Since the mid-1990s, the focus of studies on tooth wear has steadily shifted from the general condition towards the more specific area of dental erosion; equally, a shift has occurred from studies in adults to those in children and adolescents. During this time, understanding of the condition has increased greatly. This paper attempts to provide a critical overview of the development of this body of knowledge, from earlier perceptions to the present. It is accepted that dental erosion has a multifactorial background, in which individual and lifestyle factors have great significance. Notwithstanding methodological differences across studies, data from many countries confirm that dental erosion is common in children and young people, and that, when present, it progresses rapidly. That the condition, and its ramifications, warrants serious consideration in clinical dentistry, is clear. It is important for the oral healthcare team to be able to recognize its early signs and symptoms and to understand its pathogenesis. Preventive strategies are essential ingredients in the management of patients with dental erosion. When necessary, treatment aimed at correcting or improving its effects might best be of a minimally invasive nature. Still, there remains a need for further research to forge better understanding of the subject.
The aim of the study was to investigate some aspects of the oral health of male Saudi military inductees with special reference to soft-drink consumption, dental erosion, caries and fluorosis prevalences; a second aim of the study was to develop a system for assessing dental erosion. The material comprised a random selection of 95 individuals with a mean age of 20.9 years (range, 19-25 years). A questionnaire survey was made of each individual's dietary and oral hygiene habits and general and oral health, in addition to clinical, study cast, radiographic, and photographic examinations. The results showed that soft-drink consumption in the sample (x = 247 1/year) far exceeded that found in Western populations and that professional and self-administered dental care were generally scant. Twenty-eight percent of the maxillary anterior teeth showed pronounced dental erosion. Fluorosis was a common finding, and the number of untreated carious cavities was high. DMFT (mean = 10.0; DT = 7.7; MT = 0.5; FT = 1.8) and DMFS (mean = 18.3; DS = 12.6; MS = 2.5; FS = 3.2) were higher than those of comparable Western populations and showed an approximately threefold increase over a period of about 18 years as compared with that previously reported in a similar Saudi sample. In view of the high frequencies of dental erosion, untreated carious cavities, and fluorosis reported here and the strong indication of an increasing caries prevalence, the need for serious recognition of the implications in the planning of future dental health care program is stressed.
Soft drink intake, method of drinking, pH variations, plaque topography, and various salivary, microbial and clinical factors were compared in Saudi men with high (n = 10, mean = 20.5 yr) and low (n = 9, mean = 20.3 yr) dental erosion. pH-measurements were carried out with a microtouch electrode at six different intraoral locations after the subjects had consumed 330 ml of regular cola-type drink in their customary manner. The results showed that higher intake of cola-type drinks was more common in the high- (253 l yr(-1)) than in the low-erosion group (140 l yr(-1)). High erosion was associated with a method of drinking whereby the drink was kept in the mouth for a longer period (71 s vs. 40 s). pH after drinking did not differ between the groups for any of the six measuring sites. Plaque accumulation on the palatal surfaces of maxillary anterior teeth and urea concentration in unstimulated saliva were lower in high-erosion subjects. Aside from these, there were no differences in salivary and microbial factors between the groups. First molar cuppings, buccal cervical defects, and mouth breathing were more common in the high- than in the low-erosion group. In summary, consumption of cola-type drink, method of drinking, amount of palatal plaque on anterior teeth, and salivary urea concentration are factors associated with dental erosion.
The nonobese diabetic (NOD) mouse spontaneously develops autoimmune‐mediated diseases such as diabetes and Sjögren′s syndrome. To investigate whether NOD genes also promote autoimmune‐mediatedarthritis we established a NOD strain with an MHC class II fragment containing the Aq class II gene predisposing for collagen induced arthritis (NOD.Q). However, this mouse was resistant to arthritis in contrast to other Aq expressing strains such as B10.Q and DBA/1. To determine the major resistance factor/s, a genetic analysis was performed. (NOD.Q×B10.Q)F1 mice were resistant, whereas 27% of the (NOD.Q×B10.Q)F2 mice developed severe arthritis. Genetic mapping of 353 F2 mice revealed two loci associated with arthritis. One locus was found on chromosome 2 (LOD score 9.8), at the location of the complement factor 5 (C5) gene. The susceptibility allele was from B10.Q, which contains a productive C5 encoding gene in contrast to NOD.Q. The other significant locus was found on chromosome 1 (LOD score 5.6) close to the Fc‐gamma receptor IIb gene, where NOD carried the susceptible allele. An interaction between the two loci was observed, indicating that they operate on the same or on interacting pathways. The genetic control of arthritis is unique in comparison to diabetes, since none of these loci have been identified in analysis of diabetes susceptibility.
The aim of this investigation was to study the intraoral pH response on tooth surfaces in relation to dental erosion during and after drinking a sugar-free cola-type soft drink. Six different methods of drinking were tested in a randomized order: holding; short-sipping; long-sipping; gulping; nipping; and sucking. Two methods of pH measurement were used in two series of individuals. In the first series, pH was measured by using the microtouch method in 12 healthy adults at three dental erosion-prone sites: 11 palatally; 11 buccally; and at the mesiobuccal cusp tip of 16. In the second series, pH was measured by using the telemetric method in 6 healthy individuals, producing continuous recordings of pH by means of a glass electrode in a specified approximal area. The two series showed similar results, although the telemetric method generally recorded larger pH falls. Holding the drink in the mouth before swallowing led to the most pronounced pH drop, followed by the long-sipping method. Gulping resulted in only a small decrease of pH. No differences among the three intraoral sites were found when analyzed by using the microtouch method. The conclusion from this study is that the drinking method strongly affects tooth-surface pH and thereby the risk for dental erosion. It therefore seems appropriate to include advice on the method of drinking in dietary counseling related to dental erosion.
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