Erosion of Dental Enamel Among Competitive Swimmers at a Gas-Chlorinated SWLMMTNG Pool

Abstract

In September 1982, two Charlottesville, Virginia, residents were found by their dentists to have general erosion of dental enamel consistent with exposure to acid. Both patients were competitive swimmers at the same private club pool. No other common exposure could be determined. An epidemiologic survey was made of 747 club members. Symptoms compatible with dental enamel erosion were reported by 3% of nonswimmers (9/295), 12% of swimmers who were not members of the swim team (46/393), and 39% of swim team members (23/59). All four swimmers with clinically verified dental enamel erosion had trained regularly in the pool for competitive swimming meets, compared with one of eight matched swimmers without enamel erosion. Examination of the implicated swimming pool revealed a gas-chlorinated pool with corrosion of metal fixtures and etching of cement exposed to the pool water. A pool water sample had a pH of 2.7, i.e., an acid concentration approximately 100,000 times that recommended for swimming pools (pH 7.2-8.0). A review of pool management practices revealed inadequate monitoring of pool water pH. Acid erosion of dental enamel--"swimmer's erosion"--is a painful, costly, irreversible condition which can be caused by inadequately maintained gas-chlorinated swimming pools.

Salivary Factors Affecting Dental Erosion in Children

“…Unadjusted odds do not eliminate the influence of other factors that an individual has in the calculation, but other authors have found that creating adjusted odds makes little difference to the odds ratio and it is a more complicated calculation [Centerwall et al, 1986]. When commenting on the odds ratios each control group needs to be considered individually, and the risk of each factor causing erosion in a caries-free individual and a caries-active individual calculated.…”

“…The chi-squared test was used for differences in salivary buffering capacity. Unadjusted odds ratios were then calculated for the various factors in order to make some assessment of the risk of developing erosion from each individual factor [Centerwall et al, 1986]. Each factor that had been examined in association with erosion was taken and the odds ratios calculated at the 95% confidence level, for the erosion study group compared with each of the control groups.…”

Dental Erosion – An Overview with Emphasis on Chemical and Histopathological Aspects

“…Employees in the chemical industry or professional wine tasters have a higher risk of suffering erosions due to the increased acid-tooth contact . Tooth erosion associated with professional athletes or excessive exercise has also been reported occasionally [Centerwall et al, 1986]. Excessive exposure to water or sport drinks with low pH, or the increased gastrooesophageal reflux resulting from strenuous exercise may be responsible for the sport-induced erosion [Centerwall et al, 1986].…”

Tooth surface loss: an overview

“…35,36 Health and safety laws have probably reduced the risk of environmental erosion although it should not be ignored as a possible aetiological factor. Environmental erosion predominantly affects the labial surfaces of the maxillary and mandibular incisors.…”