin)]] [[nl:Tanderosie]] [[ja:酸蝕症]] [[pt:Erosão dentária]]