What is dental erosin?
Toothwear is becoming more common, both in children, and in adults who are now keeping their teeth for very much longer. There are several ways in which teeth can wear away but one of them is known as dental erosion and this is due to a chemical process which literally dissolves the surface of the teeth away - rather like a sugar lump dissolving in hot tea!
Substances that cause this chemical dissolution are usually acids and can come from a variety of sources.
Is dental erosion Common?
In the 1940's and 1950's it was regarded as very rare and indeed the cause was not fully known. Since this time, and particularly in the last 10 years, there have been an increasing number of reports which suggest that erosion is increasing. This is largely anecdotal evidence and hard facts are difficult to come by.
However, we now have some published studies, mainly in children, which show that almost half of 5 year old children have significant erosion in their deciduous (milk) teeth and a third of teenagers show erosion in their permanent teeth. The limited information in adults suggests that a quarter of Americans have toothwear, and a study undertaken in Switzerland found that 30% of 26 to 30 year olds and 43% of 46 to 50 year olds had severe erosion. What we don't know is whether this is getting worse, because we don't have any studies undertaken over a long period of time.
What Causes dental erosion?
The development of erosion is undoubtedly a complex subject and is usually related to a number of factors. Erosion also seldom exists by itself and is added to by other causes of tooth wear such as abrasion from tooth brushing.
Usually, the most common causes or erosion are an excess of acidic substances consumed in the diet - both food and drink. There has been a particular change in the consumption of soft drinks with a 700 per cent increase in sales in the U.K. over the last forty years. This is much higher in younger age groups. It is the frequency of consumption of drinks, with habits such as sipping and "frothing" of drinks, which result in considerable destruction.
Acidic foods include fruit and vinegar based substances, and if these are consumed to excess then they too can cause extreme destruction.
There are also internal or "intrinsic" sources of acid from the stomach. Persistent vomiting, for example in pregnancy or bulimia and anorexia nervosa, or reflux in chronic indigestion, hiatus hernia and chronic alcoholism have all been shown to be associated with erosion.
What does dental erosion look like?
The photographs of these two 12 year old boys show that there is considerable loss of the enamel (the outer surface of the tooth) from their upper front teeth (figures 1 and 2). The third picture is that of a 4 year old child, again with loss of the surface layer (figure 3). This has resulted not only in a deterioration of their appearance but also to exposure of the dentine (the inner part of the tooth) and therefore to tooth sensitivity. This can be very painful, especially when eating or drinking anything cold.
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