ErosionManuscripts.xls - OoCities

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					                              Categorical Breakout of Manuscipts:
                                          Causes- Foods/Drinks/Medications
                                           Causes- Socioeconomic Factors
                                                  Causes- Activity
                                           Causes- Bulemia/GERD/Asthma
                                                     Prevention
                                         Methods for Studying Dental Erosion
                                                      Treatment
                                        Causes due to environment/occupation
                                              Relationship with Caries



                                    Causes- Foods/Drinks/Medications
Dental erosion among children in an Istanbul public school.
Dental erosion among 12-14 year old school children in Khartoum: a pilot study.
Dental erosion in a group of British 14-year-old school children. Part II: Influence of dietary intake.
Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of differing socioeconomic backgrounds.
Dental erosion in a population of Swiss adults.
Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study models.
A difference in perspective--the North American and European interpretations of tooth wear.
Dental Erosion and Aspirin Headache Powders: A Clinical Report
Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using focus groups of schoolchildren. A preliminar
Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors
Dental erosion: part 1. Aetiology and prevalence of dental erosion.
Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system for assessing erosive anterior tooth wear.
Dental erosion, summary.
Dental erosion. Definition, classification and links
Dental erosion – changing prevalence? A review of British national childrens’ surveys
Dental erosions in subjects living on a raw food diet.
Dental erosion--the problem and some practical solutions.
Determinants of oral health in a group of Danish alcoholics.
Diet and dental erosion.
Etiology of dental: extrinsic factors erosion
Impact of modified acidic soft drinks on enamel erosion
Influence of diet on dental erosion in 14-year-olds - Dental erosion in a group of British 14-year-old school children Part II: Influence of dietary inta
On dental erosion and associated factors. (Introduction to a Full Supplement on Erosion)
Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with dental erosion
Patterns of tooth surface loss among winemakers.
Pilot study of dental erosion and associated factors in university student volunteers
Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten children.
Prevalence of pathological tooth wear in patients with chronic alcoholism.
Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among Icelanders.
Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Ohio, USA.
The erosive potential of flavoured sparkling water drinks


                                         Causes- Socioeconomic Factors
Dental erosion – changing prevalence? A review of British national childrens’ surveys
Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren.
Dental erosion in 5-year-old Irish school children and associated factors: a pilot study
Dental erosion in four-year-old children from differing socioeconomic backgrounds
Dental erosion in schoolchildren and socioeconomics


                                                       Causes- Activity
Effects of toothbrushing on eroded dentine
Rapid general dental erosion by gas-chlorinated swimming pool water. Review of the literature and case report.


                                       Causes- Bulemia/GERD/Asthma

Childhood asthma and dental erosion.
Dental and periodontal lesions in patients with gastro-oesophageal reflux disease
Dental erosion and gastro-esophageal reflux disease.
Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?
Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits in 1990 and 1999.
Erosion caused by gastroesophageal reflux: diagnostic considerations.
Etiology of dental erosion--intrinsic factors.
Gastroesophageal Reflux Disease, Tooth Erosion, and Prosthodontic Rehabilitation: A Clinical Report
Gastroesophageal reflux in children and its relationship to erosion of primary and permanent teeth.
Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary and permanent teeth.
Is there a relationship between asthma and dental erosion? A case control study.
Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study.
Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.
Prevalence of dental erosion and the implications for oral health.
Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia
Risk factors in dental erosion.
Salivary citrate and dental erosion. II. Dental erosion and citric acid in saliva
The distribution of erosion in the dentitions of patients with eating disorders.
The oral health of children with clefts of the lip, palate, or both.
The prevalence of dental erosion in preschool children in China.
Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and gastroesophageal reflux.
Vegetarian children and dental erosion.
What dental diseases are we facing in the new millennium: some aspects of the research agenda.


                                                            Prevention
Dental erosion Clinical diagnosis and case history taking
Dental erosion in children : an increasing clinical problem.
Destructive and protective factors in the development of tooth-wear.
Diagnosis and management of dental erosion.
Prevention of progression of dental erosion by professional and individual prophylactic measures
The 1993 national survey of children's dental health.
Tooth wear--dental erosion.


                                   Methods for Studying Dental Erosion
Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia
Enamel Erosion by Some Soft Drinks and Orange Juices Relative to Their pH, Buffering Effect and Contents of Calcium Phosphate
Erosion of deciduous and permanent dental hard tissue in the oral environment
Evaluation of a profilometrical method for monitoring erosive tooth wear
Methods of assessing erosion and erosive potential
Using partial recording to assess tooth wear in older adults


                                                          Treatment
Dental erosion in children: a literature review.
Dental erosion: part 2. The management of dental erosion.
Lessening dental erosive potential by product modification
Pathogenesis and modifying factors of dental erosion
Restorative therapy for erosive lesions


                               Causes due to Environment/Occupation
A difference in perspective--the North American and European interpretations of tooth wear.
A rapid epidemiological assessment of dental erosion to assist in settling an industrial dispute.
Associations between occupational health behaviors and occupational dental erosion
Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study models.
Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil
Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2: The association of diet and habits
Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: The relationship with water fluorid
Industrial dental erosion: a cross-sectional, comparative study.
Nutrition, diet and dental public health.
Occupational dental erosion from exposure to acids: a review.
Occupational exposure to airborne proteolytic enzymes and lifestyle risk factors for dental erosion--a cross-sectional study.
Oral conditions among German battery factory workers.
Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan.
Pilot study on dental erosion in a Norwegian electrolytic zinc factory.
Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan
The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents.
The prevalence of dental erosion in the maxillary incisors of 14-year-old schoolchildren living in Tower Hamlets and Hackney, London, UK.
The progression of tooth erosion in a cohort of adolescents of mixed ethnicity


                                             Relationship with Caries
Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children in the Hague, the Netherlands. Changing preval
Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.
Prevalence of caries and dental erosion among school children in The Hague from 1996-2005.
The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi Arabia
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Titles Hyperlinks (Left CLICK to JUMP to Abstracts)
Salivary citrate and dental erosion. II. Dental erosion and citric acid in saliva
Dental erosion among 12-14 year old school children in Khartoum: a pilot study.
Prevalence of caries and dental erosion among school children in The Hague from 1996-2005.
Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren.
Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.
Occupational dental erosion from exposure to acids: a review.
Dental erosion and gastro-esophageal reflux disease.
Destructive and protective factors in the development of tooth-wear.
Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary stud
Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten
Pilot study of dental erosion and associated factors in university student volunteers
Patterns of tooth surface loss among winemakers.
Dental erosion among children in an Istanbul public school.
Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil
The prevalence of dental erosion in preschool children in China.
Dental erosion in children : an increasing clinical problem.
Dental erosion: part 2. The management of dental erosion.
Dental erosion: part 1. Aetiology and prevalence of dental erosion.
Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?
Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux amon
Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children
Associations between occupational health behaviors and occupational dental erosion
Dental erosion in 5-year-old Irish school children and associated factors: a pilot study
Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary
Dental and periodontal lesions in patients with gastro-oesophageal reflux disease
Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits
Dental erosion -- changing prevalence? A review of British National childrens' surveys
Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors
On dental erosion and associated factors. (Introduction to a Full Supplement on Erosion)
Diet and dental erosion.
Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Oh
Diagnosis and management of dental erosion.
Is there a relationship between asthma and dental erosion? A case control study.
Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia
Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.
Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia
Rapid general dental erosion by gas-chlorinated swimming pool water. Review of the literature an
The relationship between erosion, caries and rampant caries and dietary habits in preschool child
Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jorda
The oral health of children with clefts of the lip, palate, or both.
Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation usin
Vegetarian children and dental erosion.
Occupational exposure to airborne proteolytic enzymes and lifestyle risk factors for dental erosio
Dental erosion in children: a literature review.
What dental diseases are we facing in the new millennium: some aspects of the research agenda
Dental erosion in a group of British 14-year-old school children. Part II: Influence of dietary intake
Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence
The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents
Childhood asthma and dental erosion.
Industrial dental erosion: a cross-sectional, comparative study.
The prevalence of dental erosion in the maxillary incisors of 14-year-old schoolchildren living in T
A difference in perspective--the North American and European interpretations of tooth wear.
Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan
Dental erosion--the problem and some practical solutions.
Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and g
Dental erosions in subjects living on a raw food diet.
Gastroesophageal reflux in children and its relationship to erosion of primary and permanent tee
Assessment and treatment of bulimia nervosa.
A rapid epidemiological assessment of dental erosion to assist in settling an industrial dispute.
Erosion caused by gastroesophageal reflux: diagnostic considerations.
Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a s
Determinants of oral health in a group of Danish alcoholics.
Dental erosion, summary.
Etiology of dental erosion--intrinsic factors.
Prevalence of dental erosion and the implications for oral health.
Tooth wear--dental erosion.
The 1993 national survey of children's dental health.
The distribution of erosion in the dentitions of patients with eating disorders.
Dental erosion in four-year-old children from differing socioeconomic backgrounds
Nutrition, diet and dental public health.
Dental erosion in a population of Swiss adults.
Oral conditions among German battery factory workers.
Risk factors in dental erosion.
Prevalence of pathological tooth wear in patients with chronic alcoholism.
Pilot study on dental erosion in a Norwegian electrolytic zinc factory.

Dental erosion – changing prevalence? A review of British national childrens’ surveys
Dental Erosion and Aspirin Headache Powders: A Clinical Report
Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour usi
Dental erosion Clinical diagnosis and case history taking
Dental erosion in schoolchildren and socioeconomics
Effects of toothbrushing on eroded dentine
Enamel Erosion by Some Soft Drinks and Orange Juices Relative to Their pH, Buffering Effect and
 Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West En
Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West En
Erosion of deciduous and permanent dental hard tissue in the oral environment
Evaluation of a profilometrical method for monitoring erosive tooth wear
Gastroesophageal Reflux Disease, Tooth Erosion, and Prosthodontic Rehabilitation: A Clinical Re
Impact of modified acidic soft drinks on enamel erosion
Influence of diet on dental erosion in 14-year-olds - Dental erosion in a group of British 14-year-old
Lessening dental erosive potential by product modification
Methods of assessing erosion and erosive potential
Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with d
Pathogenesis and modifying factors of dental erosion
Prevention of progression of dental erosion by professional and individual prophylactic measures
Restorative therapy for erosive lesions
The erosive potential of flavoured sparkling water drinks
The progression of tooth erosion in a cohort of adolescents of mixed ethnicity
Using partial recording to assess tooth wear in older adults
Dental erosion. Definition, classification and links
Etiology of dental: extrinsic factors erosion
 from 1996-2005.




n: a preliminary study.
 erman kindergarten children.




hern Brazil




phageal reflux among Icelanders.
 old school children in the Hague, the Netherlands. Changing prevalences?.


o erosion of primary and permanent teeth.

g Norwegian recruits in 1990 and 1999.


on Erosion)

tes in Columbus, Ohio, USA.




 audi Arabia
w of the literature and case report.
ts in preschool children in Saudi Arabia.
y industries in Jordan.

al investigation using study models.
ors for dental erosion--a cross-sectional study.

he research agenda.
nce of dietary intake.
 ence and influence of differing socioeconomic backgrounds.
mple of adolescents.


olchildren living in Tower Hamlets and Hackney, London, UK.
 of tooth wear.


cerebral palsy and gastroesophageal reflux.

 and permanent teeth.

ndustrial dispute.

 development of a system for assessing erosive anterior tooth wear.




e and behaviour using focus groups of schoolchildren. A preliminary study




Buffering Effect and Contents of Calcium Phosphate
en in North West England. Part 2: The association of diet and habits
en in North West England. Part 1: The relationship with water fluoridation and social deprivation


tation: A Clinical Report

of British 14-year-old school children Part II: Influence of dietary intake


f adolescents with dental erosion

ophylactic measures
ocial deprivation
  1   Salivary citrate and dental erosion. II. Dental erosion and citric acid in saliva
  5   Dental erosion among 12-14 year old school children in Khartoum: a pilot study.
  9   Prevalence of caries and dental erosion among school children in The Hague from 1996-2005.
 13   Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren.
 17   Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.
 21   Occupational dental erosion from exposure to acids: a review.
 25   Dental erosion and gastro-esophageal reflux disease.
 29   Destructive and protective factors in the development of tooth-wear.
 33   Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study.
 37   Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten children.
 41   Pilot study of dental erosion and associated factors in university student volunteers
 45   Patterns of tooth surface loss among winemakers.
 49   Dental erosion among children in an Istanbul public school.
 53   Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil
 57   The prevalence of dental erosion in preschool children in China.
 61   Dental erosion in children : an increasing clinical problem.
 65   Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1:
 69   Dental erosion: part 2. The management of dental erosion.
 73   Dental erosion: part 1. Aetiology and prevalence of dental erosion.
 77   Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?
 81   Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among Icelanders.
 85   Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children in the Hague
 89   Associations between occupational health behaviors and occupational dental erosion
 93   Dental erosion in 5-year-old Irish school children and associated factors: a pilot study
 97   Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary and permane
101   Dental and periodontal lesions in patients with gastro-oesophageal reflux disease
105   Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits in 1990 and 1
109   Dental erosion -- changing prevalence? A review of British National childrens' surveys
113   Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors
117   On dental erosion and associated factors. (Introduction to a Full Supplement on Erosion)
121   Diet and dental erosion.
125   Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Ohio, USA.
129   Diagnosis and management of dental erosion.
133   Is there a relationship between asthma and dental erosion? A case control study.
137   Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia
141   Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.
145   Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia
149   Rapid general dental erosion by gas-chlorinated swimming pool water. Review of the literature and case report
153   The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi A
157   Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan.
161   The oral health of children with clefts of the lip, palate, or both.
165   Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study mode
169   Vegetarian children and dental erosion.
173   Occupational exposure to airborne proteolytic enzymes and lifestyle risk factors for dental erosion--a cross-sec
177   Dental erosion in children: a literature review.
181   What dental diseases are we facing in the new millennium: some aspects of the research agenda.
185   Dental erosion in a group of British 14-year-old school children. Part II: Influence of dietary intake.
189   Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of differing so
193   The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents.
197   Childhood asthma and dental erosion.
201   Industrial dental erosion: a cross-sectional, comparative study.
205   The prevalence of dental erosion in the maxillary incisors of 14-year-old schoolchildren living in Tower Hamlets
209   A difference in perspective--the North American and European interpretations of tooth wear.
213   Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan
217   Dental erosion--the problem and some practical solutions.
221   Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and gastroesopha
225   Dental erosions in subjects living on a raw food diet.
229   Gastroesophageal reflux in children and its relationship to erosion of primary and permanent teeth.
233   Assessment and treatment of bulimia nervosa.
237   A rapid epidemiological assessment of dental erosion to assist in settling an industrial dispute.
241   Erosion caused by gastroesophageal reflux: diagnostic considerations.
245   Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system for ass
249   Determinants of oral health in a group of Danish alcoholics.
253   Dental erosion, summary.
257   Etiology of dental erosion--intrinsic factors.
261   Prevalence of dental erosion and the implications for oral health.
265   Tooth wear--dental erosion.
269   The 1993 national survey of children's dental health.
273   The distribution of erosion in the dentitions of patients with eating disorders.
277   Dental erosion in four-year-old children from differing socioeconomic backgrounds
281   Nutrition, diet and dental public health.
285   Dental erosion in a population of Swiss adults.
289   Oral conditions among German battery factory workers.
293   Risk factors in dental erosion.
297   Prevalence of pathological tooth wear in patients with chronic alcoholism.
301   Pilot study on dental erosion in a Norwegian electrolytic zinc factory.

309   Dental erosion – changing prevalence? A review of British national childrens’ surveys
313   Dental Erosion and Aspirin Headache Powders: A Clinical Report
317   Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using focus grou
321   Dental erosion Clinical diagnosis and case history taking
325   Dental erosion in schoolchildren and socioeconomics
329   Effects of toothbrushing on eroded dentine
333   Enamel Erosion by Some Soft Drinks and Orange Juices Relative to Their pH, Buffering Effect and Contents of C
337   Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2:
341   Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1:
345   Erosion of deciduous and permanent dental hard tissue in the oral environment
349   Evaluation of a profilometrical method for monitoring erosive tooth wear
353   Gastroesophageal Reflux Disease, Tooth Erosion, and Prosthodontic Rehabilitation: A Clinical Report
357   Impact of modified acidic soft drinks on enamel erosion
361   Influence of diet on dental erosion in 14-year-olds - Dental erosion in a group of British 14-year-old school child
365   Is there a relationship between asthma and dental erosion? A case control study
369   Lessening dental erosive potential by product modification
373   Methods of assessing erosion and erosive potential
377   Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with dental erosion
381   Pathogenesis and modifying factors of dental erosion
385   Prevention of progression of dental erosion by professional and individual prophylactic measures
389   Restorative therasv for erosive lesions
393   The erosive potential of flavoured sparkling water drinks
397   The progression of tooth erosion in a cohort of adolescents of mixed ethnicity
401   The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi A
405   Using partial recording to assess tooth wear in older adults

409 Dental erosion. Definition, classification and links
413 Etiology of dental: extrinsic factors erosion
eliminary study.
n kindergarten children.




 North West England. Part 1: The relationship with water fluoridation and social deprivation



al reflux among Icelanders.
chool children in the Hague, the Netherlands. Changing prevalences?.


 on of primary and permanent teeth.

wegian recruits in 1990 and 1999.




 Columbus, Ohio, USA.




he literature and case report.
 reschool children in Saudi Arabia.
stries in Jordan.

stigation using study models.

r dental erosion--a cross-sectional study.

 earch agenda.
  dietary intake.
and influence of differing socioeconomic backgrounds.
of adolescents.


dren living in Tower Hamlets and Hackney, London, UK.
ral palsy and gastroesophageal reflux.

permanent teeth.

 rial dispute.

 opment of a system for assessing erosive anterior tooth wear.




 behaviour using focus groups of schoolchildren. A preliminary study



ring Effect and Contents of Calcium Phosphate
North West England. Part 2: The association of diet and habits
North West England. Part 1: The relationship with water fluoridation and social deprivation


: A Clinical Report

ish 14-year-old school children Part II: Influence of dietary intake




escents with dental erosion

 ctic measures



reschool children in Saudi Arabia
Salivary citrate and dental erosion. II. Dental erosion and citric acid in saliva
Zipkin, Isadore; McClure, F. J. Natl. Inst. Dental Research, Bethesda, MD, Journal of Dental Research
(1949), 28 618-26. CODEN: JDREAF ISSN: 0022-0345. Journal language unavailable. CAN 44:12903
The citric acid content of stimulated saliva varies between 0.20 and approx. 2.00 mg. per 100 cc.; it increases
slightly with age. The severity of erosion also increases with age. Erosion occurs to a greater degree and
greater prevalence in the upper teeth than in the lower teeth, and to a similar degree in the teeth of the right and
left quadrants of both jaws. There appears to be a pos. statistical correlation between the severity of human

 Dental erosion among 12-14 year old school children in Khartoum: a pilot study.
 El Karim I A; Sanhouri N M; Hashim N T; Ziada H M Department of Restorative Dentistry, School of Clinical
Dentistry, Royal Victoria Hospital, Grosvenor Road, BT12 6BA, Northern Ireland. ielkarim@hotmail.com
OBJECTIVES: To investigate dental erosion among 12-14 year old Sudanese school children and evaluate the
associated risk factors. BASIC RESEARCH DESIGN: Cross sectional survey in secondary schools in Khartoum
city, Sudan. METHOD AND PARTICIPANTS: A sample of 157 school children was obtained from both private
and public schools. Erosion on the labial and palatal surfaces of maxillary incisors was measured by criterion
based on the Smith and Knight Tooth Wear Index. Dietary intake and other related factors were assessed using
a questionnaire. RESULTS: The overall erosion prevalence in this group was 66.9%, of which 45.2% was mild

 Prevalence of caries and dental erosion among school children in The Hague from 1996-2005.
Truin G J; Frencken J E; Mulder J; Kootwijk A J; Jong E de Afdeling Preventieve en Curatieve Tandheelkunde
van het Universitair Medisch Centrum St Radboud, Nijmegen. g.truin@dent.umcn.nl Nederlands tijdschrift
In 2005 a dental survey of the prevalence of caries among 6- and 12-year-old schoolchildren in The Hague was
carried out. In the case of the 12-year-olds, the prevalence of dental erosion was also studied. The sample
consisted of 814 students in twelve primary schools in The Hague. The results reveal that since the previous
study, in 2002, the trend in the direction of an increasing percentage of children with deciduous caries-free teeth
and permanent caries-free teeth had continued. In the case of the children who were not caries-free, it was
noticeable that, in general, the number of new dental caries (dmfs- and DMFS-score) had not changed in the
period 1996-2005, while the number of restorations among the 6- and 12-year olds had decreased. The mean
restorative index in the deciduous dentition of 6-year-olds decreased from approximately 40% in 1996 to
approximately 20% in 2005; with respect to permanant dentition among 12-year-olds, the percentage decreased

 Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren.
Auad Sheyla M; Waterhouse Paula J; Nunn June H; Steen Nick; Moynihan Paula J The School of Dental
Sciences, Newcastle upon Tyne, UK International dental journal (2007), 57(3), 161-7.
OBJECTIVES: To assess the prevalence of dental erosion in a sample of 13- and 14-year-old Brazilian
schoolchildren and to assess the relationship of dental erosion and socio-demographic characteristics.
METHODS: A convenience sample of 458 children (190 boys and 268 girls) from 14 schools in Tres Coracoes,
south east Brazil, was examined. Socio-demographic data were collected by self-completion questionnaires.
RESULTS: Dental erosion was observed in 34.1% of subjects, involving enamel only and showing a symmetrical
distribution. The palatal surfaces of the upper incisors were the most commonly affected surfaces. Erosion
experience was higher in boys; pupils from Government funded schools; those resident in rural areas and those
from the high economic class, but none of these were statistically significant.
CONCLUSION: These data are the first to show that in a cohort of 13-14-year old Brazilian schoolchildren,

 Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.
 Sugawa Takashi; Fujiwara Yasuhiro; Okuyama Masatsugu; Tanigawa Tetsuya; Shiba Masatsugu; Tominaga
Kazunari; Watanabe Toshio; Oshitani Nobuhide; Higuchi Kazuhide; Arakawa Tetsuo Department of
Gastroenterology, Osaka City University, Graduate School of Medicine Nippon rinsho. Japanese journal of
Gastroesophageal reflux disease (GERD) is associated with a variety of extraesophageal symptoms including
asthma, chronic cough, laryngeal disorders, and various ENT symptoms. Recent studies suggest that GERD
underlies or contributes to chronic sinusitis, chronic otitis media, dental erosion, and obstructive sleep apnea
syndrome (OSAS).
 Occupational dental erosion from exposure to acids: a review.
 Wiegand Annette; Attin Thomas Clinic for Preventive Dentistry, Periodontology and Cariology, University of
Zurich, Plattenstrasse 11, Zurich, Switzerland. annette.wiegand@zzmk.unizh.ch Occupational medicine
(Oxford, England) (2007), 57(3), 169-76. Journal code: 9205857. ISSN:0962-7480. Journal; Article;
OBJECTIVE: Dental erosion is characterized as a disorder with a multifactorial aetiology including environmental
acid exposure. The purpose of this article was to summarize and discuss the available information concerning
occupational dental erosion. METHODS: Information from original scientific papers, case reports and reviews
with additional case reports listed in PubMed, Medline or EMBASE [search term: (dental OR enamel OR dentin)
AND (erosion OR tooth wear) AND (occupational OR worker)] were included in the review. References from the
identified publications were manually searched to identify additional relevant articles. RESULTS: The systematic
search resulted in 59 papers, of which 42 were suitable for the present review. Seventeen papers demonstrated
evidence that battery, galvanizing and associated workers exposed to sulphuric or hydrochloric acid were at
higher risk of dental erosion. For other industrial workers, wine tasters and competitive swimmers, only a few

 Dental erosion and gastro-esophageal reflux disease.
Jasz Mate; Varga Gabor; Toth Zsuzsanna Fogpotlastani Klinika, Budapest Fogorvosi szemle (2007), 100(1),
3-10. Journal code: 0374613. ISSN:0015-5314. (ENGLISH ABSTRACT); Journal; Article; (JOURNAL
The prevalence of gastro-esophageal reflux disease (GERD), as well as that of dental erosion (DE), increases
steeply in the 21th century societies of Europe and North America. GERD is a multicausal disease, with genetic,
anatomical and neurological insufficiencies in the background, complemented with behavioral factors. In GERD,
as reflux occurs more often and lasts longer than physiologically, the result is esophagitis and supraesophageal
manifestations. The acid, which might even reach the mouth, interacts with the material of the teeth and
demineralization, a form of dental erosion takes place. Clinical studies have proved, that in patients suffering
from GERD dental erosion takes place significantly more often than in patients who do not. It was also
confirmed that in patients with idiopathic dental erosion GERD is significantly more frequent than in the
"uneroded" population.
These data suggest that in case of extended dental erosion the dentist should think of a - possibly not yet
 Destructive and protective factors in the development of tooth-wear.
Mate Jasz; Gabor Varga; Zsuzsanna Toth Semmelweis Egyetem, Fogpotlastani Klinika, Budapest Fogorvosi
szemle (2006), 99(6), 223-30. Journal code: 0374613. ISSN:0015-5314. (ENGLISH ABSTRACT); Journal;
The experience of the past decade proves that tooth wear occurs in an increasing number of cases in general
dental practice. Tooth wear may have physical (abrasion and attrition) and/or chemical (erosion) origin. The
primary physical causes are inadequate dental hygienic activities, bad oral habits or occupational harm. As for
dental erosion, it is accelerated by the highly erosive foods and drinks produced and sold in the past decades,
and the number of cases is also boosted by the fact that bulimia, anorexia nervosa and gastro-oesophageal
reflux disease prevalence have become more common. The most important defensive factor against tooth wear
is saliva, which protects teeth from the effect of acids. Tertiary dentin formation plays an important role in the
protection of the pulp. Ideally, destructive and protective factors are in balance. Both an increase in the
destructive forces, and the insufficiency of defense factors result in the disturbance of the equilibrium. This
results in tooth-wear, which means an irreversible loss of dental hard tissue. The rehabilitation of the lost tooth
material is often very difficult, irrespectively of whether it is needed because of functional or esthetic causes.
For that reason, the dentist should carry out primary and secondary dental care and prevention more often, i.e.

Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study.
Ersin Nazan Kocatas; Oncag Ozant; Tumgor Gokhan; Aydogdu Sema; Hilmioglu Suleyha Department of
Pedodontics, Dental Faculty, Ege University, Bornova-Izmir, Turkey. nazan.ersin@ege.edu.tr Pediatric
PURPOSE: The aim of this study was to investigate the effects of gastroeophageal reflux disease (GERD) on:
(1) erosion; (2) caries formation; (3) salivary function; and (4) salivary microbiological counts. METHODS: Thirty-
eight GERD patients with a mean age of 6 1/2 years and 42 healthy children of the same age and gender and
social background comprised the study group. All subjects answered a detailed frequency questionnaire related
to acidic drinks, foods, and sugar consumption and participated in a clinical dental examination. The caries
experience of the children was recorded according to World Health Organization criteria, and erosion was scored
according to the Eccles and Jenkins grading scale. The children were also investigated for stimulated salivary
flow rate, buffer capacity, and salivary mutans streptococci (MS), lactobacilli, and yeast colonization. RESULTS:
The prevalence of dental erosion and the salivary yeast and MS colonization in GERD children was found to be
significantly higher than for healthy subjects (P<.05). The caries experience, salivary flow rate, buffering
 Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten
Wiegand A; Muller J; Werner C; Attin T Department of Operative Dentistry, Preventive Dentistry and
Periodontology, University of Gottingen, Gottingen, Germany. annette.wiegand@med.uni-goettingen.de Oral
OBJECTIVES: The aims of this study were to (1) investigate prevalence and severity of erosive tooth wear
among kindergarten children and (2) determine the relationship between dental erosion and dietary intake, oral
hygiene behaviour, systemic diseases and salivary concentration of calcium and phosphate. MATERIALS AND
METHODS: A sample of 463 children (2-7 years old) from 21 kindergartens were examined under standardized
conditions by a calibrated examiner. Dental erosion of primary and permanent teeth was recorded using a
scoring system based on O'Sullivan Index [Eur J Paediatr Dent 2 (2000) 69]. Data on the rate and frequency of
dietary intake, systemic diseases and oral hygiene behaviour were obtained from a questionnaire completed by
the parents. Unstimulated saliva samples of 355 children were analysed for calcium and phosphate

 Pilot study of dental erosion and associated factors in university student volunteers
Hou Xiao-mei; Zhang Qing; Gao Xue-jun; Wang Jin-sheng Department of Operative Dentistry and
Endodontics, Peking University School of Stomatology, Beijing 100081, China Zhonghua kou qiang yi xue za zhi
= Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology (2005), 40(6), 478-80. Journal code:
OBJECTIVE: To investigate dental erosion and associated etiologic factors among students from one university.
METHODS: A total of 179 student volunteers from one university were examined clinically for their dental
erosion. Each was required to complete a questionnaire regarding potentially associated etiologic factors. A
modified criteria was used to grade the severity of dental erosion. RESULTS: The prevalence of dental erosion
of this group was 45.8%, mostly in enamel. Facial surfaces of anterior teeth were most vulnerable to erosion.

 Patterns of tooth surface loss among winemakers.
Chikte U M E; Naidoo S; Kolze T J v W; Grobler S R Department of Community Health, Faculty of Health
Sciences, University of Stellenbosch, PO Box 19063, Tygerberg. umec@sun.ac.za SADJ : journal of the South
African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging (2005), 60(9), 370-
There are a few documented case studies on the adverse effect of wine on both dental hard and soft tissues.
Professional wine tasting could present some degree of increased risk to dental erosion. Alcoholic beverages
with a low pH may cause erosion, particularly if the attack is of long duration, and repeated over time. The
purpose of this study was to compare the prevalence and severity of tooth surface loss between winemakers
(exposed) and their spouses (non-exposed). Utilising a cross-sectional, comparative study design, a clinical
examination was conducted to assess caries status; the presence and severity of tooth surface loss; staining
(presence or absence); fluorosis and prosthetic status. The salivary flow rate, buffering capacity and pH were
also measured. Thirty-six persons, twenty-one winemakers and fifteen of their spouses participated in the study.
 It was possible to show that there was a difference in terms of the prevalence and severity of tooth surface loss
between the teeth of winemakers and those who are not winemakers. The occurrence of tooth surface loss
Dental erosion among children in an Istanbul public school.
Caglar Esber; Kargul Betul; Tanboga Ilknur; Lussi Adrian Department of Pediatric Dentistry, School of
Dentistry, Marmara University, Istanbul, Turkey. caglares@yahoo.com Journal of dentistry for children
The aim of this study was to evaluate the prevalence, clinical manifestations, and etiology of dental erosion
among children. A total of 153 healthy, 11-year-old children were sampled from a downtown public school in
Istanbul, Turkey comprised of middle-class children. Data were obtained via: (1) dinical examination; (2)
questionnaire; and (3) standardized data records. A new dental erosion index for children designed by O'Sullivan
(2000) was used. Twenty-eight percent (N=43) of the children exhibited dental erosion. Of children who
consumed orange juice, 32% showed erosion, while 40% who consumed carbonated beverages showed

 Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil
Peres K G; Armenio M F; Peres M A; Traebert J; De Lacerda J T Universidade do Sul de Santa Catarina
(UNISUL), Tubarao, Brazil. karengp@ig.com.br International journal of paediatric dentistry / the British
Paedodontic Society [and] the International Association of Dentistry for Children (2005), 15(4), 249-55. Journal
OBJECTIVE: The aim of this study was to assess the prevalence and severity of dental erosion among 12-year-
old schoolchildren in Joacaba, southern Brazil, and to compare prevalence between boys and girls, and between
public and private school students. METHODS: A cross-sectional study was carried out involving all of the
municipality's 499, 12-year-old schoolchildren. The dental erosion index proposed by O'Sullivan was used for the
four maxillary incisors. Data analysis included descriptive statistics, location, distribution, and extension of
affected area and severity of dental erosion. RESULTS: The prevalence of dental erosion was 13.0% (95%
confidence interval = 9.0-17.0). There was no statistically significant difference in prevalence between boys and
girls, but prevalence was higher in private schools (21.1%) than in public schools (9.7%) (P < 0.001). Labial
surfaces were less often affected than palatal surfaces. Enamel loss was the most prevalent type of dental
erosion (4.86 of 100 incisors). Sixty-three per cent of affected teeth showed more than a half of their surface
 The prevalence of dental erosion in preschool children in China.
Luo Y; Zeng X J; Du M Q; Bedi R Dental Public Health, Faculty of Dentistry, University of Hong Kong, Hong
Kong SAR, China Journal of dentistry (2005), 33(2), 115-21. Journal code: 0354422. ISSN:0300-5712.
OBJECTIVE: To describe the prevalence of dental erosion and associated factors in preschool children in
Guangxi and Hubei provinces of China. METHODS: Dental examinations were carried out on 1949 children
aged 3-5 years. Measurement of erosion was confined to primary maxillary incisors. The erosion index used
was based upon the 1993 UK National Survey of Children's Dental Health. The children's general information as
well as social background and dietary habits were collected based on a structured questionnaire. RESULTS: A
total of 112 children (5.7%) showed erosion on their maxillary incisors. Ninety-five (4.9%) was scored as being
confined to enamel and 17 (0.9%) as erosion extending into dentine or pulp. There was a positive association
between erosion and social class in terms of parental education. A significantly higher prevalence of erosion was
observed in children whose parents had post-secondary education than those whose parents had secondary or
lower level of education. There was also a correlation between the presence of dental erosion and intake of fruit
drink from a feeding bottle or consumption of fruit drinks at bedtime. CONCLUSION: Erosion is not a serious
 Dental erosion in children : an increasing clinical problem.
Deshpande S D; Hugar S M Department of Pedodontics and Preventive Dentistry, KLES's Institute of Dental
Sciences, Belgaum, Karnataka Journal of the Indian Society of Pedodontics and Preventive Dentistry (2004),
Epidemiological studies carried out on dental erosion have established that the prevalence is high in young
people and adolescents. The objective of this study was to look at the prevalence and etiology of dental erosion,
particularly in children, and its practical management for its possible control. The children between 5-6 yrs were
examined and findings recorded, and this study has shown that approximately 1/3rd of 5-6 yrs old children have
appreciable tooth wear and dental erosion.
Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England.
Comment in: Br Dent J. 2005 Mar 12;198(5):283; author reply 283. PubMed ID: 15870754 Bardsley P F; Taylor
S; Milosevic A Dept. of Restorative Dentistry, Birmingham Dental Hospital, University of Liverpool, Pembroke
Place, Liverpool L3 5PS, UK British dental journal (2004), 197(7), 413-6; discussion 399. Journal code:
OBJECTIVE: The effect of water fluoridation upon dental erosion/tooth wear in the UK has not been investigated.
 This study aimed to compare the prevalence of tooth wear in 14-year-old schoolchildren in non-fluoridated and
fluoridated districts of North West (NW) England. The influence of deprivation and tooth brushing was also
investigated.
DESIGN: A random sample of 10% of the 14-year-old population in NW England was selected and stratified
according to fluoridation status as determined from water authority postcode listings.
METHODS: Tooth wear was scored on the labial, incisal and palatal/lingual surfaces of the 12 anterior teeth and
the occlusal surfaces of the first molars. Enamel wear was scored 0, dentine was scored 1 or 2, dependent on
whether less than or more than a third of the surface had exposed dentine. Secondary dentine or pulpal
exposure scored 3. Townsend deprivation scores were gained from residential post codes.
RESULTS: A total of 2,351 children were examined, of which 637 (27%) lived in the one fluoridated district of
South Cheshire and 1,714 (73%) lived in 11 non-fluoridated districts. Fifty-three per cent of the children had
exposed dentine with significantly more males affected than females (p<0.001). In the fluoridated district,
significantly fewer children had exposed dentine on labial and palatal smooth surfaces (p<0.001) but no
differences were found for incisal and occlusal surfaces.
 Dental erosion: part 2. The management of dental erosion.
Kilpatrick Nicky; Mahoney Erin K Dental Department, The Royal Children's Hospital, Parkville, VIC, Australia
The New Zealand dental journal (2004), 100(2), 42-7. Journal code: 0401065. ISSN:0028-8047. Journal;
Dental erosion is an important cause of tooth tissue loss in both children and adults. An earlier article (Mahoney
and Kilpatrick, 2003) discussed the prevalence and causes of dental erosion. This second article will discuss the
management of this condition which is often complicated by the multifactorial nature of tooth wear. Management
of dental erosion can be considered in three phases: immediate, interim and long-term. Immediate management
includes the early diagnosis of dental erosion, recording the status of the disorder at baseline and implementing
appropriate preventive strategies including those aimed at reducing the acidic exposure as well as those that
attempt to increase an individual's resistance to erosive tooth tissue loss. Interim and long-term treatment

 Dental erosion: part 1. Aetiology and prevalence of dental erosion.
Mahoney Erin K; Kilpatrick Nicky M Biomaterials Research Unit, University of Sydney, National Innovation
Centre, Eveleigh, NSW, Australia. emah0137@mail.usyd.edu.au The New Zealand dental journal (2003),
Non-carious tooth tissue loss due to abrasion, attrition, abfraction and erosion has become a significant problem,
occurring in up to 80 percent of children and in up to 43 percent of adults. Dental erosion is now recognised as
an important cause of tooth tissue loss in both children and adults. It is caused by the presence of intrinsic or
extrinsic acid of non-bacterial origin in the mouth. Intrinsic sources of acid include vomiting, regurgitation, gastro-
oesophageal reflux or rumination. Extrinsic sources of acid are most commonly dietary acids. Medications, a
patient's lifestyle choices and environment can also increase the risk of dental erosion. In this article we identify

 Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?
Moazzez Rebecca; Bartlett David; Anggiansah Angela Department of Conservative Dentistry, Floor 25 Guy's
Tower, St Thomas' Street, London Bridge, London SE1 9RT, United Kingdom. rebecca.moazzez@kcl.ac.uk
AIMS: The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary
parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD)
compared with a group of control subjects. MATERIALS AND METHODS: Tooth wear, stimulated salivary flow
rate and buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal
Laboratory. Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD.
Tooth wear was assessed using a modification of the Smith and Knight tooth wear index. The results were
compared to those obtained from a group of controls with no symptoms of GORD. RESULTS: Patients with
symptoms of GORD and those subsequently diagnosed with GORD had higher total and palatal tooth wear
(p<0.05). The buffering capacity of the stimulated saliva from the control subjects was greater than patients with
symptoms of GORD (p<0.001). Patients with hoarseness had a lower salivary flow rate compared with those
with no hoarseness. CONCLUSIONS: Tooth wear involving dentine was more prevalent in patients complaining
Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among
Jensdottir T; Arnadottir I B; Thorsdottir I; Bardow A; Gudmundsson K; Theodors A; Holbrook W P Department
of Oral Medicine, Dental School of Copenhagen, University of Copenhagen, Norre Alle 20, 2200 Copenhagen N,
Denmark. tje@odont.ku.dk Clinical oral investigations (2004), 8(2), 91-6. Journal code: 9707115.
The aim of this study was to determine the prevalence of dental erosion in young Icelandic adults (19-22 years
old) and patients with gastroesophageal reflux disease (GERD), in relation to their soft drink consumption and
gastroesophageal reflux. Eighty subjects (40 males and 40 females), comprising 57 young adults (mean age 21
+/- 2 years) and 23 GERD patients (mean age 35 +/- 10 years), were enrolled in this study. All subjects
answered a detailed frequency questionnaire of soft drink consumption and participated in a clinical examination.
 Erosion was scored for incisor and molar teeth separately. No significant difference was observed in the
prevalence of dental erosion between young adults and GERD patients. However, by combining the two study
groups a three-fold higher risk of having erosion in molars or incisors was found for subjects drinking Coca-Cola
three times a week or more often ( p < 0.05). Additionally, significantly higher erosion scores were found in
 Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children in the
Truin G J; van Rijkom H M; Mulder J; van' t Hof M A Afdeling Preventieve en Curatieve Tandheelkunde van de
Faculteit der Medische Wetenschappen van het Universitair Medisch Centrum Sint Radboud, Nijmegen.
g.truin@dent.umcn.nl Nederlands tijdschrift voor tandheelkunde (2004), 111(3), 74-9. Journal code:
In 2002 a dental survey amongst 6- and 12-year-old schoolchildren in The Hague had been carried out. The
2002 survey suggested that in the period 1996-2002 the caries prevalence (% of cariesfree children) and the
caries experience (mean dmfs/dmft scores) among 6-year-old children did not have changed significantly.
Children of low socio-economic status in 2002 had an average higher dmfs/dmft count compared to 6-year-olds
of medium and high SES. However, the survey suggested in the period 1996-2002 a significant increase of
cariesfree 12-year-old children in low SES. Among 12-year-olds socio-economic differences in caries
experience of the permanent dentition have diminished in 2002. In 1998 and 2002 respectively 3 and 23% of the

 Associations between occupational health behaviors and occupational dental erosion
Kim Hyun-duck; Douglass Chester W Department of Preventive and Public Health Dentistry, College of
Dentistry, Seoul National University, 28, Younkeon-dong, Chongro-ku, Seoul, 110-460, Korea.
OBJECTIVES: The aim of this study was to evaluate the associations between occupational health behaviors
and occupational dental erosion. METHODS: Using data for 943 workers among 34 factories, selected by three-
stage stratified cluster sampling from 888 factories using acids, two sets of modified case-control studies were
performed. The cases were 242 workers with any dental erosion (G1-5) and 78 with severe dental erosion (G3-
5); the controls were 701 workers with no erosion (GO) and 864 workers with no or mild erosion grades, GO-2,
respectively. The main explanatory variables were behaviors such as wearing a respiratory mask and gargling at
work. The results were adjusted for employment, age, sex, knowledge, and opinion about occupational health,
attrition, and abrasion. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The
odds of overall occupational dental erosion (G1-5) was 0.63 (95% CI = 0.42, 0.94) for respiratory mask wearers
compared to nonwearers; the odds of severe occupational dental erosion (G3-5) was not significantly less in
respiratory mask wearers (OR = 0.94; 95% CI = 0.53, 1.67). Gargling did not show a significant association with
 Dental erosion in 5-year-old Irish school children and associated factors: a pilot study
Harding M A; Whelton H; O'Mullane D M; Cronin M Oral Health Services Research Centre, University Dental
School and Hospital, Wilton, Cork, Ireland Community dental health (2003), 20(3), 165-70. Journal code:
OBJECTIVE: To determine the prevalence of dental erosion in a stratified sample of 5-year-old children and to
investigate whether demographic and dietary factors were associated. DESIGN: Cross sectional study in Cork
City and County. METHODS: A sample of 202 5-year-old children stratified on fluoridation status was selected.
Measurement of erosion used a scoring system and criteria based on those used in the UK. Wear on the palatal
and labial surfaces of primary maxillary teeth considered to be predominantly erosive was assessed.
Demographic and dietary details were collected via a parental questionnaire. Statistical analysis was stepwise
logistic regression. RESULTS: In lifetime residents of fluoridated areas (n = 114) 47% had evidence of erosion;
in 21% erosion had progressed to the dentine or pulp. The corresponding figures in non-fluoridated areas (n =
76) were 43% and 21% respectively. The variables significantly associated with erosion to dentine or pulp were
low socio-economic status, measured by low family income and the frequency of fruit squash and carbonated
 Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary and
Su Jo-Mei; Tsamtsouris Anthi; Laskou Meletia Department of Pediatric Dentistry, Tufts University School of
Dental Medicine, USA Journal of the Massachusetts Dental Society (2003), 52(2), 20-4. Journal code:
Patients with cerebral palsy are known to have a high incidence of feeding difficulties, including problems with
swallowing, vomiting, recurrent chest infections, and irritability. Gastroesophageal reflux (GER) is an involuntary
passage of the gastric contents into the esophagus. It has been found in a higher prevalence (up to 75 percent)
in cerebral palsy patients. Long-term gastric acid attacks teeth and can cause dental erosion. Bargen and
Austin first discovered the relationship between GER and dental erosion in 1937 when they concluded that the
loss of dental hard tissue could be an indicator and the predominant oral manifestation of GER. The purpose of
this study is to investigate the correlation between GER and dental erosion in primary and permanent teeth in
cerebral palsy patients. Twenty-one patients participated in this study. Results showed that out of the 21
patients, 15 had erosion and 11 of them had GER history. The chi-square analysis with the p value of less than
or equal to 0.025 showed the distribution to be significant. The severity of the erosion was correlated to the
duration of the disease, frequency of vomiting, pH of the acid, type of acid, and quantity and quality of saliva.
The study revealed that children with cerebral palsy have an increased prevalence of tooth erosion, which may
 Dental and periodontal lesions in patients with gastro-oesophageal reflux disease
Munoz J V; Herreros B; Sanchiz V; Amoros C; Hernandez V; Pascual I; Mora F; Minguez M; Bagan J V; Benages
A Department of Gastroenterology, Clinic University Hospital, University of Valencia, Avda. Blasco Ibanez 17,
46010 Valencia, Spain Digestive and liver disease : official journal of the Italian Society of Gastroenterology and
OBJECTIVE: Dental erosion has been considered an extraesophageal manifestation of gastro-oesophageal
reflux disease, but few reports have studied the relationship between this disease and other periodontal or dental
lesions. The aim of this study was to investigate the prevalence of dental and periodontal lesions in patients with
gastro-oesophageal reflux disease. PATIENTS AND METHODS: A total of 253 subjects were prospectively
studied between April 1998 and May 2000. Two study groups were established: 181 patients with gastro-
oesophageal reflux disease and 72 healthy volunteers. Clinical assessment, including body mass index and
consumption of tobacco and alcohol, was performed in all subjects, as well as a dental and periodontal
examination performed by a dentist physician, blind as to the diagnosis of subjects. Parameters evaluated were:
(a) presence and number of dental erosion, location and severity, according to the Eccles and Jenkins index
[Prosthet Dent 1979;42:649-53], modified by Hattab [Int J Prosthes 2000;13:101-71; (b) assessment of dental
condition by means of the CAO index; and (c) periodontal status analysed by the plaque index, the haemorrhage

 Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits in
Myklebust Stale; Espelid Ivar; Svalestad Sigurd; Tveit Anne Bjorg Faculty of Odontology, University of Bergen,
Norway. Stale.Myklebust@odont.uib.no Acta odontologica Scandinavica (2003), 61(2), 100-4. Journal code:
A questionnaire was given to representative samples of Norwegian recruits in 1990 and 1999 to explore dental
health habits, history of gastroesophageal disorders and diet with possible relations to dental erosion. The
samples were 792 (mean age 20.9 years) and 676 (mean age 21.6 years), respectively, and the corresponding
responses were 62% and 100%. Minor differences in self-reported dental health habits and gastroesophageal
disorders were found. The respondents' dentists had provided information about dental erosion for 8.2% of the
respondents in 1990 versus 14.5% in 1999. There was an increase in the reported frequency of daily intake of
juice from 17% to 24% (P = 0.006) and carbonated soft drink from 54% to 61% (P = 0.025) in the period 1990-
99. The frequency of training activity showed minor changes, but in 1999 it was more common to drink during
exercise (94% versus 74% in 1990, P < 0.001), and the majority drank water. Sixteen percent of recruits ate
oranges daily in 1990; in 1999 this had dropped to 11% (P = 0.012). The corresponding proportion that ate

 Dental erosion -- changing prevalence? A review of British National childrens' surveys
Nunn J H; Gordon P H; Morris A J; Pine C M; Walker A Public and Child Dental Health, School of Dental
Science, Trinity College, Dublin, Ireland. june.nunn@dental.tcd.ie International journal of paediatric dentistry /
the British Paedodontic Society [and] the International Association of Dentistry for Children (2003), 13(2), 98-
OBJECTIVES: To investigate the change in the prevalence of dental erosion, over time, by a review of the data
from the published national dental surveys of young people in the UK. A subsidiary objective was to investigate
the relationship between erosion and possible associated risk factors. DESIGN: The review was based on cross-
sectional prevalence studies incorporating a clinical dental examination and structured interviews. SAMPLE: The
data were collated from the 1993 UK childrens' dental health survey and the dental report of the two National Diet
and Nutrition Surveys (NDNS) of children aged 1(1/2)-4(1/2) in 1992/3 and 4-18 years in 1996/7. The criteria
used for data collection were comparable between the three different studies. RESULTS: Comparing the data
from the different studies, the prevalence of erosion was seen to increase from the time of the childrens' dental
health survey in 1993 and the NDNS study of 4-18-year-olds in 1996/7. There was a trend towards a higher
prevalence of erosion in children aged between 3(1/2) and 4(1/2) and in those who consumed carbonated drinks
on most days compared with toddlers consuming these drinks less often. Drinks overnight were associated with
an increased prevalence of erosion. More 4-6-year-olds with reported symptoms of gastro-oesophageal reflux
had erosion compared with symptom-free children. On multivariate analysis, the strongest independent
association with erosion was geography, with children living in the North having twice the odds of having erosion
compared with those in London and the South-east.
 Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors
Arnadottir Inga B; Saemundsson Sigurdur Runar; Holbrook W Peter Faculty of Odontology, University of
Iceland, Reykjavik, Iceland. iarnad@hi.is Acta odontologica Scandinavica (2003), 61(1), 25-8. Journal code:
High consumption of fruit juices and carbonated drinks has been related to dental erosion. Teenage male
Icelanders consume about 800 ml of carbonated drinks per day on average and this corresponds with the main
age group and gender of patients seen with erosion. This study examined the prevalence of dental erosion in 15-
year-old children in Reykjavik and looked at the association between erosion and some lifestyle factors in a case-
control study drawn from the same sample. A 20% sample of the 15-year-cohort population (n = 278) was
selected. Dental erosion was classified by location and severity (1 = enamel erosion; 2 = dentine erosion; 3 =
severe dentine erosion) and was seen in 21.6% of subjects (68.3% male; 72% scored as grade 1; 23% grade 2;
5% grade 3). Control subjects were the first healthy subjects examined after a case subject had beens
diagnosed. In the case-control study, information was gathered by multiple-choice questionnaire on symptoms of
gastric reflux, tooth sensitivity, some lifestyle and dietar-factors. Several lifestyle and dietary factors, previously
shown to be significantly related to dental caries in Icelandic teenagers, showed no significant relationship to

 On dental erosion and associated factors. (Introduction to a Full Supplement on Erosion)
Johansson Ann-Katrin Department of Cariology, Faculty of Odontology, Sahlgrenska Academy, Goteborg
University Swedish dental journal. Supplement (2002), (156), 1-77. Journal code: 7905899. ISSN:0348-6672.
The aim of this thesis was to explore aspects of dental erosion by investigating its prevalence among young
Saudi men and young children, develop a system for its assessment and to evaluate various tentative
background factors that may be associated with its occurrence. Saudi military inductees (n = 95) were subjected
to questionnaire and clinical examination, including recordings of severity of dental erosion and a number of
other oral health parameters. The system applied for grading the severity of dental erosion showed an
intraexaminer agreement of 78%. Around one-fourth of the maxillary anterior tooth surfaces exhibited
pronounced dental erosion and the average soft drink consumption was 247 liters/year. High level of soft drink
consumption and long retention time of the drink in the mouth before swallowing, intensified oral hygiene, mouth
breathing and low gingival bleeding index were found to have significant correlations with the presence of dental
erosion.
Furthermore, less plaque on maxillary palatal tooth surfaces, increased numbers of buccal cervical defects, first
permanent molar "cuppings", missing teeth, and lower salivary urea content had significant correlations with the
severity of dental erosion. High intake of acidic drinks and fruits, upper respiratory tract problems and frequent
taking of medication were common findings in young Saudi children (n = 16) with severe dental erosion. The
clinical diagnosis of erosion in deciduous teeth was confirmed by SEM. Enamel from various healthy teeth were
subjected to microhardness measurements before and after in vitro exposure to citric acid.
 Diet and dental erosion.
 Lussi A; Jaeggi T; Schaffner M Department of Operative, Preventive and Pediatric Dentistry, School of Dental
Medicine, University of Bern, Switzerland Nutrition (Burbank, Los Angeles County, Calif.) (2002), 18(9), 780-1.
NO ABSTRACT

 Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Ohio,
Mathew Tanya; Casamassimo Paul S; Hayes John R College of Dentistry, The Ohio State University,
Children's Hospital, Columbus, Ohio 43017, USA. mathew.15@osu.edu Caries research (2002), 36(4), 281-
Acidic soft drinks, including sports drinks, have been implicated in dental erosion with limited supporting data in
scarce erosion studies worldwide. The purpose of this study was to determine the prevalence of dental erosion
in a sample of athletes at a large Midwestern state university in the USA, and to evaluate whether regular
consumption of sports drinks was associated with dental erosion. A cross-sectional, observational study was
done using a convenience sample of 304 athletes, selected irrespective of sports drinks usage. The Lussi Index
was used in a blinded clinical examination to grade the frequency and severity of erosion of all tooth surfaces
excluding third molars and incisal surfaces of anterior teeth. A self-administered questionnaire was used to
gather details on sports drink usage, lifestyle, health problems, dietary and oral health habits. Intraoral color
slides were taken of all teeth with erosion. Sports drinks usage was found in 91.8% athletes and the total
 Diagnosis and management of dental erosion.
Gandara B K; Truelove E L Department of Oral Medicine, School of Dentistry, University of Washington,
Seattle 98195, USA. bgandara@u.washington.edu The journal of contemporary dental practice (1999), 1(1),
Early recognition of dental erosion is important to prevent serious irreversible damage to the dentition. This
requires awareness of the clinical appearance of erosion compared to other forms of tooth wear. An
understanding of the etiologies and risk factors for erosion is also important. These form the basis of a

 Is there a relationship between asthma and dental erosion? A case control study.
Al-Dlaigan Y H; Shaw L; Smith A J Unit of Paediatric Dentistry, Unit of Oral Biology, The University of
Birmingham Dental School, St Chads, Queensway, Birmingham B4 6NN, UK International journal of paediatric
dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children (2002),
OBJECTIVES: The aims of this study were firstly to assess and compare the prevalence of dental erosion and
dietary intake between three groups of children; children with asthma, those with significant tooth erosion but with
no history of asthma, and children with no history of asthma or other medical problems. Secondly, to discover
whether there was a relationship between medical history and dietary practises of these children and the levels of
dental erosion. Thirdly, to measure and compare their salivary flow rates, pH and buffering capacity.
METHODS: The study consisted of 3 groups of children aged 11-18 years attending Birmingham Dental
Hospital: 20 children with asthma requiring long-term medication, 20 children referred with dental erosion, and 20
children in the age and sex matched control group. Tooth wear was recorded using a modification of the tooth
wear index (TWI) of Smith and Knight. Data on the medical and dietary history were obtained from a self-
reported questionnaire supplemented by a structured interview. The salivary samples were collected under
standard methods for measurements. RESULTS: Fifty percent of the children in the control group had low
erosion and 50% moderate erosion. However, high levels were recorded in 35% of children in the asthma group

Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia
Al-Majed Ibrahim; Maguire Anne; Murray John J Department of Child Dental Health, Dental School,
Framlington Place, Newcastle upon Tyne, NE2 4BW, United Kingdom Community dentistry and oral
MATERIAL AND METHODS: Dental examinations were carried out on 354 boys aged 5-6 years, and 862 boys aged 12-14
years, attending 40 schools in Riyadh. The prevalence of dental erosion was assessed using diagnostic criteria similar to
those employed in the 1993 UK National Survey of Child Dental Health. RESULTS: Pronounced dental erosion (into dentine
or dentine and pulp) was observed in 34% of 5-6 year olds and 26% of 12-14 year olds. Information on food and drink
consumed and dietary habits was obtained by means of a questionnaire. Parents reported that 65% of 5-6 year old boys
took a drink to bed. Water was the commonest drink consumed (37%) followed by carbonated soft drinks (21%). One third
of parents reported that their son had something to eat in bed or during the night and 60% of this was sweet food or
confectionery. Seventy per cent of 12-14 year old boys reported consuming drinks at night; these were mainly water (30%),
carbonated soft drinks (27%) and tea or coffee, with sugar (18%). Forty-six per cent of the 12-14 year olds reported that
they ate in bed at least once a week and 54% of this was sweet food or confectionery. When the dental examination and
questionnaire results were correlated, a statistically significant relationship was found between the number of primary
maxillary incisors with pronounced erosion of their palatal surfaces and the consumption of carbonated soft drinks at night
(P=0.015).

 Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.
Al-Malik Manal I; Holt Ruth D; Bedi Raman Department of Transcultural Oral Health, Eastman Dental Institute,
University College London, University of London, London, UK Community dentistry and oral epidemiology
OBJECTIVES: The objective of this study was to determine the prevalence of dental erosion in preschool
children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children.
METHODS: A sample of 987 children (2-5 years) was drawn from 17 kindergartens. Clinical examinations were
carried out under standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of
erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in
the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries
was defined as caries affecting the smooth surfaces of two or more maxillary incisors.
RESULTS: Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to
enamel but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and
rampant caries in 336 (34%). The mean dmft for the 987 children was 4.80 (+/-4.87). Of the 384 children who
had caries but not rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out
of 267 who were clinically caries free (SND=2.61, P<0.01). Of the 336 with rampant caries, 96 (29%) also had
evidence of erosion.
 Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia
Al-Malik M I; Holt R D; Bedi R Department of Transcultural Oral Health, Eastman Dental Institute, University
College London, UK Community dental health (2001), 18(4), 232-5. Journal code: 8411261. ISSN:0265-539X.
OBJECTIVE: To compare findings from photographs of incisor teeth in pre-school children in Jeddah, Saudi
Arabia to those on clinical examination for dental erosion. BASIC RESEARCH DESIGN: Cross sectional study of
2-5-year-old Saudi Arabian children using two methods of examination. MEASUREMENT: of erosion was
carried out clinically using a scoring system and criteria based on those used in the United Kingdom national
surveys. Photographs of labial and palatal surfaces of maxillary primary incisors were taken for each child and
scored in the same way. SETTING: Kindergarten schools in Jeddah, Saudi Arabia. PARTICIPANTS: 987
children from 17 randomly selected schools in Jeddah, Saudi Arabia. RESULTS: Readable photographs were
available for 727 children. Two hundred and twenty (30%) had photographic evidence of tooth tissue loss.
Prevalence estimates derived from clinical examination were higher than those for photographs (36% compared
to 30%). Agreement was seen between the two methods for 93% of the surfaces included.

 Rapid general dental erosion by gas-chlorinated swimming pool water. Review of the literature and case
Geurtsen W Department of Conservative Dentistry and Periodontology, Medical University Hannover,
Germany. Geurtsen.Werner@mh-Hannover.de American journal of dentistry (2000), 13(6), 291-3. Journal
Several reports indicate an increased prevalence of dental erosion among intensive swimmers due to low pH
gas-chlorinated pool water. Contrary to other extrinsic factors which induce erosion located on the facial aspect,
low pH pool water results in general dental erosion. Additionally, a case report is presented which describes the
very rapid occurrence of excessive general dental erosion of a competitive swimmer due to gas-chlorinated pool
water within 27 days. The observation of several authors as well as this case underscore the significance of a

The relationship between erosion, caries and rampant caries and dietary habits in preschool children in
Al-Malik M I; Holt R D; Bedi R Department of Transcultural Oral Health, Eastman Dental Institute, University
College, London, UK International journal of paediatric dentistry / the British Paedodontic Society [and] the
International Association of Dentistry for Children (2001), 11(6), 430-9. Journal code: 9107511. ISSN:0960-
OBJECTIVES: The aim of this study was to investigate the possible association between dental erosion and
caries, and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a
sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and
questionnaire survey was carried out at a number of kindergartens. SAMPLE AND METHODS: A sample of 987
children (2-5-year-olds) was drawn from 17 kindergartens. Clinical examinations were carried out under
standardized conditions by a trained and calibrated examiner (MAM). Information regarding diet and socio-
economic factors was drawn from questionnaires distributed to the parents through the schools. These were
completed before the dental examination. RESULTS: Of the 987 children, 309 (31%) showed signs of erosion.
Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). Vitamin C supplements,

 Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan.
Amin W M; Al-Omoush S A; Hattab F N wami@ju.edu.jo International dental journal (2001), 51(3), 169-74.
Journal code: 0374714. ISSN:0020-6539. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
OBJECTIVES: To investigate the prevalence and nature of oral health problems among workers exposed to acid
fumes in two industries in Jordan. SETTING: Jordan's Phosphate Mining Company and a main private battery
factory. DESIGN: Comparison of general and oral health conditions between workers exposed to acid fumes
and control group from the same workplace. SUBJECTS AND METHODS: The sample consisted of 68 subjects
from the phosphate industry (37 acid workers and 31 controls) drawn as a sample of convenience and 39
subjects from a battery factory (24 acid workers and 15 controls). Structured questionnaires on medical and
dental histories were completed by interview. Clinical examinations were carried out to assess dental erosion,
oral hygiene, and gingival health using the appropriate indices. Data were statistically analysed using Wilcoxon
rank-sum test to assess the significance of differences between results attained by acid workers and control
groups for the investigated parameters. RESULTS: Differences in the erosion scores between acid workers in
both industries and their controls were highly significant (P<0.05). In both industries, acid workers showed
 The oral health of children with clefts of the lip, palate, or both.
Chapple J R; Nunn J H Dental Hospital, Newcastle upon Tyne, NE2 4BW, United Kingdom The Cleft palate-
craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association (2001), 38(5), 525-
OBJECTIVE: The purpose of this study was to assess the prevalence of dental caries, developmental defects of
enamel, and related factors in children with clefts. DESIGN: This cross-sectional prevalence study used
standard dental indices for assessment. SETTING: Children underwent a dental examination under standard
conditions of seating and lighting in the outpatient department of a dental hospital as part of an ongoing audit to
monitor clinical outcomes. PARTICIPANTS: Ninety-one children aged 4, 8, and 12 years were included in the
study. OUTCOME MEASUREMENTS: Dental caries were assessed by use of the decayed, missing, and filled
index for primary teeth (dmft); Decayed, Missing, and Filled index for permanent teeth (DMFT) according to the
criteria as used in the national survey of children's dental health in the United Kingdom. Developmental defects
were assessed using the modified Developmental Defects of Enamel Index (Clarkson and O'Mullane, 1989).
Dental erosion was assessed using the criteria derived for the national survey of children's dental health.
RESULTS: Caries prevalence increased with age; 63% of patients at 4 years and 34% at 12 years were caries

Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study
Ganss C; Klimek J; Giese K Dental Clinic, Department of Operative and Preventive Dentistry, Justus-Liebeg-
University, Giessen, Germany. Carolina.Ganss@dentist.med.uni-giessen.de Community dentistry and oral
OBJECTIVE: To investigate the prevalence and incidence of dental erosion in children and adolescents.
METHODS: Lesions were registered for all tooth surfaces of primary and permanent teeth using pre-orthodontic
study models. A total of 1,000 individuals (mean age 11.4+/-3.3 years) were included; 265 of them were followed
over a 5-year period using their final orthodontic casts. RESULTS: In the primary teeth, 26.4% of the individuals
had no erosive lesions, 70.6% had at least one tooth with grade 1 erosion and 26.4% had grade 2 erosion.
Grade 1 erosion was found in 44% of the occlusal surfaces of molars (36% of the incisal surfaces of the canines)
and grade 2 erosion in 11% (9%). Lesions affecting oral or vestibular surfaces were negligible. In the
permanent teeth, 11.6% of individuals had at least one tooth with grade 1 erosion but only 0.2% had at least one
tooth with grade 2 erosion. The most affected teeth were the mandibular first molars (7% with grade 1 lesions).
Lesions affecting oral or vestibular surfaces were negligible. Mandibular first molars were identified as possible
marker teeth for the onset of erosive lesions. Within the last two decades, the percentage of subjects with at
 Vegetarian children and dental erosion.
al-Dlaigan Y H; Shaw L; Smith A J Department of Paediatric Dentistry, University of Birmingham, Dental
School, St Chads Queensway, Birmingham, B4 6NN, UK. y.h.aldlaigan@bham.ac.uk International journal of
paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children
BACKGROUND: There have been recent changes in teenage lifestyle and diet. The increasing consumption of
soft drinks and foods containing significant acidic components may play a role in the development of dental
erosion. OBJECTIVE: The aims of this investigation were firstly to assess the prevalence of vegetarian children
in a cluster random sample of 14-year-old children in Birmingham, United Kingdom. Secondly, to determine the
prevalence of dental erosion in these children, and thirdly, to see if there were any differences between
vegetarian and non-vegetarian children in the prevalence of dental erosion and dietary intake. DESIGN: A
cluster random sample of 418 14-year-old children (209 males and 209 females) were examined from 12
different schools in Birmingham, United Kingdom; a dietary questionnaire was completed and the levels of tooth
wear were recorded using a modification of the (TWI) index. All data were analysed using SPSS with t-test and
Chi-square analysis. Significance was accepted at the P < 0.05 level. RESULTS: The results showed that 10%

 Occupational exposure to airborne proteolytic enzymes and lifestyle risk factors for dental erosion--a
Westergaard J; Larsen I B; Holmen L; Larsen A I; Jorgensen B; Holmstrup P; Suadicani P; Gyntelberg F
Department of Periodontology, School of Dentistry, University of Copenhagen, Norre Alle 20, DK-2200
Copenhagen N, Denmark. jytte.westergaard@odont.ku.dk Occupational medicine (Oxford, England) (2001),
This study examined the hypothesis that occupational exposure to airborne proteolytic enzymes is associated
with dental erosions on the facial surfaces of exposed teeth. Individuals (n = 425) working at a pharmaceutical
and biotechnological enterprise (Novozymes A/S) were examined; their mean age was 35 years (range = 18-67
years) and 143 (34%) were women. Two hundred and two of these individuals were newly employed by the
company. Occupational exposure was assessed from questionnaire and workplace information. For practical
analytical purposes, individuals were categorized as either previously exposed to proteolytic enzymes or not.
Information on relevant lifestyle factors and medical history was obtained from a questionnaire. The main effect
measure was facial erosion, but lingual erosion indices and the presence of Class V restorations were also
considered. The validity of these measures was shown to be very high. Adjusted for potential confounders,

 Dental erosion in children: a literature review.
Linnett V; Seow W K University of Queensland School of Dentistry, Brisbane, Australia Pediatric dentistry
(2001), 23(1), 37-43. Journal code: 7909102. ISSN:0164-1263. Journal; Article; (JOURNAL ARTICLE);
Epidemiological studies have shown that the prevalence of dental erosion in children varies widely between 2
and 57%. Changes seen in dental erosion range from removal of surface characteristics to extensive loss of
tooth tissue with pulp exposure and abscess formation. Symptoms of dental erosion range from sensitivity to
severe pain associated with pulp exposure. The etiology of dental erosion is dependent on the presence of
extrinsic or intrinsic acid in the oral environment. Extrinsic sources of acids in children include frequent
consumption of acidic foods and drinks, and acidic medications. Regurgitation of gastric contents into the
mouth, as occurs in gastroesophageal reflux, is the most common source of intrinsic acid in children. A
multitude of factors may modify the erosion process, such as saliva, oral hygiene practices, and presence or
 What dental diseases are we facing in the new millennium: some aspects of the research agenda.
 ten Cate J M Department of Cariology Endodontology Pedodontology, Academic Center for Dentistry
Amsterdam, The Netherlands Caries research (2001), 35 Suppl 1 2-5. Journal code: 0103374. ISSN:0008-
The next decades will show a shift in the attention given to diseases of the dental hard tissues. Clinical evidence
on how to prevent dental caries is now available. More emphasis should be given to optimising the rational use
of schemes of prevention. Caries still shows epidemic patterns in many countries while in some developed
countries a high prevalence of the disease is limited to a small group. Increased attention is needed for new
manifestations of pathology such as dental erosion, and for caries in special high-risk groups.
New methods of presenting caries prevalence and incidence data should be implemented to ensure that the

 Dental erosion in a group of British 14-year-old school children. Part II: Influence of dietary intake.
Al-Dlaigan Y H; Shaw L; Smith A The University of Birmingham, School of Dentistry British dental journal
(2001), 190(5), 258-61. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL ARTICLE)
OBJECTIVES: The aims of the present study were first to investigate the dietary intake pattern of UK teenagers
and secondly to determine the relationship, if any, between dental erosion and dietary intake in these children.
METHODS: The study group consisted of a cluster random sample of 14-year-old school children in
Birmingham, UK: 418 children were examined from 12 different schools; 209 were male and 209 female. Data
on the rate and frequency of consumption of drinks, foods, and fruits were obtained from a self-reported
questionnaire supplemented by a structured interview. The data were analysed using SPSS with Chi-square,
and Spearman correlation analysis. RESULTS: Over 80% of the teenagers regularly consumed soft drinks but
approximately half of these children had a relatively low weekly consumption. However, 13% and 10%
respectively had more than 22 intakes per week of cola and other carbonated drinks. Almost a quarter of these

 Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of
Al-Dlaigan Y H; Shaw L; Smith A The University of Birmingham, School of Dentistry, St Chads, Queensway
British dental journal (2001), 190(3), 145-9. Journal code: 7513219. ISSN:0007-0610. Journal; Article;
OBJECTIVES: To establish the prevalence of erosion in a cluster random sample of 14- year-olds in Birmingham
UK. To determine whether socioeconomic group influences the prevalence of erosion. METHODS: The study
group consisted of a cluster random sample of 14-year-old school children in Birmingham UK: 418 children were
examined from 12 different schools; 209 were male and 209 female. The level of tooth wear was recorded using
a modification of the (TWI) index of Smith and Knight (1984). The ACORN classification was used to assess the
socioeconomic status of all children. RESULTS: Results showed that 48% of the children had low erosion, 51%
had moderate erosion and only 1% had severe erosion. There were statistically significant differences between
males and females; more males had buccal/labial and lingual/palatal tooth surface erosion than females (Chi-

 The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents.
Deery C; Wagner M L; Longbottom C; Simon R; Nugent Z J Dental Health Services Research Unit, University
of Dundee, Scotland, UK. c.h.deery@dundee.ac.uk Pediatric dentistry (2000), 22(6), 505-10. Journal code:
7909102. ISSN:0164-1263. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE); (RESEARCH
PURPOSE: A high prevalence of tooth surface loss due to erosion is well recognized in the United Kingdom
(UK), but not in the United States (US). This could be due to prevalence or perception or a combination of both.
The aim of this study was to measure the prevalence of erosion of the upper permanent incisors in US and UK
samples of 11-13 year old children. METHODS: Convenience samples of 129 subjects were examined in the US
and 125 in the UK by two trained examiners. The palatal and buccal surfaces of the upper permanent incisors
were assessed for the presence of erosion. Subjects also completed a questionnaire investigating any
association between the presence of erosion and possible etiological factors. RESULTS: The prevalence of
erosion was 41% in the US and 37% in the UK samples, this difference was not statistically significant. Similarly
no statistically significant difference was found between the sexes. The erosion present was confined to enamel

 Childhood asthma and dental erosion.
Shaw L; al-Dlaigan Y H; Smith A University of Birmingham Dental School, United Kingdom ASDC journal of
dentistry for children (2000), 67(2), 102-6, 82. Journal code: 0146172. Journal; Article; (JOURNAL ARTICLE)
The aim of this investigation was first to assess the prevalence of asthma in a random sample of fourteen-year-
old children in Birmingham UK. Secondly to assess the levels of dental erosion in these children, and thirdly to
see whether there was any correlation between children with asthma and the levels of dental erosion. A random
sample of 418 children from twelve secondary schools was examined, 209 were male and 209 female. The level
of tooth wear was recorded using a modification of the Tooth Wear Index of Smith and Knight. The prevalence

 Industrial dental erosion: a cross-sectional, comparative study.
Chikte U M; Josie-Perez A M Department of Community Dentistry, University of Stellenbosch, Tygerberg,
South Africa SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse
Occupational exposure to sulphuric acid mist (H2SO4) is a health hazard. The threshold limit value-time
weighted average (TLV-TWA) of exposure to H2SO4 recommended by the American Conference of
Governmental Industrial Hygienists (ACGIH, 1994-1996) is 1 mg/m3. This single-blind study conducted in an
electro-winning facility in South Africa, compared dental erosion of anterior and premolar teeth of male workers
exposed daily to H2SO4 in an exposed group (H2SO4 range: 0.3 mg/m3-1 mg/m3) and an unexposed group
(H2SO4 range: 0.1 mg/m3-0.3 mg/m3). The exposed group comprised all workers at the facility exposed to the
aforesaid range of H2SO4 (N = 103). A total of 102 unexposed subjects similar in composition with respect to
age and length of service were randomly selected from the rest of the 700 workers at the facility. A questionnaire
was administered to seek information on possible worker habits associated with dental erosion and to determine

 The prevalence of dental erosion in the maxillary incisors of 14-year-old schoolchildren living in Tower
Williams D; Croucher R; Marcenes W; O'Farrell M Tower Hamlets Healthcare NHS Trust (Dental
Administration), St Leonard's Primary Care Centre, London, UK International dental journal (1999), 49(4), 211-
The purpose of this study was to assess the prevalence of dental erosion in the maxillary incisors of a sample of
14-year-old schoolchildren and to explore the aetiological factors responsible for that erosion. The cross-
sectionally design study took place in secondary schools in inner-city London, UK and involved 525, 14-year-old
schoolchildren selected at random in a clinical examination and a self-completed questionnaire. The outcomes
measures for dental erosion were; the prevalence, the area and depth of lesions and the risk factors. The
prevalence of labial and palatal erosion was 16.9 per cent and 12 per cent respectively. Risk factors and
behaviours including daily frequency of ingestion of acidic fruits and drinks, food vomiting, toothbrushing
frequency, and swimming habits were not shown to have any relationship with the presence of erosion. It was
concluded that the prevalence of erosion in the maxillary incisors of this sample was higher labially and lower

 A difference in perspective--the North American and European interpretations of tooth wear.
Bartlett D; Phillips K; Smith B Division of Conservative Dentistry, Guy's, King's and St Thomas' Dental Institute,
London, UK. david.bartlett@kcl.ac.uk The International journal of prosthodontics (1999), 12(5), 401-8.
Journal code: 8900938. ISSN:0893-2174. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
PURPOSE: There is considerable interest in the European dental research literature about the problem of tooth
wear and specifically about dental erosion, but this interest does not appear to be matched in North America
based on the volume of the literature there. The purpose of this article is to consider the possible explanations
for this difference. MATERIALS AND METHODS: This article examines the reasons for this disparity and
attempts to explain the difference by reviewing the North American and European literature on the etiology,
pathogenesis, and prevalence of tooth wear. RESULTS: It would appear from the literature that the reason for
the difference in interest between the 2 continents is a reflection of how the appearance, etiology, and
terminology are interpreted and used to define tooth wear, attrition, and erosion. CONCLUSION: Attrition is the
wear of teeth against teeth; therefore, by definition any worn surface that does not contact the opposing tooth

Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan
Fukayo S; Nonaka K; Shinozaki T; Motohashi M; Yano T Department of Hygiene and Public Health, Teikyo
University School of Medicine, Tokyo, Japan Sangyo eiseigaku zasshi = Journal of occupational health (1999),
The effect of occupational sulfuric acid exposure and other factors on teeth was explored in a cross-sectional
study with blind dental examinations. Among 350 male workers in a copper-smelter in Japan, 28 had mild dental
erosion with silky-glazed opaque appearance of the enamel and/or shallow concavities on the enamel. While
opaqueness was observed in 20 and concavities found in 11 workers, only 3 had both signs, suggesting that the
concave lesions were often accompanied with enough remineralization to keep the dental surface gloss, possibly
due to acid exposure at a low level. The cases had a history of working in an electrolytic refining plant (36%),
significantly more than in the non-cases (14%, p < 0.05). Some significant differences were found between the
cases and the non-cases: the cases were older, had less dental plaque, less gingivitis, and more frequent
toothbrushing habits. No significant differences were observed in possibly related dietary habits such as several

 Dental erosion--the problem and some practical solutions.
Shaw L; Smith A J University of Birmingham School of Dentistry, St Chads Queensway British dental journal
(1999), 186(3), 115-8. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL ARTICLE)
There has been a clinical impression among dental practitioners, particularly those working with children, that the
problem of dental erosion is increasing. Is this really the case or are we more aware of the problem? What is
causing this increase, if it really exists? Perhaps more importantly, what can we do about it?
This article looks at the prevalence, and aetiology of dental erosion, particularly in children, and makes some

 Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and
Shaw L; Weatherill S; Smith A Department of Paediatric Dentistry, University of Birmingham Dental School,
United Kingdom ASDC journal of dentistry for children (1998), 65(6), 484-6, 439. Journal code: 0146172.
This investigation was undertaken to establish the prevalence and distribution of tooth wear in different groups of
medically compromised children and to assess the possible influence of gastroesophageal reflux, dietary factors,
and parafunctional activity. Four groups of children including twenty-one with cerebral palsy were clinically
examined and had in-depth, structured interviews, including information on medical history, medication,
gastroesophageal reflux, feeding and drinking habits, parafunctional activity, and tooth-brushing procedures. All
the children with cerebral palsy also had twenty-four-hour gastroesophageal pH monitoring. Of the fifty-one
children in total, twenty-five had moderate or severe levels of dental erosion. No statistically significant
differences were found between the groups as far as dietary influences, feeding habits, and tooth-brushing
procedures. There was a significant association, however, between gastroesophageal reflux and erosion.

 Dental erosions in subjects living on a raw food diet.
Ganss C; Schlechtriemen M; Klimek J Department of Operative and Preventive Dentistry, Dental Clinic, Justus
Liebig University, Giessen, Germany. Carolina.Ganss@dentist.med.uni-giessen.de Caries research (1999),
The aim of the study was to investigate the frequency and severity of dental erosions and its association with
nutritional and oral hygiene factors in subjects living on a raw food diet. As part of a larger dietary study 130
subjects whose ingestion of raw food was more than 95% of the total food intake were examined. The median
duration of the diet was 39 (minimum 17, maximum 418) months. Before the clinical examination, the
participants answered questionnaires and recorded their food intake during a 7-day period. Dental erosions were
registered using study models. As a control 76 sex- and age-matched patients from our clinic were randomly
selected. The raw food diet records showed the median daily frequency of ingesting citrus fruit to be 4.8
(minimum 0.5, maximum 16.1). The median intake of fruit was 62% (minimum 25%, maximum 96%) of the total,
corresponding to an average consumption of 9.5 kg of fruit (minimum 1.5, maximum 23.7) per week. Compared
 Gastroesophageal reflux in children and its relationship to erosion of primary and permanent teeth.
O'Sullivan E A; Curzon M E; Roberts G J; Milla P J; Stringer M D Department of Paediatric Dentistry, Leeds
Dental Institute, UK. deneao@leeds.ac.uk European journal of oral sciences (1998), 106(3), 765-9. Journal
code: 9504563. ISSN:0909-8836. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
Gastroesophageal reflux (GOR) is often a self-limiting condition but nevertheless is a common cause of
morbidity in childhood. Studies of adult patients with hiatus hernias and GOR have suggested that there is an
increased incidence of dental erosion in these individuals. The aim of this study was to investigate the
relationship between dental erosion and GOR in children. Fifty-three children aged 2 to 16 yr (mean 4.9 yr) with
moderate to severe GOR, defined by pH monitoring, were examined for dental erosion. A questionnaire
investigating dietary habits, other relevant medical conditions, and erosion risk factors was also completed.
Results showed that the prevalence of dental erosion was low, when compared with the UK National Survey, with

 Assessment and treatment of bulimia nervosa.
Mcgilley B M; Pryor T L University of Kanasas School of Medicine, Wichita American family physician (1998),
57(11), 2743-50. Journal code: 1272646. ISSN:0002-838X. Journal; Article; (JOURNAL ARTICLE);
Bulimia nervosa is characterized by binge eating and inappropriate compensatory behaviors, such as vomiting,
fasting, excessive exercise and the misuse of diuretics, laxatives or enemas. Although the etiology of this
disorder is unknown, genetic and neurochemical factors have been implicated. Bulimia nervosa is 10 times
more common in females than in males and affects up to 3 percent of young women. The condition usually
becomes symptomatic between the ages of 13 and 20 years, and it has a chronic, sometimes episodic course.
The long-term outcome has not been clarified. Other psychiatric conditions, including substance abuse, are
frequently associated with bulimia nervosa and may compromise its diagnosis and treatment. Serious medical

 A rapid epidemiological assessment of dental erosion to assist in settling an industrial dispute.
Chikte U M; Josie-Perez A M; Cohen T L Department of Community Dentistry, Faculty of Dentistry, University
of Stellenbosch, Tygerberg, South Africa The Journal of the Dental Association of South Africa = Die Tydskrif van
die Tandheelkundige Vereniging van Suid-Afrika (1998), 53(1), 7-12. Journal code: 7505600. ISSN:0011-
A rapid epidemiological assessment (REA) of industrial dental erosion was undertaken with the aim of
formulating a range of treatment strategies which could be used to settle an industrial dispute. This dispute
concerned compensation for a group of adult male metalworkers who had complained of dental sensitivity and
that their teeth had been "eaten by acid" at their workplace, an electroplating factory in Springs near
Johannesburg, South Africa. The REA methods employed included a clinical examination, a structured socio-
demographic questionnaire and colour photographs of each subject. Sixty per cent of the subjects reported pain
and/or sensitivity to eating and/or drinking, 76 per cent showed varying degrees of loss of tooth structure, and 25
per cent reported teeth had been lost as a result of the industrial erosion. The project involved negotiating with
mine management and trade union representatives, each with conflicting interests, and with people's oral health

 Erosion caused by gastroesophageal reflux: diagnostic considerations.
Gregory-Head B; Curtis D A Department of Graduate Prosthodontics, University of California, San Francisco,
USA Journal of prosthodontics : official journal of the American College of Prosthodontists (1997), 6(4), 278-
Dental erosion occurs with a high prevalence in the general population, but its impact on prosthodontic care is
often unrecognized. The etiology of dental erosion is difficult to establish because it may result from a variety of
causes and may have different presentations. Our purpose was to review the literature relevant to dental erosion

 Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system
Johansson A K; Johansson A; Birkhed D; Omar R; Baghdadi S; Carlsson G E Department of Cariology,
Faculty of Odontology, Goteborg University, Sweden Acta odontologica Scandinavica (1996), 54(6), 369-78.
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

 Determinants of oral health in a group of Danish alcoholics.
 Hede B Department for Community Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark
European journal of oral sciences (1996), 104(4 ( Pt 1)), 403-8. Journal code: 9504563. ISSN:0909-8836.
The purposes of this survey were to describe dental health in a group of alcoholics and to analyze the influence
of social background, dental health behavior and alcohol-related variables on dental health among alcoholics.
The dental health in a group of consecutively admitted alcoholics (n = 195) was described with respect to number
of teeth present, DMFS, DS and the prevalence of dental erosion, removable dentures, edentulousness, and
untreated dental decay. No major differences were found with respect to number of teeth and dental caries
(DMFS), when compared to reference figures of the general population. As to untreated decay, however, 3-5 x
more actual decayed surfaces were found among the alcoholics. In the multivariate analyses, neither DMFS, nor
untreated decay were found to be associated with alcohol-related indicators. These variables were, however,
related to variables of social background and dental health behavior. As to number of teeth present, an

 Dental erosion, summary.
ten Cate J M; Imfeld T Academic Centre for Dentistry Amsterdam. jm.ten.cate@acta.nl European journal of
oral sciences (1996), 104(2 ( Pt 2)), 241-4. Journal code: 9504563. ISSN:0909-8836. Journal; Article;
Although reports on dental erosion have always appeared in the dental literature, there is currently a growing
interest among researchers and clinicians. Potential risk factors for dental erosion are changed lifestyle and
eating patterns, with increased consumption of acidic foods and beverages. Various gastrointestinal and eating
disorders expose the dentition to frequent contacts with very acidic gastric content, which may lead to erosion.
Whether these factors indeed lead, on a population scale, to a higher prevalence and incidence of erosion is yet
to be established.

 Etiology of dental erosion--intrinsic factors.
 Scheutzel P Department of Prosthodontics, Centre for Dentistry, University of Munster, Germany European
journal of oral sciences (1996), 104(2 ( Pt 2)), 178-90. Journal code: 9504563. ISSN:0909-8836. Journal;
Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result
of vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric
acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by
intrinsic factors has been observed only in those diseases which are associated with chronic vomiting or
persistent gastroesophageal reflux over a long period. Examples of such conditions include disorders of the
upper alimentary tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug
abuse, and certain psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia

 Prevalence of dental erosion and the implications for oral health.
Nunn J H Dental School, University of Newcastle upon Tyne, U.K. j.h.nunn@ncl.ac.uk European journal of
oral sciences (1996), 104(2 ( Pt 2)), 156-61. Journal code: 9504563. ISSN:0909-8836. Journal; Article;
The literature on dental erosion is made up of a number of areas, some of which are reviewed here: there are
anecdotal case reports, linking a small number of clinical cases with a possible etiological factor. The second
area of evidence concentrates on case control studies in which there is a strong association with dental erosion,
for example, patients with bulimia. The final piece of epidemiological evidence is beginning to emerge as
prevalence studies, but the information from prevalence data worldwide is scanty. It is difficult to compare
prevalence studies because of the different indices used in the various studies and also because of the different
teeth assessed in the sample. Standardization of indices used would overcome some of these differences as
would the reporting of results in a comparable way. However, identifying the true prevalence of erosion per se is
fraught with difficulty because there may be more than one etiological factor operating and attrition and or

 Tooth wear--dental erosion.
Nunn J; Shaw L; Smith A Department of Child Dental Health, Dental School, Newcastle-upon-Tyne British
dental journal (1996), 180(9), 349-52. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL
This article aims to address the issues arising out of the increasing concern by general dental practitioners of
erosion-related tooth wear. The prevalence, common presentation, differential diagnosis, likely aetiology,
prevention and management of suspected cases of this form of tooth wear are considered.

 The 1993 national survey of children's dental health.
Comment in: Br Dent J. 1995 Aug 19;179(4):124. PubMed ID: 7546953 Comment in: Br Dent J. 1995 Sep
9;179(5):160. PubMed ID: 7546965 Comment in: Br Dent J. 1996 Jun 8;180(11):406. PubMed ID: 8762795
Downer M C Department of Dental Health Policy, Eastman Dental Institute for Oral Health Care Sciences,
The 1993 national survey report shows encouraging evidence of general improvements in children's dental
health compared with earlier surveys in 1973 and 1983. There have been dramatic declines in dental caries at
all ages and this is evident in the different parts of the United Kingdom and in all social classes. However,
among 5-year-old children average caries levels have remained unchanged since 1983, although a higher
proportion now have no known decay experience. The amount of decay treated by restoration as a proportion of
total caries experience has fallen in all age groups and the disease appears to be becoming concentrated at
higher levels in a diminishing number of children who are not obtaining dental care. A disturbing finding was the
high prevalence of dental erosion, particularly in the primary dentition. Other findings included more than half of
children in Scotland and Northern Ireland having fissure sealants, improved parental knowledge about preventing
dental disease, reduced numbers of orthodontic extractions and a reduction of one-third in the rate of
traumatised permanent incisors.

 The distribution of erosion in the dentitions of patients with eating disorders.
Comment in: Br Dent J. 1995 Jun 24;178(12):445. PubMed ID: 7605714 Comment in: Br Dent J. 1996 Mar
23;180(6):207. PubMed ID: 8996921 Robb N D; Smith B G; Geidrys-Leeper E Department of Restorative
Dentistry, Dental School, Newcastle upon Tyne British dental journal (1995), 178(5), 171-5. Journal code:
Anorexia and bulimia nervosa (the eating disorders) are potentially life threatening and are becoming more
prevalent. This paper reviews the effects of these disorders on dental erosion and reports a study to assess the
effects of the eating disorders on the erosion of teeth relating the severity of erosion to factors such as the
frequency of self-induced vomiting (SIV). One hundred and twenty-two eating disorder patients and an equal
number of age, sex, and social class matched controls were studied. The study population was divided into
subgroups according to the eating disorder. All the subgroups had significantly more abnormal toothwear than

 Dental erosion in four-year-old children from differing socioeconomic backgrounds
Millward A; Shaw L; Smith A University of Birmingham School of Dentistry, England ASDC journal of dentistry
for children (1994), 61(4), 263-6. Journal code: 0146172. Journal; Article; (JOURNAL ARTICLE) written in
Although there is very little epidemiological evidence on the prevalence and severity of erosion in children and
adults, there have been recent case reports suggesting that the problem of erosion is increasing. This study
describes the use of a simple reproducible erosion index. A total of 178 four-year-old children were assessed;
almost half of these children showed signs of erosion. The most common site affected was the palatal surface of
the upper incisors with 17 percent of the children examined showing visible dentine for greater than one third of
the tooth surface. When considering the influence of socioeconomic group on the prevalence of erosion, four

 Nutrition, diet and dental public health.
Rugg-Gunn A J Department of Child Dental Health, Dental School, University of Newcastle upon Tyne, UK
Community dental health (1993), 10 Suppl 2 47-56. Journal code: 8411261. ISSN:0265-539X. Journal; Article;
Nutrition and diet can affect teeth in three ways: by affecting the structure of teeth (and thus appearance), by
causing dental caries and by eroding teeth. The importance of dietary sugars in causing dental caries is clearly
established and a reduction in consumption of non-milk extrinsic sugars recommended by government. The
Health Education Authority has played a major role in promoting this aspect of dietary advice. The structure of
teeth is influenced by nutrition; much of the evidence for this being published by Mellanby and colleagues in this
country. Interest in this topic has increased recently and it seems probable that malnutrition enhances
susceptibility to dental caries, and possible that it increases susceptibility to enamel defects especially in areas

 Dental erosion in a population of Swiss adults.
Lussi A; Schaffner M; Hotz P; Suter P University of Berne, School of Dental Medicine, Department of Operative
and Preventive Dentistry, Switzerland Community dentistry and oral epidemiology (1991), 19(5), 286-90.
The purpose of this study was to determine the prevalence of dental erosion in an adult population in
Switzerland. 391 randomly selected persons from two age groups (26-30 and 46-50 yr) were examined for
frequency and severity of erosion on all tooth surfaces. Information was gathered by interview about lifestyle,
dietary and oral health habits. For facial surfaces 7.7% of the younger age group and 13.2% of the older age
group showed at least one tooth affected with erosion with involvement of dentin (grade 2). 3.5 teeth per person
in the younger and 2.8 teeth per person in the older age group were affected. Occlusally, at least one severe
erosion was observed in 29.9% of the younger and 42.6% of the older sample with 3.2 and 3.9 erosion-affected
teeth per person, respectively. 3.6% of the younger age group and 6.1% of the older age group showed slight

 Oral conditions among German battery factory workers.
Petersen P E; Gormsen C Institute for Community Dentistry and Graduate Studies, Royal Dental College,
Copenhagen, Denmark Community dentistry and oral epidemiology (1991), 19(2), 104-6. Journal code:
The purpose of the study was to evaluate the oral health situation of workers in a modern battery factory; in
particular, to describe the prevalence and the severity of dental erosion and attrition in relation to exposure of
airborne acids in the work environment. Measurements of the work environment at a German battery factory
showed that the workers were exposed to sulfuric acids (0.4-4.1 mg/cm3). All workers at the factory were
included in the survey and a total of 61 dentate individuals completed a questionnaire on their work environment,
dental health, and symptoms from the mouth, nose, and throat. Information on oral health status, erosion, and
attrition was collected by clinical examinations. Nearly all workers reported exposure to etching substances in
their work environment: 56% complained of sharp and thin teeth and 29% of short teeth. Poor dental health
conditions were observed (e.g. mean D-T = 3.8); the mean number of teeth with crown restoration was 5.3. The

 Risk factors in dental erosion.
Jarvinen V K; Rytomaa I I; Heinonen O P Department of Cariology, University of Helsinki, Finland Journal of
dental research (1991), 70(6), 942-7. Journal code: 0354343. ISSN:0022-0345. Journal; Article; (JOURNAL
Dental erosion and factors affecting the risk of its occurrence were investigated with a case-control approach.
One hundred and six cases with erosion and 100 randomly selected controls from the same source population
were involved in the study. All cases and controls were evaluated by the recording of structured medical and
dietary histories and by examination of the teeth and saliva. Erosion was classified according to pre-determined
criteria. The relative importance of associations between factors and erosion was analyzed by a logistic
multivariable model. Adjusted odds ratios (AOR) were estimated. There was considerable risk of erosion when
citrus fruits were eaten more than twice a day (AOR 37), soft drinks were drunk daily (AOR 4), apple vinegar was
ingested weekly (AOR 10), or sport drinks were drunk weekly (AOR 4). The risk of erosion was also high in

 Prevalence of pathological tooth wear in patients with chronic alcoholism.
Robb N D; Smith B G Dental School, Framlington Place, Newcastle upon Tyne British dental journal (1990),
169(11), 367-9. Journal code: 7513219. ISSN:0007-0610. (COMPARATIVE STUDY); Journal; Article;
Although chronic alcoholism is a very common condition, with potentially harmful consequences for the sufferer,
there has been little emphasis in the literature on its effects on the teeth. This study of 37 alcoholic patients
showed that their teeth had significantly more wear than age and sex matched controls. The tooth wear was
most marked in males, and those whose alcohol consumption was continuous rather than in the form of episodic
binges. The wear appeared to be erosive in nature, and in 40% of the sample it affected the palatal surfaces of
the upper anterior teeth.

 Pilot study on dental erosion in a Norwegian electrolytic zinc factory.
Skogedal O; Silness J; Tangerud T; Laegreid O; Gilhuus-Moe O Community dentistry and oral epidemiology
(1977), 5(5), 248-51. Journal code: 0410263. ISSN:0301-5661. Journal; Article; (JOURNAL ARTICLE) written
In 12 workers in a Norwegian factory using electrolytic methods to extract zinc, a relationship was found to exist
between degree of erosion, number of teeth affected and the length of service. The prevalence of caries,
abrasion and attrition was not higher than in comparable population groups.




Dental erosion – changing prevalence? A review of British national childrens’ surveys
J. H. NUNN 1 , P. H. GORDON 2 , A. J. MORRIS 3 , C. M. PINE 4 & A. WALKER 5 1 Public and Child Dental
Health, School of Dental Science, Trinity College, Dublin, Ireland, 2 Department of Child Dental Health, Dental
School, Newcastle upon Tyne, 3 Dental Public Health, Dental School, Birmingham, 4 Department of Clinical
Objectives. To investigate the change in the prevalence of dental erosion, over time, by a review of the data from
the published national dental surveys of young people in the UK. A subsidiary objective was to investigate the
relationship between erosion and possible associated risk factors. Design. The review was based on cross-
sectional prevalence studies incorporating a clinical dental examination and structured interviews. Sample. The
data were collated from the 1993 UK childrens’ dental health survey and the dental report of the two National Diet
and Nutrition Surveys (NDNS) of children aged 1 1 / 2 - 4 1 / 2 in 1992/3 and 4–18 years in 1996/7. The criteria
used for data collection were comparable between the three different studies. Results: Comparing the data
from the different studies, the prevalence of erosion was seen to increase from the time of the childrens’ dental
health survey in 1993 and the NDNS study of 4–18-year-olds in 1996/7. There was a trend towards a higher
prevalence of erosion in children aged between 3 1 / 2 and 4 1 / 2 and in those who consumed carbonated drinks
on most days compared with toddlers consuming these drinks less often.
Drinks overnight were associated with an increased prevalence of erosion. More 4–6-year-olds with reported
symptoms of gastro-oesophageal reflux had erosion
compared with symptom- free children. On multivariate analysis, the strongest independent association with
erosion was geography, with children living in the
Dental Erosion and Aspirin Headache Powders: A Clinical Report
Michael McCracken, DDS, PhD, 1 and Sandra Jean O’Neal, DMD 2 J Prosthod 2000;9:95-98 .
The causes of tooth erosion are varied, but all are associated with a chemical attack on the teeth and
resulting loss of tooth structure. Etiologic factors related to erosion cited in the literature include
Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using
J. MAY & P. J. WATERHOUSE Department of Child Dental Health, The Dental School, University of Newcastle
upon Tyne, Newcastle, UK International Journal of Paediatric Dentistry 2003; 13: 425–433
Objectives. This qualitative study was designed to record the perception by Newcastle children of the
influences on their choice of drinks and their knowledge of the dental health problems caused by acidic
drinks. Methods. Four focus groups, each involving 8 Newcastle schoolchildren (4 boys and 4 girls)
formed the basis of the study. Two age groups, 13–14-year-olds and 8–9-yearolds, and two socio-
economic groups were investigated, using state schools in Newcastle upon Tyne. A moderator guided
the children to discuss their choice of drink and its dental effects amongst themselves. Results. In total,
32 children participated in the focus groups and the results suggested that 8–9-year-olds preferred still,
fruit-flavoured drinks whilst 13–14-year-olds preferred carbonated drinks. Taste was the most important
influence on drink choice in all age groups. Parents and friends were more influential in younger
children, whilst cost, availability and thirst were more important to older children. Younger children did
not believe advertisements whilst older children thought they might work if seen enough times. Dental
knowledge was confused in all age groups and only the 13–14-year-old-high socio-economic groups

Dental erosion Clinical diagnosis and case history taking
Adrian Lussi Department of Operative, Preventive and Pediatric Dentistry, University of Bern, School of Dental
Dental erosion is not a very rare condition. Early correct diagnosis of this damage of dental hard tissue
consequently is of clinical importance. The aim of this paper is to present an easy-to-learn rating
scheme for the assessment of the severity of dental erosive lesions with high inter- and intra-examiner
agreement. It differentiates between facial, occlusal and oral surfaces of a tooth and has already been

Dental erosion in schoolchildren and socioeconomics
Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of differing
socioeconomic backgrounds. by Y. H. Al-Dlaigan, L. Shaw and A. Smith, Br Dent J 2001; 190: 145-149
The aims of the study were to establish the prevalence of erosion in a cluster random sample of 14-year-
olds in Birmingham, UK and to determine whether socioeconomic group influences the prevalence of
erosion. • 418 children were examined from 12 different schools; 209 were male and 209 female. The
level of tooth wear was recorded using a modification of the (TWI) index of Smith and Knight (1984). The
ACORN classification was used to assess the socioeconomic status of all children. • 48% of the children
had low erosion, 51% had moderate erosion and only 1% had severe erosion. Statistically significant

Effects of toothbrushing on eroded dentine
Carolina Ganss 1 , Nadine Schlueter 1 , Martin Hardt 2 , Judith von Hinckeldey 2 , Joachim Klimek 1 1Department of
Conservative, Preventive Dentistry, Dental Clinic, and 2Central Biotechnology Unit, Electron Microscopy
It is an established assumption that eroded dental hard tissues are particularly prone to toothbrush
abrasion. Only a few studies have aimed to show this for dentine and, if so, disregarded the complex
histological structure of this tissue. Therefore, the present study sought (i) to investigate the effects of
toothbrushing on eroded dentine and (ii) to analyze how the organic matrix influences the outcome of
established methods for quantifying dental hard tissue loss. The effects of brushing were investigated
by optical (P-O) and mechanical (P-M) profilometry, by longitudinal microradiography (LMR), and by
scanning electron microscopy (SEM). The SEM images showed that a demineralized organic layer had
developed, which was unaffected by brushing. For substance loss, there was no significant difference
between eroded and eroded/abraded samples. Considerable differences occurred, however, when
results from the different methods were compared. P-O yielded the lowest (7.0 ± 3.4 lm) and LMR the
highest (109.8 ± 10.7 lm) substance loss values. When the organic material was removed enzymatically,
all methods gave comparable results. The results of this study do not lend support to the notion that
brushing increases substance loss of eroded dentine.
Enamel Erosion by Some Soft Drinks and Orange Juices Relative to Their pH, Buffering Effect and
M.J. Larsen B. Nyvad Department of Operative Dentistry and Endodontics, Royal Dental College, Faculty of
The capability of a soft drink or a juice to erode dental enamel depends not only on the pH of the drink, but
also on its buffering effect. As the latter is the ability of the drink to resist a change of pH it may add to the
effects of the actual pH. The aim of the present study was to compare the pH and the buffering effect of
various soft drinks with their erosive effects and the solubility of apatite. In 18 soft drinks, mineral waters and
juices available on the Danish market, pH and the concentrations of calcium, phosphate and fluoride were
determined. The buffering effect was determined by titration with NaOH. Human teeth (n = 54) covered with
nail varnish except for 3E4-mm windows were exposed to 1.5 liters of the drink for either 7 days or 24 h under
constant agitation. The depth of the erosions was assessed in longitudinal sections. The depth was found to
vary greatly from 3 mm eroded by the most acidic drinks and fresh orange juice to only slightly affected
surfaces by most of the mineral waters. The dissolution of enamel increased logarithmically inversely with the
pH of the drink and parallel with the solubility of enamel apatite. Orange juice, pH 4.0, supplemented with 40
mmol/l calcium and 30 mmol/l phosphate did not erode the enamel as the calcium and phosphate saturated
Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England.
A. Milosevic ,1 P. F. Bardsley 2 and S. Taylor 3,1 *Honorary Senior Lecturer and Consultant in Restorative
Dentistry, Dept of Restorative Dentistry, Liverpool University Dental Hospital 3Research Associate, Centre for
Medical Statistics and Health Evaluation, University of Liverpool,2Consultant, Dept. of Restorative Dentistry,
● Wide range of foods and drinks were associated with tooth wear & dental erosion but the strengths of
association (Odds Ratios) were generally low.
● Dentists should question patients, even teenagers, with dental erosion about heart burn, reflux and
any positive family history of reflux disease.

Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England.
P. F. Bardsley, 1 S. Taylor 2 and A. Milosevic 3 1Consultant, Dept. of Restorative Dentistry, Birmingham Dental
Hospital, 2Research associate, Centre for Medical Statistics and Health Evaluation, University of Liverpool,
3*Honorary Senior Lecturer and Consultant in Restorative Dentistry, Dept of Restorative Dentistry, Liverpool
● This is the first study to show that water fluoridation protects from dental erosion/toothwear in 14-year-
old children.
● The benefits of water fluoridation as a public health measure is strengthened.

Erosion of deciduous and permanent dental hard tissue in the oral environment
M.L. Huntera,*, N.X. Westb, J.A. Hughesb, R.G. Newcombec, M. Addyb aDental Health and Development,
University of Wales College of Medicine Dental School, Heath Park, Cardiff CF4 4XN, UK bRestorative
Dentistry, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY, UK cMedical Computing
Objectives: The objectives of this study were two-fold: (1) to determine (by surfometry) loss of
deciduous and permanent enamel and dentine following consumption of a single low pH orange drink
for 15 days; and (2) to determine (by surfometry) loss of deciduous and permanent enamel and dentine
following consumption of the product 2 versus 4 times per day for 15 days.
Methods: Sixteen healthy volunteers participated in a single centre, single blind, 2-phase crossover
study, conducted according to Good Clinical Practice, and employing the validated model described by
West and co-workers (Journal of Dentistry 1998; 26:329–335).
Results: In all tissues, erosion was progressive over time, the pattern being more linear in enamel than
in dentine. In general, erosion of deciduous enamel was greater than that of permanent enamel, though
this difference was significant only for those specimens exposed to 4 drinks per day. Conversely,
erosion of dentine was generally greater in the permanent tissue, though differences rarely reached
conventional levels of statistical significance. Increasing frequency of consumption resulted in
increased loss of tissue, but this difference was neither proportional nor consistently statistically
Evaluation of a profilometrical method for monitoring erosive tooth wear
Schlueter N, Ganss C, De Sanctis S, Klimek J. Evaluation of a profilometrical method for monitoring erosive
tooth wear. Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig- University
The in vivo monitoring of erosive wear is difficult because lesions mostly progress relatively slowly and
reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of
erosive loss have been described, which either require extensive equipment or do not provide sufficient
sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a
procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable
observation periods. The method is the profilometric measurement of erosive tissue loss using acid-
resistant markers, which represent both a reference area and a structure for the defined retracing of a
given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the
precision was < 4 lm, and the repeatability was good (95% limits of repeatability ranging from )4.7 to 5.2

Gastroesophageal Reflux Disease, Tooth Erosion, and Prosthodontic Rehabilitation: A Clinical Report
Ned B. Van Roekel, DDS, MSD, Consultant in Prosthodontics, Department of Dental Specialties, Assistant
Professor of Dentistry, Mayo Medical School, Rochester, MN, J Prosthodont 2003;12:255-259.
Gastroesophageal reflux disease (GERD) is a relatively common gastrointestinal disorder in the United
States. The reflux of acid adversely affects the mucosal lining of the esophagus and is responsible for
dental erosion. This article briefly reviews the etiology, risk factors, and medical management of GERD.
The patient presentation describes the rehabilitation of a young adult with GERD who needed

Impact of modified acidic soft drinks on enamel erosion
T Attin, K Weiss, K Becker, W Buchalla, A Wiegand, Department of Operative Dentistry, Preventive Dentistry
and Periodontology, Georg-August-University Go¨ttingen, Go¨ttingen, Germany, Oral Diseases (2005) 11, 7–12
OBJECTIVE: To evaluate the enamel erosive potential of modified acidic soft drinks under controlled
conditions in an artificial mouth.
MATERIALS AND METHODS: From each of 144 bovine incisors one enamel sample was prepared. Labial
surfaces of the samples were ground flat, polished and covered with adhesive tape, leaving an exposed
area. The samples were distributed among four (A–D) groups for treatment with A: Coca-Cola, B: Sprite;
C: Sprite light, D: orange juice. Either 1.0 mmol l)1 calcium (Ca) or a combination (comb.) of 0.5 mmol l)1
calcium plus 0.5 mmol l)1 phosphate plus 0.031 mmol l)1 fluoride was added to the beverages. Samples
of each group were subdivided into three subgroups (-original; -Ca and -comb.) for treatment with
original and modified drinks. De- and remineralization cycles were based on a standard protocol
described earlier. Surface loss of the specimens was determined using profilometry after test procedure.
RESULTS: In all subgroups, loss of enamel was observed. The enamel loss recorded for the samples
rinsed with original Sprite and original orange juice was significantly higher compared with all other
solutions (P ¼ 0.001). Lowest enamel loss was recorded for the original Coca-Cola
Influence of diet on dental erosion in 14-year-olds - Dental erosion in a group of British 14-year-old
Y. H. Al-Dlaigan, L. Shaw and A. Smith Br Dent J 2001; 190: 258-261
• The aims of the present study were first to investigate the dietary intake pattern of UK teenagers and
secondly to determine the relationship, if any, between dental erosion and dietary intake in these
children. • Data on the rate and frequency of consumption of drinks, foods, and fruits were obtained
from a self-reported questionnaire supplemented by a structured interview to 418 children (209 male, 209
female). • Over 80% of the teenagers regularly consumed soft drinks, but approximately half of these

Is there a relationship between asthma and dental erosion? A case control study
Y. H. AL-DLAIGAN 1 , L. SHAW 1 & A. J. SMITH 2 1 Unit of Paediatric Dentistry and 2Unit of Oral Biology, The
University of Birmingham, Dental School, Birmingham, UK , International Journal of Paediatric Dentistry
Objectives. The aims of this study were firstly to assess and compare the prevalence of dental erosion
and dietary intake between three groups of children; children with asthma, those with significant tooth
erosion but with no history of asthma, and children with no history of asthma or other medical problems.
Secondly, to discover whether there was a relationship between medical history and dietary practises of
these children and the levels of dental erosion. Thirdly, to measure and compare their salivary flow
rates, pH and buffering capacity.
Methods. The study consisted of 3 groups of children aged 11–18 years attending Birmingham Dental
Hospital: 20 children with asthma requiring long-term medication, 20 children referred with dental
erosion, and 20 children in the age and sex matched control group. Tooth wear was recorded using a
modification of the tooth wear index (TWI) of Smith and Knight. Data on the medical and dietary history
were obtained from a self-reported questionnaire supplemented by a structured interview. The salivary
samples were collected under standard methods for measurements.
Results. Fifty percent of the children in the control group had low erosion and 50% moderate erosion.
However, high levels were recorded in 35% of children in the asthma group and 65% in the erosion
group. There appeared to be no overall differences in diet between the groups. There was
an association between dental erosion and the consumption of soft drinks, carbonated beverages and

Lessening dental erosive potential by product modification
Grenby TH, Department of Oral Medicine & Pathology, U M D S, Guy's Hospital, London SEI 9RT, UK, Eur J
Current interest in dental erosion has led to increasing attention to ways in which potentially erosive
products might be modified. Information on how this could be achieved has been hard to gather, and
has focused chiefly on possibilities in reformulating soft drinks. The bulk of the work published on this
relates to calcium and phosphate supplementation, ranging from early experimentation on saturation of
a demineralising medium with tri-calcium phosphate, through tests of more soluble phosphates and
other calcium salts providing various levels of Ca2+ and PO4", to a calcium citrate malate additive
specially formulated to curb erosion by soft drinks. Opinions on the effectiveness of citrate, the
practicability of reducing the acidity levels of soft drinks, and the possible applications of fluoride,
bicarbonates and certain constituents of milk products are also included. Finally, an attempt has been

Methods of assessing erosion and erosive potential
Crenb!. TH, Department of Oral Medicine & Pathology, United Medical & Dental Schools, Guv’s Hospital, London
Methods for use in vitro are reviewed first, classified under the examination of extracted teeth, chemical
and physical methods, digital image analysis, scanning electron microscopy and other potentially useful
techniques. Methods for recording erosion in laboratory animals are dealt with next, including
techniques that can also be used in vitro, Restarski’s system and various modifications of it, and digital
image analysis. Thirdly the main systems and indices that have been designed for clinical use are

Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with dental
R. Moazzez, B.G.N. Smith, D.W. Bartlett* Division of Conservative Dentistry, Guy’s, King’s and St Thomas’
School of Dentistry, King’s College, London SE1 9RT, UK, Journal of Dentistry 28 (2000) 395–397
Objectives: To investigate the relationship between dental erosion, oral pH and drinking habit in a group
of adolescents. Methods: Oral pH was measured simultaneously at the surface of four teeth in 11
patients, aged 10–16 years, with erosion and in 10 controls subjects without erosion using antimony
electrodes. Measurements were made before, during and after drinking 330 ml of a carbonated drink.
The method and timing of drinking the beverage, reported dietary intake of acidic foods and flow rate
and buffering capacity of saliva were recorded. Results: The erosion patients reported drinking more
carbonated drinks .p , 0:01. and drinking directly from a can more frequently than the controls .p , 0:05.:
They also drank twice as quickly .p , 0:05.: The pH at the buccal surface of a molar remained lower for
longer in the erosion patients than in the patients without erosion .p , 0:01.; whilst the labial surface of

Pathogenesis and modifying factors of dental erosion
Meurrnan JH, ten Care JM, 'Faculty of Dentistry, University of Kuopio. P0.B. 1627, FIN-7021 1 Kuopio, Finland:
'Academic Centre for Dentistry Amsterdam, Louwesweg 1, NL-1066 EA Amsterdam, The Netherlands, Eur J
Dental erosion is caused by acidic solutions which come into contact with the teeth. Because the critical
pH of dental enamel is approximately 5.5, any solution with a lower pH value may cause erosion,
particularly if the attack is of long duration, and repeated over time. Saliva and salivary pellicle
counteract the acid attacks but if the challenge is severe, a total destruction of tooth tissue follows.
Ultrastructural studies have shown that erosive lesions are seen in prismatic enamel as characteristic
demineralization patterns where either the prism cores or interprismatic areas dissolve, leading to a
honeycomb structure. In aprismatic enamel the pattern of dissolution is more irregular and areas with
various degrees of mineral loss are seen side by side. In dentin the first area to be affected is the
peritubular dentin. With progressing lesions, the dentinal tubules become enlarged but finally disruption
is seen also in the intertubular areas. If the erosion process is rapid, increased sensitivity of the teeth is
the presenting symptom. However, in cases with slower progression, the patient may remain without
symptoms even though the whole dentition may become severely damaged.
Prevention of progression of dental erosion by professional and individual prophylactic measures
Thomas lmfeld Clinic of Preventive Dentistry, Periodontology and Cariology, Dental institute, University of Zurich,
The key elements for the establishment of a preventive program for patients suffering from erosion are
described on pathophysiologic grounds. These elements aim 1) to diminish frequency and severity of
acid challenge, 2) enhance salivary flow, 3) to enhance acid resistance, remineralization and
rehardening by fluoride application, 4) to offer chemical protection by buffering substances, 5) to

Restorative therapy for erosive lesions
Larnhrechts P, Van Meerbeek B, Perdig60 J, Gladys S, Braeni M, Vanherle G, 1 BIOMAT, Department of
Operative Dentistry and Dental Materials, Catholic University Leuven, U.Z . St. Rafael, Leuven, Belgium.
2
  School of Dentistry, lnstituto Superior de Ciencias da Salide, Monte da Caparica, Portugal and 3 Dental
More needs to be learned about the etiology of erosion lesions before they can be accurately diagnosed,
confidently treated and, more importantly, prevented. The treatment is dependent on the location and
the degree of erosion. The decision to treat an erosion lesion should be based on careful consideration
of the etiology and progression of the condition. Reasons for restoring noncarious enamelidentin
lesions are discussed and various therapeutic measures are provided. Preventive and restorative
therapeutic measures for noncarious abrasive/ erosive lesions are proposed such as: a change of
dietary or behavior patterns; application of desensitization products; intensive fluoride therapy with or

The erosive potential of flavoured sparkling water drinks
CATRIONA J. BROWN, GAY SMITH, LINDA SHAW, JASON PARRY & ANTHONY J. SMITH School of
Dentistry, University of Birmingham and Birmingham Dental Hospital, Birmingham, UK, International Journal
Objective. The potential role of acidic drinks in the aetiology of dental erosion is well recognized. Whilst
the wide-scale consumption of bottled waters is unlikely to contribute significantly to erosion, the role of
flavoured sparkling water drinks is unclear. The aim of this study was to determine the pH, titratable
acidity and in vitro erosive potential of a selection of these drinks drawn from the UK market to identify
what dietary advice would be appropriate in relation to their consumption.
Methods. pH was measured using a pH electrode and titratable acidity recorded by titration with 0.1- M
NaOH. Erosive potential was assessed using an in vitro dissolution assay with hydroxyapatite powder
and electron microscopic examination of surface enamel of extracted human teeth, following exposure
to the flavoured sparkling waters for 30 min.
Results. All of the flavoured waters tested showed appreciable titratable acidity (0.344–0.663 mmol) and
low pH (2.74–3.34). In the hydroxyapatite dissolution assay, all of the waters demonstrated erosive
potential (89–143%) similar to or greater than that of pure orange juice, an established erosive drink.
The progression of tooth erosion in a cohort of adolescents of mixed ethnicity
C. R. DUGMORE 1 & W. P. ROCK 2 1 Melton, Rutland and Harborough NHS Trust, Pasley Road Dental Clinic,
Leicester and 2 Birmingham Dental School, St. Chad’s Queensway, Birmingham, International Journal of
Objectives. To establish the prevalence of tooth erosion in a sample of 12- year-old children and to monitor
changes over the subsequent 2 years.
Methods. A random sample of 1753 children aged 12 years was drawn from all 62 state maintained schools in
Leicestershire. A total of 1308 were re-examined 2 years later. Erosion was recorded on incisors and first molars
using an erosion index based upon that from the Children’s Dental Health in the United Kingdom 1993 survey. A
score was also allocated to each subject according to the most advanced lesion in the mouth.
Results. Erosion was present in 56•3% of subjects at age 12 and 64•1% at age 14. Deep enamel or dentine was
eroded in 4•9% and 13•1% of subjects, respectively, at the same ages. One hundred and sixty-one (12•3%)
children who were erosion-free at 12 years of age developed erosion over the subsequent 2 years. Boys had
more erosion than girls, as did white compared to Asian children. Associations were found between erosion
The relationship between erosion, caries and rampant caries and dietary habits in preschool children in
M. I. AL-MALIK, R. D. HOLT & R. BEDI Department of Transcultural Oral Health, Eastman Dental Institute,
University College London, UK, International Journal of Paediatric Dentistry (2001), 11: 430–439
Objectives. The aim of this study was to investigate the possible association between dental erosion and
caries, and variables including socio-economic status, reported dietary practices and oral hygiene
behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental
examination and questionnaire survey was carried out at a number of kindergartens.
Sample and methods. A sample of 987 children (2–5-year-olds) was drawn from 17 kindergartens.
Clinical examinations were carried out under standardized conditions by a trained and calibrated
examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires
distributed to the parents through the schools. These were completed before the dental examination.
Results. Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of
the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of
carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child
was a baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also
related to caries but
Using partial recording to assess tooth wear in older adults
Steele JG, Walls AWG: Department of Restorative Dentistry, Dental School, Newcastle upon Tyne, UK
Objectives: To establish whether partial recording can be used for the measurement and reporting of
tooth wear data in samples of adult populations, whilst maintaining the usefulness of the index.
Methods: Using whole mouth coronal tooth wear data from a large random population sample of 1200
dentate older adults in England, several different partial recording systems were investigated to
establish which teeth would maintain a high level of sensitivity for the most economic use of codes and
index teeth. Tooth wear data were recorded on a surface-by-surface basis on all teeth in sample using
the tooth wear index.
Results: Five different partial mouth recording systems were assessed, including half-mouth scoring,
assessment of just upper or just lower anterior teeth, assessment of all anterior teeth and use of six
index teeth. The 12 anterior teeth were the ones most often affected by moderate or severe wear, and
when all 12 teeth Key words: abrasion; epidemiology; index; tooth wear were used as the index teeth
few wear cases were missed, and all the most exten- sive and severe cases of coronal wear were
classified as having some wear. A James G. Steele,
Department of Restorative Dentistry, Dental School, Framlington Place, limited index of only six anterior
Dental erosion. Definition, classification and links
Thomas lmfeld, Clinic of Preventive Dentistry, Periodontology and Cariology, Dental Institute, University of
An overview of tooth wear, i.e. of non-carious destructive processes affecting the teeth including
abrasion, demastication, attrition, abfraction, resorption and erosion is presented. The nomenclature
and classification of dental erosion commonly used in the dental literature are summarized. They are
based on etiology (extrinsic, intrinsic, idiopathic), on clinical severity (Classes I to III), on pathogenetic
Etiology of dental: extrinsic factors erosion
Zero DT, Eastman Dental Center, Eur J Oral Sci 1996. 104: 162-177.
The extrinsic causes of dental erosion can be grouped under the headings of environmental, diet, medications and
lifestyle. Environmental factors mainly involve exposure to acid fumes by workers in factories without proper
safeguards. Swimming pools with low pH due to inadequate maintenance have also been implicated. Dietary factors
have received the most attention and are likely to affect the broadest segment of the population. Most acidic foods
and drinks have the potential to cause dental erosion in the human mouth. The total acid level (titratable acid) of
dietary substances is considered more important than their pH because it will determine the actual H+ available to
interact with the tooth surface. Other constituents of foods and beverages will also have a modifying effect including
the calcium, phosphate and fluoride concentration the acid type and physical and chemical properties that influence
the clearance rate from the mouth. It is not appropriate to assign relative degrees of risk to the different dietary
substances except in general categories, because of the many human biological and behavioral factors that influence
the clinical expression of dental erosion.
The types of foods and beverages consumed, and the frequency and time of consumption are lifestyle factors that are
Salivary citrate and dental erosion. II. Dental erosion and citric acid in saliva
Zipkin, Isadore; McClure, F. J. Natl. Inst. Dental Research, Bethesda, MD, Journal of Dental Research
(1949), 28 618-26. CODEN: JDREAF ISSN: 0022-0345. Journal language unavailable. CAN 44:12903
The citric acid content of stimulated saliva varies between 0.20 and approx. 2.00 mg. per 100 cc.; it increases
slightly with age. The severity of erosion also increases with age. Erosion occurs to a greater degree and greater
prevalence in the upper teeth than in the lower teeth, and to a similar degree in the teeth of the right and left
quadrants of both jaws. There appears to be a pos. statistical correlation between the severity of human erosion
and the salivary citrate content.
                                               RETURN to Titles
Dental erosion among 12-14 year old school children in Khartoum: a pilot study.
El Karim I A; Sanhouri N M; Hashim N T; Ziada H M Department of Restorative Dentistry, School of Clinical
Dentistry, Royal Victoria Hospital, Grosvenor Road, BT12 6BA, Northern Ireland. ielkarim@hotmail.com
OBJECTIVES: To investigate dental erosion among 12-14 year old Sudanese school children and evaluate the
associated risk factors. BASIC RESEARCH DESIGN: Cross sectional survey in secondary schools in Khartoum city,
Sudan. METHOD AND PARTICIPANTS: A sample of 157 school children was obtained from both private and public
schools. Erosion on the labial and palatal surfaces of maxillary incisors was measured by criterion based on the
Smith and Knight Tooth Wear Index. Dietary intake and other related factors were assessed using a questionnaire.
RESULTS: The overall erosion prevalence in this group was 66.9%, of which 45.2% was mild and 21.7% was
moderate erosion. A strong association was found between erosion and private schooling (higher socioeconomic
groups), carbonated drinks, herbal hibiscus drink and traditional acidic food consumption.
                                               RETURN to Titles
 Prevalence of caries and dental erosion among school children in The Hague from 1996-2005.
Truin G J; Frencken J E; Mulder J; Kootwijk A J; Jong E de Afdeling Preventieve en Curatieve Tandheelkunde
van het Universitair Medisch Centrum St Radboud, Nijmegen. g.truin@dent.umcn.nl Nederlands tijdschrift
In 2005 a dental survey of the prevalence of caries among 6- and 12-year-old schoolchildren in The Hague was
carried out. In the case of the 12-year-olds, the prevalence of dental erosion was also studied. The sample
consisted of 814 students in twelve primary schools in The Hague. The results reveal that since the previous study,
in 2002, the trend in the direction of an increasing percentage of children with deciduous caries-free teeth and
permanent caries-free teeth had continued. In the case of the children who were not caries-free, it was noticeable
that, in general, the number of new dental caries (dmfs- and DMFS-score) had not changed in the period 1996-2005,
while the number of restorations among the 6- and 12-year olds had decreased. The mean restorative index in the
deciduous dentition of 6-year-olds decreased from approximately 40% in 1996 to approximately 20% in 2005; with
respect to permanant dentition among 12-year-olds, the percentage decreased from more than 90% to 60%. The
                                                   RETURN to Titles
Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren.
Auad Sheyla M; Waterhouse Paula J; Nunn June H; Steen Nick; Moynihan Paula J The School of Dental
Sciences, Newcastle upon Tyne, UK International dental journal (2007), 57(3), 161-7.
OBJECTIVES: To assess the prevalence of dental erosion in a sample of 13- and 14-year-old Brazilian
schoolchildren and to assess the relationship of dental erosion and socio-demographic characteristics.
METHODS: A convenience sample of 458 children (190 boys and 268 girls) from 14 schools in Tres Coracoes, south
east Brazil, was examined. Socio-demographic data were collected by self-completion questionnaires. RESULTS:
Dental erosion was observed in 34.1% of subjects, involving enamel only and showing a symmetrical distribution.
The palatal surfaces of the upper incisors were the most commonly affected surfaces. Erosion experience was
higher in boys; pupils from Government funded schools; those resident in rural areas and those from the high
economic class, but none of these were statistically significant.
CONCLUSION: These data are the first to show that in a cohort of 13-14-year old Brazilian schoolchildren,
approximately one third of those examined showed mild erosion, requiring clinical preventive counselling.
                                              RETURN to Titles
Prevalence, diagnosis and treatment of extraesophageal manifestations of GERD.
Sugawa Takashi; Fujiwara Yasuhiro; Okuyama Masatsugu; Tanigawa Tetsuya; Shiba Masatsugu; Tominaga
Kazunari; Watanabe Toshio; Oshitani Nobuhide; Higuchi Kazuhide; Arakawa Tetsuo Department of
Gastroenterology, Osaka City University, Graduate School of Medicine Nippon rinsho. Japanese journal of
Gastroesophageal reflux disease (GERD) is associated with a variety of extraesophageal symptoms including
asthma, chronic cough, laryngeal disorders, and various ENT symptoms. Recent studies suggest that GERD
underlies or contributes to chronic sinusitis, chronic otitis media, dental erosion, and obstructive sleep apnea
syndrome (OSAS).
In this article, we review the prevalence, diagnosis, and treatment of extraesophageal symptoms and including
Montreal definition, a new definition and classification of GERD by an International Consensus Group.
                                                RETURN to Titles
 Occupational dental erosion from exposure to acids: a review.
 Wiegand Annette; Attin Thomas Clinic for Preventive Dentistry, Periodontology and Cariology, University of
Zurich, Plattenstrasse 11, Zurich, Switzerland. annette.wiegand@zzmk.unizh.ch Occupational medicine
(Oxford, England) (2007), 57(3), 169-76. Journal code: 9205857. ISSN:0962-7480. Journal; Article;
OBJECTIVE: Dental erosion is characterized as a disorder with a multifactorial aetiology including environmental
acid exposure. The purpose of this article was to summarize and discuss the available information concerning
occupational dental erosion. METHODS: Information from original scientific papers, case reports and reviews with
additional case reports listed in PubMed, Medline or EMBASE [search term: (dental OR enamel OR dentin) AND
(erosion OR tooth wear) AND (occupational OR worker)] were included in the review. References from the
identified publications were manually searched to identify additional relevant articles. RESULTS: The systematic
search resulted in 59 papers, of which 42 were suitable for the present review. Seventeen papers demonstrated
evidence that battery, galvanizing and associated workers exposed to sulphuric or hydrochloric acid were at higher
risk of dental erosion. For other industrial workers, wine tasters and competitive swimmers, only a few clinical
studies exist and these do not allow the drawing of definitive conclusions.
                                           RETURN to Titles
 Dental erosion and gastro-esophageal reflux disease.
Jasz Mate; Varga Gabor; Toth Zsuzsanna Fogpotlastani Klinika, Budapest Fogorvosi szemle (2007), 100(1),
3-10. Journal code: 0374613. ISSN:0015-5314. (ENGLISH ABSTRACT); Journal; Article; (JOURNAL
The prevalence of gastro-esophageal reflux disease (GERD), as well as that of dental erosion (DE), increases
steeply in the 21th century societies of Europe and North America. GERD is a multicausal disease, with genetic,
anatomical and neurological insufficiencies in the background, complemented with behavioral factors. In GERD, as
reflux occurs more often and lasts longer than physiologically, the result is esophagitis and supraesophageal
manifestations. The acid, which might even reach the mouth, interacts with the material of the teeth and
demineralization, a form of dental erosion takes place. Clinical studies have proved, that in patients suffering from
GERD dental erosion takes place significantly more often than in patients who do not. It was also confirmed that in
patients with idiopathic dental erosion GERD is significantly more frequent than in the "uneroded" population.
                                                 RETURN to Titles
 Destructive and protective factors in the development of tooth-wear.
Mate Jasz; Gabor Varga; Zsuzsanna Toth Semmelweis Egyetem, Fogpotlastani Klinika, Budapest Fogorvosi
szemle (2006), 99(6), 223-30. Journal code: 0374613. ISSN:0015-5314. (ENGLISH ABSTRACT); Journal;
The experience of the past decade proves that tooth wear occurs in an increasing number of cases in general
dental practice. Tooth wear may have physical (abrasion and attrition) and/or chemical (erosion) origin. The
primary physical causes are inadequate dental hygienic activities, bad oral habits or occupational harm. As for
dental erosion, it is accelerated by the highly erosive foods and drinks produced and sold in the past decades, and
the number of cases is also boosted by the fact that bulimia, anorexia nervosa and gastro-oesophageal reflux
disease prevalence have become more common. The most important defensive factor against tooth wear is saliva,
which protects teeth from the effect of acids. Tertiary dentin formation plays an important role in the protection of
the pulp. Ideally, destructive and protective factors are in balance. Both an increase in the destructive forces, and
the insufficiency of defense factors result in the disturbance of the equilibrium. This results in tooth-wear, which
means an irreversible loss of dental hard tissue. The rehabilitation of the lost tooth material is often very difficult,
                                              RETURN to Titles
 Oral and dental manifestations of gastroesophageal reflux disease in children: a preliminary study.
Ersin Nazan Kocatas; Oncag Ozant; Tumgor Gokhan; Aydogdu Sema; Hilmioglu Suleyha Department of
Pedodontics, Dental Faculty, Ege University, Bornova-Izmir, Turkey. nazan.ersin@ege.edu.tr Pediatric
dentistry (2006), 28(3), 279-84. Journal code: 7909102. ISSN:0164-1263. Journal; Article; (JOURNAL
PURPOSE: The aim of this study was to investigate the effects of gastroeophageal reflux disease (GERD) on: (1)
erosion; (2) caries formation; (3) salivary function; and (4) salivary microbiological counts. METHODS: Thirty-eight
GERD patients with a mean age of 6 1/2 years and 42 healthy children of the same age and gender and social
background comprised the study group. All subjects answered a detailed frequency questionnaire related to acidic
drinks, foods, and sugar consumption and participated in a clinical dental examination. The caries experience of
the children was recorded according to World Health Organization criteria, and erosion was scored according to
the Eccles and Jenkins grading scale. The children were also investigated for stimulated salivary flow rate, buffer
capacity, and salivary mutans streptococci (MS), lactobacilli, and yeast colonization. RESULTS: The prevalence of
dental erosion and the salivary yeast and MS colonization in GERD children was found to be significantly higher
than for healthy subjects (P<.05). The caries experience, salivary flow rate, buffering capacities of the children, and
                                                RETURN to Titles
 Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten
Wiegand A; Muller J; Werner C; Attin T Department of Operative Dentistry, Preventive Dentistry and
Periodontology, University of Gottingen, Gottingen, Germany. annette.wiegand@med.uni-goettingen.de Oral
diseases (2006), 12(2), 117-24. Journal code: 9508565. ISSN:1354-523X. Journal; Article; (JOURNAL
OBJECTIVES: The aims of this study were to (1) investigate prevalence and severity of erosive tooth wear among
kindergarten children and (2) determine the relationship between dental erosion and dietary intake, oral hygiene
behaviour, systemic diseases and salivary concentration of calcium and phosphate. MATERIALS AND METHODS:
A sample of 463 children (2-7 years old) from 21 kindergartens were examined under standardized conditions by a
calibrated examiner. Dental erosion of primary and permanent teeth was recorded using a scoring system based
on O'Sullivan Index [Eur J Paediatr Dent 2 (2000) 69]. Data on the rate and frequency of dietary intake, systemic
diseases and oral hygiene behaviour were obtained from a questionnaire completed by the parents. Unstimulated
saliva samples of 355 children were analysed for calcium and phosphate concentration by colorimetric assessment.
Descriptive statistics and multiple regression analysis were applied to the data. RESULTS: Prevalence of erosion
amounted to 32% and increased with increasing age of the children. Dentine erosion affecting at least one tooth
                                             RETURN to Titles
Pilot study of dental erosion and associated factors in university student volunteers
Hou Xiao-mei; Zhang Qing; Gao Xue-jun; Wang Jin-sheng Department of Operative Dentistry and
Endodontics, Peking University School of Stomatology, Beijing 100081, China Zhonghua kou qiang yi xue za zhi
= Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology (2005), 40(6), 478-80. Journal code:
OBJECTIVE: To investigate dental erosion and associated etiologic factors among students from one university.
METHODS: A total of 179 student volunteers from one university were examined clinically for their dental erosion.
Each was required to complete a questionnaire regarding potentially associated etiologic factors. A modified
criteria was used to grade the severity of dental erosion. RESULTS: The prevalence of dental erosion of this group
was 45.8%, mostly in enamel. Facial surfaces of anterior teeth were most vulnerable to erosion. Statistic analysis
indicated that acidic diets, such as carbonated drink, fruit juice, fruit drink and banana were risk factors to dental
erosion.                                          RETURN to Titles
 Patterns of tooth surface loss among winemakers.
Chikte U M E; Naidoo S; Kolze T J v W; Grobler S R Department of Community Health, Faculty of Health
Sciences, University of Stellenbosch, PO Box 19063, Tygerberg. umec@sun.ac.za SADJ : journal of the
South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging (2005), 60(9),
370-4. Journal code: 9812497. ISSN:1029-4864. (COMPARATIVE STUDY); Journal; Article; (JOURNAL
There are a few documented case studies on the adverse effect of wine on both dental hard and soft tissues.
Professional wine tasting could present some degree of increased risk to dental erosion. Alcoholic beverages with
a low pH may cause erosion, particularly if the attack is of long duration, and repeated over time. The purpose of
this study was to compare the prevalence and severity of tooth surface loss between winemakers (exposed) and
their spouses (non-exposed). Utilising a cross-sectional, comparative study design, a clinical examination was
conducted to assess caries status; the presence and severity of tooth surface loss; staining (presence or absence);
fluorosis and prosthetic status. The salivary flow rate, buffering capacity and pH were also measured. Thirty-six
persons, twenty-one winemakers and fifteen of their spouses participated in the study. It was possible to show that
there was a difference in terms of the prevalence and severity of tooth surface loss between the teeth of
winemakers and those who are not winemakers. The occurrence of tooth surface loss amongst winemakers was
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Dental erosion among children in an Istanbul public school.
Caglar Esber; Kargul Betul; Tanboga Ilknur; Lussi Adrian Department of Pediatric Dentistry, School of
Dentistry, Marmara University, Istanbul, Turkey. caglares@yahoo.com Journal of dentistry for children
(Chicago, Ill.) (2005), 72(1), 5-9. Journal code: 101180951. ISSN:1551-8949. Journal; Article; (JOURNAL
The aim of this study was to evaluate the prevalence, clinical manifestations, and etiology of dental erosion among
children. A total of 153 healthy, 11-year-old children were sampled from a downtown public school in Istanbul,
Turkey comprised of middle-class children. Data were obtained via: (1) dinical examination; (2) questionnaire; and
(3) standardized data records. A new dental erosion index for children designed by O'Sullivan (2000) was used.
Twenty-eight percent (N=43) of the children exhibited dental erosion. Of children who consumed orange juice, 32%
showed erosion, while 40% who consumed carbonated beverages showed erosion. Of children who consumed
fruit yogurt, 36% showed erosion. Of children who swam professionally in swimming pools, 60% showed erosion.
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 Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil
Peres K G; Armenio M F; Peres M A; Traebert J; De Lacerda J T Universidade do Sul de Santa Catarina
(UNISUL), Tubarao, Brazil. karengp@ig.com.br International journal of paediatric dentistry / the British
Paedodontic Society [and] the International Association of Dentistry for Children (2005), 15(4), 249-55.
OBJECTIVE: The aim of this study was to assess the prevalence and severity of dental erosion among 12-year-old
schoolchildren in Joacaba, southern Brazil, and to compare prevalence between boys and girls, and between public
and private school students. METHODS: A cross-sectional study was carried out involving all of the municipality's
499, 12-year-old schoolchildren. The dental erosion index proposed by O'Sullivan was used for the four maxillary
incisors. Data analysis included descriptive statistics, location, distribution, and extension of affected area and
severity of dental erosion. RESULTS: The prevalence of dental erosion was 13.0% (95% confidence interval = 9.0-
17.0). There was no statistically significant difference in prevalence between boys and girls, but prevalence was
higher in private schools (21.1%) than in public schools (9.7%) (P < 0.001). Labial surfaces were less often affected
than palatal surfaces. Enamel loss was the most prevalent type of dental erosion (4.86 of 100 incisors). Sixty-three
per cent of affected teeth showed more than a half of their surface affected. CONCLUSION: The prevalence of
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 The prevalence of dental erosion in preschool children in China.
Luo Y; Zeng X J; Du M Q; Bedi R Dental Public Health, Faculty of Dentistry, University of Hong Kong, Hong
Kong SAR, China Journal of dentistry (2005), 33(2), 115-21. Journal code: 0354422. ISSN:0300-5712.
Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT, NON-U.S. GOV'T) written in English.
OBJECTIVE: To describe the prevalence of dental erosion and associated factors in preschool children in Guangxi
and Hubei provinces of China. METHODS: Dental examinations were carried out on 1949 children aged 3-5 years.
Measurement of erosion was confined to primary maxillary incisors. The erosion index used was based upon the
1993 UK National Survey of Children's Dental Health. The children's general information as well as social
background and dietary habits were collected based on a structured questionnaire. RESULTS: A total of 112
children (5.7%) showed erosion on their maxillary incisors. Ninety-five (4.9%) was scored as being confined to
enamel and 17 (0.9%) as erosion extending into dentine or pulp. There was a positive association between erosion
and social class in terms of parental education. A significantly higher prevalence of erosion was observed in
children whose parents had post-secondary education than those whose parents had secondary or lower level of
education. There was also a correlation between the presence of dental erosion and intake of fruit drink from a
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 Dental erosion in children : an increasing clinical problem.
Deshpande S D; Hugar S M Department of Pedodontics and Preventive Dentistry, KLES's Institute of Dental
Sciences, Belgaum, Karnataka Journal of the Indian Society of Pedodontics and Preventive Dentistry (2004),
22(3), 118-27. Journal code: 8710631. ISSN:0970-4388. Journal; Article; (JOURNAL ARTICLE) written in
Epidemiological studies carried out on dental erosion have established that the prevalence is high in young people
and adolescents. The objective of this study was to look at the prevalence and etiology of dental erosion,
particularly in children, and its practical management for its possible control. The children between 5-6 yrs were
examined and findings recorded, and this study has shown that approximately 1/3rd of 5-6 yrs old children have
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Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England.
Part 1: The relationship with water fluoridation and social deprivation
Comment in: Br Dent J. 2005 Mar 12;198(5):283; author reply 283. PubMed ID: 15870754 Bardsley P F;
Taylor S; Milosevic A Dept. of Restorative Dentistry, Birmingham Dental Hospital, University of Liverpool,
Pembroke Place, Liverpool L3 5PS, UK British dental journal (2004), 197(7), 413-6; discussion 399. Journal
code: 7513219. ISSN:0007-0610. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
OBJECTIVE: The effect of water fluoridation upon dental erosion/tooth wear in the UK has not been investigated.
This study aimed to compare the prevalence of tooth wear in 14-year-old schoolchildren in non-fluoridated and
fluoridated districts of North West (NW) England. The influence of deprivation and tooth brushing was also
investigated.
DESIGN: A random sample of 10% of the 14-year-old population in NW England was selected and stratified
according to fluoridation status as determined from water authority postcode listings.
METHODS: Tooth wear was scored on the labial, incisal and palatal/lingual surfaces of the 12 anterior teeth and the
occlusal surfaces of the first molars. Enamel wear was scored 0, dentine was scored 1 or 2, dependent on whether
less than or more than a third of the surface had exposed dentine. Secondary dentine or pulpal exposure scored 3.
Townsend deprivation scores were gained from residential post codes.
RESULTS: A total of 2,351 children were examined, of which 637 (27%) lived in the one fluoridated district of South
Cheshire and 1,714 (73%) lived in 11 non-fluoridated districts. Fifty-three per cent of the children had exposed
dentine with significantly more males affected than females (p<0.001). In the fluoridated district,
significantly fewer children had exposed dentine on labial and palatal smooth surfaces (p<0.001) but no differences
were found for incisal and occlusal surfaces.
The interaction of fluoridation and tooth brushing twice per day resulted in a significant
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Dental erosion: part 2. The management of dental erosion.
Kilpatrick Nicky; Mahoney Erin K Dental Department, The Royal Children's Hospital, Parkville, VIC, Australia
The New Zealand dental journal (2004), 100(2), 42-7. Journal code: 0401065. ISSN:0028-8047. Journal;
Dental erosion is an important cause of tooth tissue loss in both children and adults. An earlier article (Mahoney
and Kilpatrick, 2003) discussed the prevalence and causes of dental erosion. This second article will discuss the
management of this condition which is often complicated by the multifactorial nature of tooth wear. Management
of dental erosion can be considered in three phases: immediate, interim and long-term. Immediate management
includes the early diagnosis of dental erosion, recording the status of the disorder at baseline and implementing
appropriate preventive strategies including those aimed at reducing the acidic exposure as well as those that
attempt to increase an individual's resistance to erosive tooth tissue loss. Interim and long-term treatment includes
the provision of temporary diagnostic restorations, ongoing monitoring of disease progression, definitive
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 Dental erosion: part 1. Aetiology and prevalence of dental erosion.
Mahoney Erin K; Kilpatrick Nicky M Biomaterials Research Unit, University of Sydney, National Innovation
Centre, Eveleigh, NSW, Australia. emah0137@mail.usyd.edu.au The New Zealand dental journal (2003),
99(2), 33-41. Journal code: 0401065. ISSN:0028-8047. Journal; Article; (JOURNAL ARTICLE); General
Non-carious tooth tissue loss due to abrasion, attrition, abfraction and erosion has become a significant problem,
occurring in up to 80 percent of children and in up to 43 percent of adults. Dental erosion is now recognised as an
important cause of tooth tissue loss in both children and adults. It is caused by the presence of intrinsic or
extrinsic acid of non-bacterial origin in the mouth. Intrinsic sources of acid include vomiting, regurgitation, gastro-
oesophageal reflux or rumination. Extrinsic sources of acid are most commonly dietary acids. Medications, a
patient's lifestyle choices and environment can also increase the risk of dental erosion. In this article we identify
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 Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?
Moazzez Rebecca; Bartlett David; Anggiansah Angela Department of Conservative Dentistry, Floor 25 Guy's
Tower, St Thomas' Street, London Bridge, London SE1 9RT, United Kingdom. rebecca.moazzez@kcl.ac.uk
Journal of dentistry (2004), 32(6), 489-94. Journal code: 0354422. ISSN:0300-5712. Journal; Article;
AIMS: The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary
parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD) compared
with a group of control subjects. MATERIALS AND METHODS: Tooth wear, stimulated salivary flow rate and
buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal Laboratory.
Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD. Tooth wear
was assessed using a modification of the Smith and Knight tooth wear index. The results were compared to those
obtained from a group of controls with no symptoms of GORD. RESULTS: Patients with symptoms of GORD and
those subsequently diagnosed with GORD had higher total and palatal tooth wear (p<0.05). The buffering capacity
of the stimulated saliva from the control subjects was greater than patients with symptoms of GORD (p<0.001).
Patients with hoarseness had a lower salivary flow rate compared with those with no hoarseness. CONCLUSIONS:
                                                  RETURN to Titles
 Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among
Jensdottir T; Arnadottir I B; Thorsdottir I; Bardow A; Gudmundsson K; Theodors A; Holbrook W P Department
of Oral Medicine, Dental School of Copenhagen, University of Copenhagen, Norre Alle 20, 2200 Copenhagen N,
Denmark. tje@odont.ku.dk Clinical oral investigations (2004), 8(2), 91-6. Journal code: 9707115.
The aim of this study was to determine the prevalence of dental erosion in young Icelandic adults (19-22 years old)
and patients with gastroesophageal reflux disease (GERD), in relation to their soft drink consumption and
gastroesophageal reflux. Eighty subjects (40 males and 40 females), comprising 57 young adults (mean age 21 +/- 2
years) and 23 GERD patients (mean age 35 +/- 10 years), were enrolled in this study. All subjects answered a
detailed frequency questionnaire of soft drink consumption and participated in a clinical examination. Erosion was
scored for incisor and molar teeth separately. No significant difference was observed in the prevalence of dental
erosion between young adults and GERD patients. However, by combining the two study groups a three-fold higher
risk of having erosion in molars or incisors was found for subjects drinking Coca-Cola three times a week or more
often ( p < 0.05). Additionally, significantly higher erosion scores were found in molars among subjects drinking
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 Dental caries and dental erosion among 5- and 6-year old and 11- and 12-year old school children in the
Hague, the Netherlands. Changing prevalences?.
Truin G J; van Rijkom H M; Mulder J; van' t Hof M A Afdeling Preventieve en Curatieve Tandheelkunde van de
Faculteit der Medische Wetenschappen van het Universitair Medisch Centrum Sint Radboud, Nijmegen.
g.truin@dent.umcn.nl Nederlands tijdschrift voor tandheelkunde (2004), 111(3), 74-9. Journal code:
0400771. ISSN:0028-2200. (COMPARATIVE STUDY); (ENGLISH ABSTRACT); Journal; Article; (JOURNAL
In 2002 a dental survey amongst 6- and 12-year-old schoolchildren in The Hague had been carried out. The 2002
survey suggested that in the period 1996-2002 the caries prevalence (% of cariesfree children) and the caries
experience (mean dmfs/dmft scores) among 6-year-old children did not have changed significantly. Children of low
socio-economic status in 2002 had an average higher dmfs/dmft count compared to 6-year-olds of medium and
high SES. However, the survey suggested in the period 1996-2002 a significant increase of cariesfree 12-year-old
children in low SES. Among 12-year-olds socio-economic differences in caries experience of the permanent
dentition have diminished in 2002. In 1998 and 2002 respectively 3 and 23% of the 12-year-olds showed the
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 Associations between occupational health behaviors and occupational dental erosion
Kim Hyun-duck; Douglass Chester W Department of Preventive and Public Health Dentistry, College of
Dentistry, Seoul National University, 28, Younkeon-dong, Chongro-ku, Seoul, 110-460, Korea.
hyundkim@unitel.co.kr Journal of public health dentistry (2003), 63(4), 244-9. Journal code: 0014207.
OBJECTIVES: The aim of this study was to evaluate the associations between occupational health behaviors and
occupational dental erosion. METHODS: Using data for 943 workers among 34 factories, selected by three-stage
stratified cluster sampling from 888 factories using acids, two sets of modified case-control studies were
performed. The cases were 242 workers with any dental erosion (G1-5) and 78 with severe dental erosion (G3-5);
the controls were 701 workers with no erosion (GO) and 864 workers with no or mild erosion grades, GO-2,
respectively. The main explanatory variables were behaviors such as wearing a respiratory mask and gargling at
work. The results were adjusted for employment, age, sex, knowledge, and opinion about occupational health,
attrition, and abrasion. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The
odds of overall occupational dental erosion (G1-5) was 0.63 (95% CI = 0.42, 0.94) for respiratory mask wearers
compared to nonwearers; the odds of severe occupational dental erosion (G3-5) was not significantly less in
respiratory mask wearers (OR = 0.94; 95% CI = 0.53, 1.67). Gargling did not show a significant association with
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 Dental erosion in 5-year-old Irish school children and associated factors: a pilot study
Harding M A; Whelton H; O'Mullane D M; Cronin M Oral Health Services Research Centre, University Dental
School and Hospital, Wilton, Cork, Ireland Community dental health (2003), 20(3), 165-70. Journal code:
8411261. ISSN:0265-539X. Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT, NON-U.S.
OBJECTIVE: To determine the prevalence of dental erosion in a stratified sample of 5-year-old children and to
investigate whether demographic and dietary factors were associated. DESIGN: Cross sectional study in Cork City
and County. METHODS: A sample of 202 5-year-old children stratified on fluoridation status was selected.
Measurement of erosion used a scoring system and criteria based on those used in the UK. Wear on the palatal
and labial surfaces of primary maxillary teeth considered to be predominantly erosive was assessed. Demographic
and dietary details were collected via a parental questionnaire. Statistical analysis was stepwise logistic
regression. RESULTS: In lifetime residents of fluoridated areas (n = 114) 47% had evidence of erosion; in 21%
erosion had progressed to the dentine or pulp. The corresponding figures in non-fluoridated areas (n = 76) were
43% and 21% respectively. The variables significantly associated with erosion to dentine or pulp were low socio-
economic status, measured by low family income and the frequency of fruit squash and carbonated drink
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Gastroesophageal reflux in children with cerebral palsy and its relationship to erosion of primary and
Su Jo-Mei; Tsamtsouris Anthi; Laskou Meletia Department of Pediatric Dentistry, Tufts University School of
Dental Medicine, USA Journal of the Massachusetts Dental Society (2003), 52(2), 20-4. Journal code:
Patients with cerebral palsy are known to have a high incidence of feeding difficulties, including problems with
swallowing, vomiting, recurrent chest infections, and irritability. Gastroesophageal reflux (GER) is an involuntary
passage of the gastric contents into the esophagus. It has been found in a higher prevalence (up to 75 percent) in
cerebral palsy patients. Long-term gastric acid attacks teeth and can cause dental erosion. Bargen and Austin first
discovered the relationship between GER and dental erosion in 1937 when they concluded that the loss of dental
hard tissue could be an indicator and the predominant oral manifestation of GER. The purpose of this study is to
investigate the correlation between GER and dental erosion in primary and permanent teeth in cerebral palsy
patients. Twenty-one patients participated in this study. Results showed that out of the 21 patients, 15 had erosion
and 11 of them had GER history. The chi-square analysis with the p value of less than or equal to 0.025 showed the
distribution to be significant. The severity of the erosion was correlated to the duration of the disease, frequency of
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 Dental and periodontal lesions in patients with gastro-oesophageal reflux disease
Munoz J V; Herreros B; Sanchiz V; Amoros C; Hernandez V; Pascual I; Mora F; Minguez M; Bagan J V;
Benages A Department of Gastroenterology, Clinic University Hospital, University of Valencia, Avda. Blasco
Ibanez 17, 46010 Valencia, Spain Digestive and liver disease : official journal of the Italian Society of
Gastroenterology and the Italian Association for the Study of the Liver (2003), 35(7), 461-7. Journal code:
OBJECTIVE: Dental erosion has been considered an extraesophageal manifestation of gastro-oesophageal reflux
disease, but few reports have studied the relationship between this disease and other periodontal or dental lesions.
The aim of this study was to investigate the prevalence of dental and periodontal lesions in patients with gastro-
oesophageal reflux disease. PATIENTS AND METHODS: A total of 253 subjects were prospectively studied between
April 1998 and May 2000. Two study groups were established: 181 patients with gastro-oesophageal reflux disease
and 72 healthy volunteers. Clinical assessment, including body mass index and consumption of tobacco and
alcohol, was performed in all subjects, as well as a dental and periodontal examination performed by a dentist
physician, blind as to the diagnosis of subjects. Parameters evaluated were: (a) presence and number of dental
erosion, location and severity, according to the Eccles and Jenkins index [Prosthet Dent 1979;42:649-53], modified
by Hattab [Int J Prosthes 2000;13:101-71; (b) assessment of dental condition by means of the CAO index; and (c)
periodontal status analysed by the plaque index, the haemorrhage index, and gingival recessions. RESULTS:
Clinical parameters were similar in both groups (p > 0.05). Age was statistically associated with the CAO index,
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Dental health behavior, gastroesophageal disorders and dietary habits among Norwegian recruits in
Myklebust Stale; Espelid Ivar; Svalestad Sigurd; Tveit Anne Bjorg Faculty of Odontology, University of Bergen,
Norway. Stale.Myklebust@odont.uib.no Acta odontologica Scandinavica (2003), 61(2), 100-4. Journal
A questionnaire was given to representative samples of Norwegian recruits in 1990 and 1999 to explore dental
health habits, history of gastroesophageal disorders and diet with possible relations to dental erosion. The
samples were 792 (mean age 20.9 years) and 676 (mean age 21.6 years), respectively, and the corresponding
responses were 62% and 100%. Minor differences in self-reported dental health habits and gastroesophageal
disorders were found. The respondents' dentists had provided information about dental erosion for 8.2% of the
respondents in 1990 versus 14.5% in 1999. There was an increase in the reported frequency of daily intake of juice
from 17% to 24% (P = 0.006) and carbonated soft drink from 54% to 61% (P = 0.025) in the period 1990-99. The
frequency of training activity showed minor changes, but in 1999 it was more common to drink during exercise
(94% versus 74% in 1990, P < 0.001), and the majority drank water. Sixteen percent of recruits ate oranges daily in
1990; in 1999 this had dropped to 11% (P = 0.012). The corresponding proportion that ate apples daily had dropped
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 Dental erosion -- changing prevalence? A review of British National childrens' surveys
Nunn J H; Gordon P H; Morris A J; Pine C M; Walker A Public and Child Dental Health, School of Dental
Science, Trinity College, Dublin, Ireland. june.nunn@dental.tcd.ie International journal of paediatric dentistry /
the British Paedodontic Society [and] the International Association of Dentistry for Children (2003), 13(2), 98-
OBJECTIVES: To investigate the change in the prevalence of dental erosion, over time, by a review of the data from
the published national dental surveys of young people in the UK. A subsidiary objective was to investigate the
relationship between erosion and possible associated risk factors. DESIGN: The review was based on cross-
sectional prevalence studies incorporating a clinical dental examination and structured interviews. SAMPLE: The
data were collated from the 1993 UK childrens' dental health survey and the dental report of the two National Diet
and Nutrition Surveys (NDNS) of children aged 1(1/2)-4(1/2) in 1992/3 and 4-18 years in 1996/7. The criteria used for
data collection were comparable between the three different studies. RESULTS: Comparing the data from the
different studies, the prevalence of erosion was seen to increase from the time of the childrens' dental health
survey in 1993 and the NDNS study of 4-18-year-olds in 1996/7. There was a trend towards a higher prevalence of
erosion in children aged between 3(1/2) and 4(1/2) and in those who consumed carbonated drinks on most days
compared with toddlers consuming these drinks less often. Drinks overnight were associated with an increased
prevalence of erosion. More 4-6-year-olds with reported symptoms of gastro-oesophageal reflux had erosion
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 Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors
Arnadottir Inga B; Saemundsson Sigurdur Runar; Holbrook W Peter Faculty of Odontology, University of
Iceland, Reykjavik, Iceland. iarnad@hi.is Acta odontologica Scandinavica (2003), 61(1), 25-8. Journal code:
High consumption of fruit juices and carbonated drinks has been related to dental erosion. Teenage male
Icelanders consume about 800 ml of carbonated drinks per day on average and this corresponds with the main age
group and gender of patients seen with erosion. This study examined the prevalence of dental erosion in 15-year-
old children in Reykjavik and looked at the association between erosion and some lifestyle factors in a case-control
study drawn from the same sample. A 20% sample of the 15-year-cohort population (n = 278) was selected. Dental
erosion was classified by location and severity (1 = enamel erosion; 2 = dentine erosion; 3 = severe dentine
erosion) and was seen in 21.6% of subjects (68.3% male; 72% scored as grade 1; 23% grade 2; 5% grade 3). Control
subjects were the first healthy subjects examined after a case subject had beens diagnosed. In the case-control
study, information was gathered by multiple-choice questionnaire on symptoms of gastric reflux, tooth sensitivity,
some lifestyle and dietar-factors. Several lifestyle and dietary factors, previously shown to be significantly related
                                              RETURN to Titles
 On dental erosion and associated factors. (Introduction to a Full Supplement on Erosion)
Johansson Ann-Katrin Department of Cariology, Faculty of Odontology, Sahlgrenska Academy, Goteborg
University Swedish dental journal. Supplement (2002), (156), 1-77. Journal code: 7905899. ISSN:0348-6672.
Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT, NON-U.S. GOV'T) written in English.
The aim of this thesis was to explore aspects of dental erosion by investigating its prevalence among young Saudi
men and young children, develop a system for its assessment and to evaluate various tentative background factors
that may be associated with its occurrence. Saudi military inductees (n = 95) were subjected to questionnaire and
clinical examination, including recordings of severity of dental erosion and a number of other oral health
parameters. The system applied for grading the severity of dental erosion showed an intraexaminer agreement of
78%. Around one-fourth of the maxillary anterior tooth surfaces exhibited pronounced dental erosion and the
average soft drink consumption was 247 liters/year. High level of soft drink consumption and long retention time of
the drink in the mouth before swallowing, intensified oral hygiene, mouth breathing and low gingival bleeding index
were found to have significant correlations with the presence of dental erosion.
Furthermore, less plaque on maxillary palatal tooth surfaces, increased numbers of buccal cervical defects, first
permanent molar "cuppings", missing teeth, and lower salivary urea content had significant correlations with the
severity of dental erosion. High intake of acidic drinks and fruits, upper respiratory tract problems and frequent
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 Diet and dental erosion.
 Lussi A; Jaeggi T; Schaffner M Department of Operative, Preventive and Pediatric Dentistry, School of Dental
Medicine, University of Bern, Switzerland Nutrition (Burbank, Los Angeles County, Calif.) (2002), 18(9), 780-1.
Journal code: 8802712. ISSN:0899-9007. Journal; Article; (JOURNAL ARTICLE); General Review; (REVIEW)
NO ABSTRACT
                                                 RETURN to Titles
 Relationship between sports drinks and dental erosion in 304 university athletes in Columbus, Ohio,
Mathew Tanya; Casamassimo Paul S; Hayes John R College of Dentistry, The Ohio State University,
Children's Hospital, Columbus, Ohio 43017, USA. mathew.15@osu.edu Caries research (2002), 36(4), 281-
7. Journal code: 0103374. ISSN:0008-6568. Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT,
Acidic soft drinks, including sports drinks, have been implicated in dental erosion with limited supporting data in
scarce erosion studies worldwide. The purpose of this study was to determine the prevalence of dental erosion in
a sample of athletes at a large Midwestern state university in the USA, and to evaluate whether regular consumption
of sports drinks was associated with dental erosion. A cross-sectional, observational study was done using a
convenience sample of 304 athletes, selected irrespective of sports drinks usage. The Lussi Index was used in a
blinded clinical examination to grade the frequency and severity of erosion of all tooth surfaces excluding third
molars and incisal surfaces of anterior teeth. A self-administered questionnaire was used to gather details on
sports drink usage, lifestyle, health problems, dietary and oral health habits. Intraoral color slides were taken of all
teeth with erosion. Sports drinks usage was found in 91.8% athletes and the total prevalence of erosion was 36.5%.
                                          RETURN to Titles
 Diagnosis and management of dental erosion.
Gandara B K; Truelove E L Department of Oral Medicine, School of Dentistry, University of Washington,
Seattle 98195, USA. bgandara@u.washington.edu The journal of contemporary dental practice (1999), 1(1),
16-23. Journal code: 101090552. E-ISSN:1526-3711. Journal; Article; (JOURNAL ARTICLE); General Review;
Early recognition of dental erosion is important to prevent serious irreversible damage to the dentition. This
requires awareness of the clinical appearance of erosion compared to other forms of tooth wear. An understanding
of the etiologies and risk factors for erosion is also important. These form the basis of a diagnostic protocol and
management strategy that addresses the multifactorial nature of tooth wear. The primary dental care team has the
expertise and the responsibility to provide this care for their patients with erosion
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 Is there a relationship between asthma and dental erosion? A case control study.
Al-Dlaigan Y H; Shaw L; Smith A J Unit of Paediatric Dentistry, Unit of Oral Biology, The University of
Birmingham Dental School, St Chads, Queensway, Birmingham B4 6NN, UK International journal of paediatric
dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children (2002),
12(3), 189-200. Journal code: 9107511. ISSN:0960-7439. (COMPARATIVE STUDY); Journal; Article;
OBJECTIVES: The aims of this study were firstly to assess and compare the prevalence of dental erosion and
dietary intake between three groups of children; children with asthma, those with significant tooth erosion but with
no history of asthma, and children with no history of asthma or other medical problems. Secondly, to discover
whether there was a relationship between medical history and dietary practises of these children and the levels of
dental erosion. Thirdly, to measure and compare their salivary flow rates, pH and buffering capacity. METHODS:
The study consisted of 3 groups of children aged 11-18 years attending Birmingham Dental Hospital: 20 children
with asthma requiring long-term medication, 20 children referred with dental erosion, and 20 children in the age and
sex matched control group. Tooth wear was recorded using a modification of the tooth wear index (TWI) of Smith
and Knight. Data on the medical and dietary history were obtained from a self-reported questionnaire
supplemented by a structured interview. The salivary samples were collected under standard methods for
measurements. RESULTS: Fifty percent of the children in the control group had low erosion and 50% moderate
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 Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia
Al-Majed Ibrahim; Maguire Anne; Murray John J Department of Child Dental Health, Dental School,
Framlington Place, Newcastle upon Tyne, NE2 4BW, United Kingdom Community dentistry and oral
epidemiology (2002), 30(1), 38-46. Journal code: 0410263. ISSN:0301-5661. Journal; Article; (JOURNAL
MATERIAL AND METHODS: Dental examinations were carried out on 354 boys aged 5-6 years, and 862 boys aged
12-14 years, attending 40 schools in Riyadh. The prevalence of dental erosion was assessed using diagnostic
criteria similar to those employed in the 1993 UK National Survey of Child Dental Health. RESULTS: Pronounced
dental erosion (into dentine or dentine and pulp) was observed in 34% of 5-6 year olds and 26% of 12-14 year olds.
Information on food and drink consumed and dietary habits was obtained by means of a questionnaire. Parents
reported that 65% of 5-6 year old boys took a drink to bed. Water was the commonest drink consumed (37%)
followed by carbonated soft drinks (21%). One third of parents reported that their son had something to eat in bed
or during the night and 60% of this was sweet food or confectionery. Seventy per cent of 12-14 year old boys
reported consuming drinks at night; these were mainly water (30%), carbonated soft drinks (27%) and tea or coffee,
with sugar (18%). Forty-six per cent of the 12-14 year olds reported that they ate in bed at least once a week and
54% of this was sweet food or confectionery. When the dental examination and questionnaire results were
correlated, a statistically significant relationship was found between the number of primary maxillary incisors with
                                              RETURN to Titles
 Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia.
Al-Malik Manal I; Holt Ruth D; Bedi Raman Department of Transcultural Oral Health, Eastman Dental Institute,
University College London, University of London, London, UK Community dentistry and oral epidemiology
(2002), 30(1), 16-23. Journal code: 0410263. ISSN:0301-5661. Journal; Article; (JOURNAL ARTICLE)
OBJECTIVES: The objective of this study was to determine the prevalence of dental erosion in preschool children in
Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children. METHODS: A sample of
987 children (2-5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under
standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of erosion was confined to
primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of
Child Dental Health. Caries was diagnosed using BASCD criteria. Rampant caries was defined as caries affecting
the smooth surfaces of two or more maxillary incisors.
RESULTS: Of the 987 children, 309 (31%) had evidence of erosion. For 186 children this was confined to enamel
but for 123 it involved dentine and/or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries
in 336 (34%). The mean dmft for the 987 children was 4.80 (+/-4.87). Of the 384 children who had caries but not
rampant caries, 141 (37%) had erosion, a significantly higher proportion than the 72 (27%) out of 267 who were
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Clinical and photographic assessment of erosion in 2-5-year-old children in Saudi Arabia
Al-Malik M I; Holt R D; Bedi R Department of Transcultural Oral Health, Eastman Dental Institute, University
College London, UK Community dental health (2001), 18(4), 232-5. Journal code: 8411261. ISSN:0265-539X.
OBJECTIVE: To compare findings from photographs of incisor teeth in pre-school children in Jeddah, Saudi Arabia
to those on clinical examination for dental erosion. BASIC RESEARCH DESIGN: Cross sectional study of 2-5-year-
old Saudi Arabian children using two methods of examination. MEASUREMENT: of erosion was carried out
clinically using a scoring system and criteria based on those used in the United Kingdom national surveys.
Photographs of labial and palatal surfaces of maxillary primary incisors were taken for each child and scored in the
same way. SETTING: Kindergarten schools in Jeddah, Saudi Arabia. PARTICIPANTS: 987 children from 17
randomly selected schools in Jeddah, Saudi Arabia. RESULTS: Readable photographs were available for 727
children. Two hundred and twenty (30%) had photographic evidence of tooth tissue loss. Prevalence estimates
derived from clinical examination were higher than those for photographs (36% compared to 30%). Agreement was
seen between the two methods for 93% of the surfaces included.
                                            RETURN to Titles
 Rapid general dental erosion by gas-chlorinated swimming pool water. Review of the literature and case
Geurtsen W Department of Conservative Dentistry and Periodontology, Medical University Hannover,
Germany. Geurtsen.Werner@mh-Hannover.de American journal of dentistry (2000), 13(6), 291-3. Journal
code: 8806701. ISSN:0894-8275. (CASE REPORTS); Journal; Article; (JOURNAL ARTICLE); General Review;
Several reports indicate an increased prevalence of dental erosion among intensive swimmers due to low pH gas-
chlorinated pool water. Contrary to other extrinsic factors which induce erosion located on the facial aspect, low
pH pool water results in general dental erosion. Additionally, a case report is presented which describes the very
rapid occurrence of excessive general dental erosion of a competitive swimmer due to gas-chlorinated pool water
within 27 days. The observation of several authors as well as this case underscore the significance of a regular pH
monitoring of chlorinated swimming pool water. The high incidence indicates that dental erosion due to frequent
                                                  RETURN to Titles
 The relationship between erosion, caries and rampant caries and dietary habits in preschool children in
Al-Malik M I; Holt R D; Bedi R Department of Transcultural Oral Health, Eastman Dental Institute, University
College, London, UK International journal of paediatric dentistry / the British Paedodontic Society [and] the
International Association of Dentistry for Children (2001), 11(6), 430-9. Journal code: 9107511. ISSN:0960-
OBJECTIVES: The aim of this study was to investigate the possible association between dental erosion and caries,
and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a sample
of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and questionnaire
survey was carried out at a number of kindergartens. SAMPLE AND METHODS: A sample of 987 children (2-5-year-
olds) was drawn from 17 kindergartens. Clinical examinations were carried out under standardized conditions by a
trained and calibrated examiner (MAM). Information regarding diet and socio-economic factors was drawn from
questionnaires distributed to the parents through the schools. These were completed before the dental
examination. RESULTS: Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720
(73%) of the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of
carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child was a
baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also related to caries but
                                            RETURN to Titles
 Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan.
Amin W M; Al-Omoush S A; Hattab F N wami@ju.edu.jo International dental journal (2001), 51(3), 169-74.
Journal code: 0374714. ISSN:0020-6539. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
OBJECTIVES: To investigate the prevalence and nature of oral health problems among workers exposed to acid
fumes in two industries in Jordan. SETTING: Jordan's Phosphate Mining Company and a main private battery
factory. DESIGN: Comparison of general and oral health conditions between workers exposed to acid fumes and
control group from the same workplace. SUBJECTS AND METHODS: The sample consisted of 68 subjects from the
phosphate industry (37 acid workers and 31 controls) drawn as a sample of convenience and 39 subjects from a
battery factory (24 acid workers and 15 controls). Structured questionnaires on medical and dental histories were
completed by interview. Clinical examinations were carried out to assess dental erosion, oral hygiene, and gingival
health using the appropriate indices. Data were statistically analysed using Wilcoxon rank-sum test to assess the
significance of differences between results attained by acid workers and control groups for the investigated
parameters. RESULTS: Differences in the erosion scores between acid workers in both industries and their
controls were highly significant (P<0.05). In both industries, acid workers showed significantly higher oral hygiene
scores, obtained by adding the debris and calculus scores, and gingival index scores than their controls (P<0.05).
                                              RETURN to Titles
The oral health of children with clefts of the lip, palate, or both.
Chapple J R; Nunn J H Dental Hospital, Newcastle upon Tyne, NE2 4BW, United Kingdom The Cleft palate-
craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association (2001), 38(5),
525-8. Journal code: 9102566. ISSN:1055-6656. Journal; Article; (JOURNAL ARTICLE) written in English.
OBJECTIVE: The purpose of this study was to assess the prevalence of dental caries, developmental defects of
enamel, and related factors in children with clefts. DESIGN: This cross-sectional prevalence study used standard
dental indices for assessment. SETTING: Children underwent a dental examination under standard conditions of
seating and lighting in the outpatient department of a dental hospital as part of an ongoing audit to monitor clinical
outcomes. PARTICIPANTS: Ninety-one children aged 4, 8, and 12 years were included in the study. OUTCOME
MEASUREMENTS: Dental caries were assessed by use of the decayed, missing, and filled index for primary teeth
(dmft); Decayed, Missing, and Filled index for permanent teeth (DMFT) according to the criteria as used in the
national survey of children's dental health in the United Kingdom. Developmental defects were assessed using the
modified Developmental Defects of Enamel Index (Clarkson and O'Mullane, 1989). Dental erosion was assessed
using the criteria derived for the national survey of children's dental health. RESULTS: Caries prevalence increased
with age; 63% of patients at 4 years and 34% at 12 years were caries free. The mean dmft for the 4-year-olds was 1.3
with a mean DMFT for the 12-year-olds of 1.8. All the 4-year-olds had evidence of erosion of enamel in the primary
                                            RETURN to Titles
 Dental erosion in children and adolescents--a cross-sectional and longitudinal investigation using study
Ganss C; Klimek J; Giese K Dental Clinic, Department of Operative and Preventive Dentistry, Justus-Liebeg-
University, Giessen, Germany. Carolina.Ganss@dentist.med.uni-giessen.de Community dentistry and oral
epidemiology (2001), 29(4), 264-71. Journal code: 0410263. ISSN:0301-5661. Journal; Article; (JOURNAL
OBJECTIVE: To investigate the prevalence and incidence of dental erosion in children and adolescents.
METHODS: Lesions were registered for all tooth surfaces of primary and permanent teeth using pre-orthodontic
study models. A total of 1,000 individuals (mean age 11.4+/-3.3 years) were included; 265 of them were followed
over a 5-year period using their final orthodontic casts. RESULTS: In the primary teeth, 26.4% of the individuals had
no erosive lesions, 70.6% had at least one tooth with grade 1 erosion and 26.4% had grade 2 erosion. Grade 1
erosion was found in 44% of the occlusal surfaces of molars (36% of the incisal surfaces of the canines) and grade
2 erosion in 11% (9%). Lesions affecting oral or vestibular surfaces were negligible. In the permanent teeth, 11.6%
of individuals had at least one tooth with grade 1 erosion but only 0.2% had at least one tooth with grade 2 erosion.
The most affected teeth were the mandibular first molars (7% with grade 1 lesions). Lesions affecting oral or
                                                  first molars Titles
vestibular surfaces were negligible. Mandibular RETURN towere identified as possible marker teeth for the onset
 Vegetarian children and dental erosion.
al-Dlaigan Y H; Shaw L; Smith A J Department of Paediatric Dentistry, University of Birmingham, Dental
School, St Chads Queensway, Birmingham, B4 6NN, UK. y.h.aldlaigan@bham.ac.uk International journal of
paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children
BACKGROUND: There have been recent changes in teenage lifestyle and diet. The increasing consumption of soft
drinks and foods containing significant acidic components may play a role in the development of dental erosion.
OBJECTIVE: The aims of this investigation were firstly to assess the prevalence of vegetarian children in a cluster
random sample of 14-year-old children in Birmingham, United Kingdom. Secondly, to determine the prevalence of
dental erosion in these children, and thirdly, to see if there were any differences between vegetarian and non-
vegetarian children in the prevalence of dental erosion and dietary intake. DESIGN: A cluster random sample of 418
14-year-old children (209 males and 209 females) were examined from 12 different schools in Birmingham, United
Kingdom; a dietary questionnaire was completed and the levels of tooth wear were recorded using a modification
of the (TWI) index. All data were analysed using SPSS with t-test and Chi-square analysis. Significance was
accepted at the P < 0.05 level. RESULTS: The results showed that 10% of the children were vegetarian; 52% of them
had low dental erosion and 48% moderate dental erosion. Statistically there were no significant differences
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Occupational exposure to airborne proteolytic enzymes and lifestyle risk factors for dental erosion--a
Westergaard J; Larsen I B; Holmen L; Larsen A I; Jorgensen B; Holmstrup P; Suadicani P; Gyntelberg F
Department of Periodontology, School of Dentistry, University of Copenhagen, Norre Alle 20, DK-2200
Copenhagen N, Denmark. jytte.westergaard@odont.ku.dk Occupational medicine (Oxford, England) (2001),
This study examined the hypothesis that occupational exposure to airborne proteolytic enzymes is associated with
dental erosions on the facial surfaces of exposed teeth. Individuals (n = 425) working at a pharmaceutical and
biotechnological enterprise (Novozymes A/S) were examined; their mean age was 35 years (range = 18-67 years)
and 143 (34%) were women. Two hundred and two of these individuals were newly employed by the company.
Occupational exposure was assessed from questionnaire and workplace information. For practical analytical
purposes, individuals were categorized as either previously exposed to proteolytic enzymes or not. Information on
relevant lifestyle factors and medical history was obtained from a questionnaire. The main effect measure was
facial erosion, but lingual erosion indices and the presence of Class V restorations were also considered. The
validity of these measures was shown to be very high. Adjusted for potential confounders, there was no
association between history of occupational exposure to proteolytic enzymes and prevalent facial or lingual
                                               RETURN to Titles
 Dental erosion in children: a literature review.
Linnett V; Seow W K University of Queensland School of Dentistry, Brisbane, Australia Pediatric dentistry
(2001), 23(1), 37-43. Journal code: 7909102. ISSN:0164-1263. Journal; Article; (JOURNAL ARTICLE);
Epidemiological studies have shown that the prevalence of dental erosion in children varies widely between 2 and
57%. Changes seen in dental erosion range from removal of surface characteristics to extensive loss of tooth
tissue with pulp exposure and abscess formation. Symptoms of dental erosion range from sensitivity to severe
pain associated with pulp exposure. The etiology of dental erosion is dependent on the presence of extrinsic or
intrinsic acid in the oral environment. Extrinsic sources of acids in children include frequent consumption of acidic
foods and drinks, and acidic medications. Regurgitation of gastric contents into the mouth, as occurs in
gastroesophageal reflux, is the most common source of intrinsic acid in children. A multitude of factors may
modify the erosion process, such as saliva, oral hygiene practices, and presence or absence of fluoride. When
dental erosion is diagnosed, it is important to investigate and identify the acid source, and to determine if the
process is ongoing. The aim of treatment is to eliminate the cause of acid exposure, and to minimize the effects of
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What dental diseases are we facing in the new millennium: some aspects of the research agenda.
ten Cate J M Department of Cariology Endodontology Pedodontology, Academic Center for Dentistry
Amsterdam, The Netherlands Caries research (2001), 35 Suppl 1 2-5. Journal code: 0103374. ISSN:0008-
The next decades will show a shift in the attention given to diseases of the dental hard tissues. Clinical evidence
on how to prevent dental caries is now available. More emphasis should be given to optimising the rational use of
schemes of prevention. Caries still shows epidemic patterns in many countries while in some developed countries
a high prevalence of the disease is limited to a small group. Increased attention is needed for new manifestations
of pathology such as dental erosion, and for caries in special high-risk groups.
New methods of presenting caries prevalence and incidence data should be implemented to ensure that the
diseases of the dental hard tissues continue to have an important place on the political and research agendas.
                                                  RETURN to Titles
 Dental erosion in a group of British 14-year-old school children. Part II: Influence of dietary intake.
Al-Dlaigan Y H; Shaw L; Smith A The University of Birmingham, School of Dentistry British dental journal
(2001), 190(5), 258-61. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL ARTICLE)
OBJECTIVES: The aims of the present study were first to investigate the dietary intake pattern of UK teenagers and
secondly to determine the relationship, if any, between dental erosion and dietary intake in these children.
METHODS: The study group consisted of a cluster random sample of 14-year-old school children in Birmingham,
UK: 418 children were examined from 12 different schools; 209 were male and 209 female. Data on the rate and
frequency of consumption of drinks, foods, and fruits were obtained from a self-reported questionnaire
supplemented by a structured interview. The data were analysed using SPSS with Chi-square, and Spearman
correlation analysis. RESULTS: Over 80% of the teenagers regularly consumed soft drinks but approximately half
of these children had a relatively low weekly consumption. However, 13% and 10% respectively had more than 22
intakes per week of cola and other carbonated drinks. Almost a quarter of these 14-year-olds had alcoholic drinks,
with significantly more males than females involved (Chi-square P < 0.05) . Girls had a greater intake of fruits.
                                                  RETURN to Titles
Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of
Al-Dlaigan Y H; Shaw L; Smith A The University of Birmingham, School of Dentistry, St Chads, Queensway
British dental journal (2001), 190(3), 145-9. Journal code: 7513219. ISSN:0007-0610. Journal; Article;
OBJECTIVES: To establish the prevalence of erosion in a cluster random sample of 14- year-olds in Birmingham
UK. To determine whether socioeconomic group influences the prevalence of erosion. METHODS: The study
group consisted of a cluster random sample of 14-year-old school children in Birmingham UK: 418 children were
examined from 12 different schools; 209 were male and 209 female. The level of tooth wear was recorded using a
modification of the (TWI) index of Smith and Knight (1984). The ACORN classification was used to assess the
socioeconomic status of all children. RESULTS: Results showed that 48% of the children had low erosion, 51% had
moderate erosion and only 1% had severe erosion. There were statistically significant differences between males
and females; more males had buccal/labial and lingual/palatal tooth surface erosion than females (Chi-square
analysis P < 0.001). There was also significantly more erosion observed in teenagers in the lowest socioeconomic
                                            RETURN to Titles
 The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents.
Deery C; Wagner M L; Longbottom C; Simon R; Nugent Z J Dental Health Services Research Unit, University
of Dundee, Scotland, UK. c.h.deery@dundee.ac.uk Pediatric dentistry (2000), 22(6), 505-10. Journal code:
7909102. ISSN:0164-1263. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE); (RESEARCH
PURPOSE: A high prevalence of tooth surface loss due to erosion is well recognized in the United Kingdom (UK),
but not in the United States (US). This could be due to prevalence or perception or a combination of both. The aim
of this study was to measure the prevalence of erosion of the upper permanent incisors in US and UK samples of
11-13 year old children. METHODS: Convenience samples of 129 subjects were examined in the US and 125 in the
UK by two trained examiners. The palatal and buccal surfaces of the upper permanent incisors were assessed for
the presence of erosion. Subjects also completed a questionnaire investigating any association between the
presence of erosion and possible etiological factors. RESULTS: The prevalence of erosion was 41% in the US and
37% in the UK samples, this difference was not statistically significant. Similarly no statistically significant
difference was found between the sexes. The erosion present was confined to enamel in the vast majority of
subjects. The questionnaire did not detect any link between the presence of erosion and possible etiological
                                                RETURN to Titles
 Childhood asthma and dental erosion.
Shaw L; al-Dlaigan Y H; Smith A University of Birmingham Dental School, United Kingdom ASDC journal of
dentistry for children (2000), 67(2), 102-6, 82. Journal code: 0146172. Journal; Article; (JOURNAL ARTICLE)
The aim of this investigation was first to assess the prevalence of asthma in a random sample of fourteen-year-old
children in Birmingham UK. Secondly to assess the levels of dental erosion in these children, and thirdly to see
whether there was any correlation between children with asthma and the levels of dental erosion. A random
sample of 418 children from twelve secondary schools was examined, 209 were male and 209 female. The level of
tooth wear was recorded using a modification of the Tooth Wear Index of Smith and Knight. The prevalence of
asthma in this group was 15.8 percent (66 children out of 418); the levels of dental erosion in children with asthma
                                                  RETURN to Titles
Industrial dental erosion: a cross-sectional, comparative study.
Chikte U M; Josie-Perez A M Department of Community Dentistry, University of Stellenbosch, Tygerberg,
South Africa SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse
Tandheelkundige Vereniging (1999), 54(11), 531-6. Journal code: 9812497. ISSN:1029-4864. Journal;
Occupational exposure to sulphuric acid mist (H2SO4) is a health hazard. The threshold limit value-time weighted
average (TLV-TWA) of exposure to H2SO4 recommended by the American Conference of Governmental Industrial
Hygienists (ACGIH, 1994-1996) is 1 mg/m3. This single-blind study conducted in an electro-winning facility in South
Africa, compared dental erosion of anterior and premolar teeth of male workers exposed daily to H2SO4 in an
exposed group (H2SO4 range: 0.3 mg/m3-1 mg/m3) and an unexposed group (H2SO4 range: 0.1 mg/m3-0.3 mg/m3).
The exposed group comprised all workers at the facility exposed to the aforesaid range of H2SO4 (N = 103). A total
of 102 unexposed subjects similar in composition with respect to age and length of service were randomly selected
from the rest of the 700 workers at the facility. A questionnaire was administered to seek information on possible
worker habits associated with dental erosion and to determine perceptions of oral function. Clinical examinations
assessed prevalence and severity of dental erosion. The mean age of subjects was 31.4 years and mean length of
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The prevalence of dental erosion in the maxillary incisors of 14-year-old schoolchildren living in Tower
Williams D; Croucher R; Marcenes W; O'Farrell M Tower Hamlets Healthcare NHS Trust (Dental
Administration), St Leonard's Primary Care Centre, London, UK International dental journal (1999), 49(4), 211-
The purpose of this study was to assess the prevalence of dental erosion in the maxillary incisors of a sample of 14-
year-old schoolchildren and to explore the aetiological factors responsible for that erosion. The cross-sectionally
design study took place in secondary schools in inner-city London, UK and involved 525, 14-year-old
schoolchildren selected at random in a clinical examination and a self-completed questionnaire. The outcomes
measures for dental erosion were; the prevalence, the area and depth of lesions and the risk factors. The
prevalence of labial and palatal erosion was 16.9 per cent and 12 per cent respectively. Risk factors and behaviours
including daily frequency of ingestion of acidic fruits and drinks, food vomiting, toothbrushing frequency, and
swimming habits were not shown to have any relationship with the presence of erosion. It was concluded that the
prevalence of erosion in the maxillary incisors of this sample was higher labially and lower palatally than in
                                               RETURN to Titles
 A difference in perspective--the North American and European interpretations of tooth wear.
Bartlett D; Phillips K; Smith B Division of Conservative Dentistry, Guy's, King's and St Thomas' Dental Institute,
London, UK. david.bartlett@kcl.ac.uk The International journal of prosthodontics (1999), 12(5), 401-8.
Journal code: 8900938. ISSN:0893-2174. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
PURPOSE: There is considerable interest in the European dental research literature about the problem of tooth
wear and specifically about dental erosion, but this interest does not appear to be matched in North America based
on the volume of the literature there. The purpose of this article is to consider the possible explanations for this
difference. MATERIALS AND METHODS: This article examines the reasons for this disparity and attempts to
explain the difference by reviewing the North American and European literature on the etiology, pathogenesis, and
prevalence of tooth wear. RESULTS: It would appear from the literature that the reason for the difference in interest
between the 2 continents is a reflection of how the appearance, etiology, and terminology are interpreted and used
to define tooth wear, attrition, and erosion. CONCLUSION: Attrition is the wear of teeth against teeth; therefore, by
definition any worn surface that does not contact the opposing tooth must have another etiology. An appropriate
descriptive term is "tooth wear" when the etiology is multifactorial or cannot be determined. A search of the
                                              RETURN to Titles
 Prevalence of dental erosion caused by sulfuric acid fumes in a smelter in Japan
Fukayo S; Nonaka K; Shinozaki T; Motohashi M; Yano T Department of Hygiene and Public Health, Teikyo
University School of Medicine, Tokyo, Japan Sangyo eiseigaku zasshi = Journal of occupational health (1999),
41(4), 88-94. Journal code: 9507473. ISSN:1341-0725. (ENGLISH ABSTRACT); Journal; Article; (JOURNAL
The effect of occupational sulfuric acid exposure and other factors on teeth was explored in a cross-sectional study
with blind dental examinations. Among 350 male workers in a copper-smelter in Japan, 28 had mild dental erosion
with silky-glazed opaque appearance of the enamel and/or shallow concavities on the enamel. While opaqueness
was observed in 20 and concavities found in 11 workers, only 3 had both signs, suggesting that the concave
lesions were often accompanied with enough remineralization to keep the dental surface gloss, possibly due to
acid exposure at a low level. The cases had a history of working in an electrolytic refining plant (36%), significantly
more than in the non-cases (14%, p < 0.05). Some significant differences were found between the cases and the
non-cases: the cases were older, had less dental plaque, less gingivitis, and more frequent toothbrushing habits.
No significant differences were observed in possibly related dietary habits such as several types of acidic drinks. It
was concluded that the present cases with dental erosion were most probably associated with occupational acid
                                            RETURN to Titles
 Dental erosion--the problem and some practical solutions.
Shaw L; Smith A J University of Birmingham School of Dentistry, St Chads Queensway British dental journal
(1999), 186(3), 115-8. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL ARTICLE)
There has been a clinical impression among dental practitioners, particularly those working with children, that the
problem of dental erosion is increasing. Is this really the case or are we more aware of the problem? What is
causing this increase, if it really exists? Perhaps more importantly, what can we do about it?
This article looks at the prevalence, and aetiology of dental erosion, particularly in children, and makes some
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Tooth wear in children: an investigation of etiological factors in children with cerebral palsy and
Shaw L; Weatherill S; Smith A Department of Paediatric Dentistry, University of Birmingham Dental School,
United Kingdom ASDC journal of dentistry for children (1998), 65(6), 484-6, 439. Journal code: 0146172.
This investigation was undertaken to establish the prevalence and distribution of tooth wear in different groups of
medically compromised children and to assess the possible influence of gastroesophageal reflux, dietary factors,
and parafunctional activity. Four groups of children including twenty-one with cerebral palsy were clinically
examined and had in-depth, structured interviews, including information on medical history, medication,
gastroesophageal reflux, feeding and drinking habits, parafunctional activity, and tooth-brushing procedures. All
the children with cerebral palsy also had twenty-four-hour gastroesophageal pH monitoring. Of the fifty-one
children in total, twenty-five had moderate or severe levels of dental erosion. No statistically significant differences
were found between the groups as far as dietary influences, feeding habits, and tooth-brushing procedures. There
was a significant association, however, between gastroesophageal reflux and erosion.
                                             RETURN to Titles
 Dental erosions in subjects living on a raw food diet.
Ganss C; Schlechtriemen M; Klimek J Department of Operative and Preventive Dentistry, Dental Clinic, Justus
Liebig University, Giessen, Germany. Carolina.Ganss@dentist.med.uni-giessen.de Caries research (1999),
33(1), 74-80. Journal code: 0103374. ISSN:0008-6568. (COMPARATIVE STUDY); Journal; Article;
The aim of the study was to investigate the frequency and severity of dental erosions and its association with
nutritional and oral hygiene factors in subjects living on a raw food diet. As part of a larger dietary study 130
subjects whose ingestion of raw food was more than 95% of the total food intake were examined. The median
duration of the diet was 39 (minimum 17, maximum 418) months. Before the clinical examination, the participants
answered questionnaires and recorded their food intake during a 7-day period. Dental erosions were registered
using study models. As a control 76 sex- and age-matched patients from our clinic were randomly selected. The
raw food diet records showed the median daily frequency of ingesting citrus fruit to be 4.8 (minimum 0.5, maximum
16.1). The median intake of fruit was 62% (minimum 25%, maximum 96%) of the total, corresponding to an average
consumption of 9.5 kg of fruit (minimum 1.5, maximum 23.7) per week. Compared to the control group subjects
living on a raw food diet had significantly (p</=0.001) more dental erosions. Only 2.3% of the raw food group (13.2%
                                               RETURN to Titles
 Gastroesophageal reflux in children and its relationship to erosion of primary and permanent teeth.
O'Sullivan E A; Curzon M E; Roberts G J; Milla P J; Stringer M D Department of Paediatric Dentistry, Leeds
Dental Institute, UK. deneao@leeds.ac.uk European journal of oral sciences (1998), 106(3), 765-9. Journal
code: 9504563. ISSN:0909-8836. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE);
Gastroesophageal reflux (GOR) is often a self-limiting condition but nevertheless is a common cause of morbidity
in childhood. Studies of adult patients with hiatus hernias and GOR have suggested that there is an increased
incidence of dental erosion in these individuals. The aim of this study was to investigate the relationship between
dental erosion and GOR in children. Fifty-three children aged 2 to 16 yr (mean 4.9 yr) with moderate to severe GOR,
defined by pH monitoring, were examined for dental erosion. A questionnaire investigating dietary habits, other
relevant medical conditions, and erosion risk factors was also completed. Results showed that the prevalence of
dental erosion was low, when compared with the UK National Survey, with only 9 (17%) children showing any signs
of erosion, and of these only one had erosion involving dentine. These results suggest that dental erosion may not
                                             RETURN to Titles
 Assessment and treatment of bulimia nervosa.
Mcgilley B M; Pryor T L University of Kanasas School of Medicine, Wichita American family physician (1998),
57(11), 2743-50. Journal code: 1272646. ISSN:0002-838X. Journal; Article; (JOURNAL ARTICLE);
Bulimia nervosa is characterized by binge eating and inappropriate compensatory behaviors, such as vomiting,
fasting, excessive exercise and the misuse of diuretics, laxatives or enemas. Although the etiology of this disorder
is unknown, genetic and neurochemical factors have been implicated. Bulimia nervosa is 10 times more common
in females than in males and affects up to 3 percent of young women. The condition usually becomes symptomatic
between the ages of 13 and 20 years, and it has a chronic, sometimes episodic course. The long-term outcome has
not been clarified. Other psychiatric conditions, including substance abuse, are frequently associated with bulimia
nervosa and may compromise its diagnosis and treatment. Serious medical complications of bulimia nervosa are
uncommon, but patients may suffer from dental erosion, swollen salivary glands, oral and hand trauma,
gastrointestinal irritation and electrolyte imbalances (especially of potassium, calcium, sodium and hydrogen
                                              RETURN to Titles
 A rapid epidemiological assessment of dental erosion to assist in settling an industrial dispute.
Chikte U M; Josie-Perez A M; Cohen T L Department of Community Dentistry, Faculty of Dentistry, University
of Stellenbosch, Tygerberg, South Africa The Journal of the Dental Association of South Africa = Die Tydskrif
van die Tandheelkundige Vereniging van Suid-Afrika (1998), 53(1), 7-12. Journal code: 7505600. ISSN:0011-
A rapid epidemiological assessment (REA) of industrial dental erosion was undertaken with the aim of formulating
a range of treatment strategies which could be used to settle an industrial dispute. This dispute concerned
compensation for a group of adult male metalworkers who had complained of dental sensitivity and that their teeth
had been "eaten by acid" at their workplace, an electroplating factory in Springs near Johannesburg, South Africa.
The REA methods employed included a clinical examination, a structured socio-demographic questionnaire and
colour photographs of each subject. Sixty per cent of the subjects reported pain and/or sensitivity to eating and/or
drinking, 76 per cent showed varying degrees of loss of tooth structure, and 25 per cent reported teeth had been
lost as a result of the industrial erosion. The project involved negotiating with mine management and trade union
representatives, each with conflicting interests, and with people's oral health and large sums of money at stake. In
this context, the aim of the research was to design an instrument to resolve conflict and to promote oral health at
                                                 RETURN to Titles
 Erosion caused by gastroesophageal reflux: diagnostic considerations.
Gregory-Head B; Curtis D A Department of Graduate Prosthodontics, University of California, San Francisco,
USA Journal of prosthodontics : official journal of the American College of Prosthodontists (1997), 6(4), 278-
85. Journal code: 9301275. ISSN:1059-941X. (CASE REPORTS); Journal; Article; (JOURNAL ARTICLE);
Dental erosion occurs with a high prevalence in the general population, but its impact on prosthodontic care is
often unrecognized. The etiology of dental erosion is difficult to establish because it may result from a variety of
causes and may have different presentations. Our purpose was to review the literature relevant to dental erosion
and to report a patient presentation in which an unusual pattern of severe erosion was the dental manifestation of
asymptomatic gastroesophageal reflux disease. RETURN to Titles
 Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system
for assessing erosive anterior tooth wear.
Johansson A K; Johansson A; Birkhed D; Omar R; Baghdadi S; Carlsson G E Department of Cariology,
Faculty of Odontology, Goteborg University, Sweden Acta odontologica Scandinavica (1996), 54(6), 369-78.
Journal code: 0370344. ISSN:0001-6357. Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT,
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
                                             RETURN to Titles
 Determinants of oral health in a group of Danish alcoholics.
 Hede B Department for Community Dentistry, Faculty of Health Sciences, University of Copenhagen,
Denmark European journal of oral sciences (1996), 104(4 ( Pt 1)), 403-8. Journal code: 9504563. ISSN:0909-
8836. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE); (RESEARCH SUPPORT, NON-U.S.
The purposes of this survey were to describe dental health in a group of alcoholics and to analyze the influence of
social background, dental health behavior and alcohol-related variables on dental health among alcoholics. The
dental health in a group of consecutively admitted alcoholics (n = 195) was described with respect to number of
teeth present, DMFS, DS and the prevalence of dental erosion, removable dentures, edentulousness, and untreated
dental decay. No major differences were found with respect to number of teeth and dental caries (DMFS), when
compared to reference figures of the general population. As to untreated decay, however, 3-5 x more actual
decayed surfaces were found among the alcoholics. In the multivariate analyses, neither DMFS, nor untreated
decay were found to be associated with alcohol-related indicators. These variables were, however, related to
variables of social background and dental health behavior. As to number of teeth present, an association was
found with duration of alcoholism, but this relationship was eliminated, when the analysis was controlled with
                                              RETURN to Titles
 Dental erosion, summary.
ten Cate J M; Imfeld T Academic Centre for Dentistry Amsterdam. jm.ten.cate@acta.nl European journal of
oral sciences (1996), 104(2 ( Pt 2)), 241-4. Journal code: 9504563. ISSN:0909-8836. Journal; Article;
Although reports on dental erosion have always appeared in the dental literature, there is currently a growing
interest among researchers and clinicians. Potential risk factors for dental erosion are changed lifestyle and eating
patterns, with increased consumption of acidic foods and beverages. Various gastrointestinal and eating disorders
expose the dentition to frequent contacts with very acidic gastric content, which may lead to erosion. Whether
these factors indeed lead, on a population scale, to a higher prevalence and incidence of erosion is yet to be
established.
This article summarizes the different aspects of the prevalence, pathology, etiology, assessment, prevention and
                                                 RETURN to Titles
 Etiology of dental erosion--intrinsic factors.
 Scheutzel P Department of Prosthodontics, Centre for Dentistry, University of Munster, Germany European
journal of oral sciences (1996), 104(2 ( Pt 2)), 178-90. Journal code: 9504563. ISSN:0909-8836. Journal;
Dental erosion due to intrinsic factors is caused by gastric acid reaching the oral cavity and the teeth as a result of
vomiting or gastroesophageal reflux. Since clinical manifestation of dental erosion does not occur until gastric
acid has acted on the dental hard tissues regularly over a period of several years, dental erosion caused by intrinsic
factors has been observed only in those diseases which are associated with chronic vomiting or persistent
gastroesophageal reflux over a long period. Examples of such conditions include disorders of the upper alimentary
tract, specific metabolic and endocrine disorders, cases of medication side-effects and drug abuse, and certain
psychosomatic disorders, e.g. stress-induced psychosomatic vomiting, anorexia and bulimia nervosa or
rumination. Based on a review of the medical and dental literature, the main symptoms of all disorders which must
                                              RETURN to Titles
 Prevalence of dental erosion and the implications for oral health.
Nunn J H Dental School, University of Newcastle upon Tyne, U.K. j.h.nunn@ncl.ac.uk European journal of
oral sciences (1996), 104(2 ( Pt 2)), 156-61. Journal code: 9504563. ISSN:0909-8836. Journal; Article;
The literature on dental erosion is made up of a number of areas, some of which are reviewed here: there are
anecdotal case reports, linking a small number of clinical cases with a possible etiological factor. The second area
of evidence concentrates on case control studies in which there is a strong association with dental erosion, for
example, patients with bulimia. The final piece of epidemiological evidence is beginning to emerge as prevalence
studies, but the information from prevalence data worldwide is scanty. It is difficult to compare prevalence studies
because of the different indices used in the various studies and also because of the different teeth assessed in the
sample. Standardization of indices used would overcome some of these differences as would the reporting of
results in a comparable way. However, identifying the true prevalence of erosion per se is fraught with difficulty
because there may be more than one etiological factor operating and attrition and or abrasion may complicate the
picture, especially in older populations. Case reports frequently associate evidence of erosion with excessive use
                                                 RETURN to Titles
 Tooth wear--dental erosion.
Nunn J; Shaw L; Smith A Department of Child Dental Health, Dental School, Newcastle-upon-Tyne British
dental journal (1996), 180(9), 349-52. Journal code: 7513219. ISSN:0007-0610. Journal; Article; (JOURNAL
This article aims to address the issues arising out of the increasing concern by general dental practitioners of
erosion-related tooth wear. The prevalence, common presentation, differential diagnosis, likely aetiology,
prevention and management of suspected cases of this form of tooth wear are considered.
                                              RETURN to Titles
 The 1993 national survey of children's dental health.
Comment in: Br Dent J. 1995 Aug 19;179(4):124. PubMed ID: 7546953 Comment in: Br Dent J. 1995 Sep
9;179(5):160. PubMed ID: 7546965 Comment in: Br Dent J. 1996 Jun 8;180(11):406. PubMed ID: 8762795
Downer M C Department of Dental Health Policy, Eastman Dental Institute for Oral Health Care Sciences,
London British dental journal (1995), 178(11), 407-12. Journal code: 7513219. ISSN:0007-0610. Journal;
The 1993 national survey report shows encouraging evidence of general improvements in children's dental health
compared with earlier surveys in 1973 and 1983. There have been dramatic declines in dental caries at all ages and
this is evident in the different parts of the United Kingdom and in all social classes. However, among 5-year-old
children average caries levels have remained unchanged since 1983, although a higher proportion now have no
known decay experience. The amount of decay treated by restoration as a proportion of total caries experience has
fallen in all age groups and the disease appears to be becoming concentrated at higher levels in a diminishing
number of children who are not obtaining dental care. A disturbing finding was the high prevalence of dental
erosion, particularly in the primary dentition. Other findings included more than half of children in Scotland and
Northern Ireland having fissure sealants, improved parental knowledge about preventing dental disease, reduced
numbers of orthodontic extractions and a reduction of one-third in the rate of traumatised permanent incisors.
                                              RETURN to Titles
 The distribution of erosion in the dentitions of patients with eating disorders.
Comment in: Br Dent J. 1995 Jun 24;178(12):445. PubMed ID: 7605714 Comment in: Br Dent J. 1996 Mar
23;180(6):207. PubMed ID: 8996921 Robb N D; Smith B G; Geidrys-Leeper E Department of Restorative
Dentistry, Dental School, Newcastle upon Tyne British dental journal (1995), 178(5), 171-5. Journal code:
7513219. ISSN:0007-0610. Journal; Article; (JOURNAL ARTICLE); (MULTICENTER STUDY); (RESEARCH
Anorexia and bulimia nervosa (the eating disorders) are potentially life threatening and are becoming more
prevalent. This paper reviews the effects of these disorders on dental erosion and reports a study to assess the
effects of the eating disorders on the erosion of teeth relating the severity of erosion to factors such as the
frequency of self-induced vomiting (SIV). One hundred and twenty-two eating disorder patients and an equal
number of age, sex, and social class matched controls were studied. The study population was divided into
subgroups according to the eating disorder. All the subgroups had significantly more abnormal toothwear than the
controls (P < 0.005), with the differences being most marked in the SIV groups.
                                                  RETURN to Titles
 Dental erosion in four-year-old children from differing socioeconomic backgrounds
Millward A; Shaw L; Smith A University of Birmingham School of Dentistry, England ASDC journal of dentistry
for children (1994), 61(4), 263-6. Journal code: 0146172. Journal; Article; (JOURNAL ARTICLE) written in
Although there is very little epidemiological evidence on the prevalence and severity of erosion in children and
adults, there have been recent case reports suggesting that the problem of erosion is increasing. This study
describes the use of a simple reproducible erosion index. A total of 178 four-year-old children were assessed;
almost half of these children showed signs of erosion. The most common site affected was the palatal surface of
the upper incisors with 17 percent of the children examined showing visible dentine for greater than one third of the
tooth surface. When considering the influence of socioeconomic group on the prevalence of erosion, four out of
five children examined in the low socioeconomic group showed low levels of erosion, while a much greater
                                            RETURN to Titles
Nutrition, diet and dental public health.
Rugg-Gunn A J Department of Child Dental Health, Dental School, University of Newcastle upon Tyne, UK
Community dental health (1993), 10 Suppl 2 47-56. Journal code: 8411261. ISSN:0265-539X. Journal;
Nutrition and diet can affect teeth in three ways: by affecting the structure of teeth (and thus appearance), by
causing dental caries and by eroding teeth. The importance of dietary sugars in causing dental caries is clearly
established and a reduction in consumption of non-milk extrinsic sugars recommended by government. The Health
Education Authority has played a major role in promoting this aspect of dietary advice. The structure of teeth is
influenced by nutrition; much of the evidence for this being published by Mellanby and colleagues in this country.
Interest in this topic has increased recently and it seems probable that malnutrition enhances susceptibility to
dental caries, and possible that it increases susceptibility to enamel defects especially in areas with moderate to
high levels of fluoride ingestion. The prevalence and severity of dental erosion is likely to be increasing in Britain.
                                             RETURN to Titles
 Dental erosion in a population of Swiss adults.
Lussi A; Schaffner M; Hotz P; Suter P University of Berne, School of Dental Medicine, Department of Operative
and Preventive Dentistry, Switzerland Community dentistry and oral epidemiology (1991), 19(5), 286-90.
Journal code: 0410263. ISSN:0301-5661. (COMPARATIVE STUDY); Journal; Article; (JOURNAL ARTICLE)
The purpose of this study was to determine the prevalence of dental erosion in an adult population in Switzerland.
391 randomly selected persons from two age groups (26-30 and 46-50 yr) were examined for frequency and severity
of erosion on all tooth surfaces. Information was gathered by interview about lifestyle, dietary and oral health
habits. For facial surfaces 7.7% of the younger age group and 13.2% of the older age group showed at least one
tooth affected with erosion with involvement of dentin (grade 2). 3.5 teeth per person in the younger and 2.8 teeth
per person in the older age group were affected. Occlusally, at least one severe erosion was observed in 29.9% of
the younger and 42.6% of the older sample with 3.2 and 3.9 erosion-affected teeth per person, respectively. 3.6% of
the younger age group and 6.1% of the older age group showed slight lingual erosion on the maxillary anterior
                                          RETURN to Titles
Oral conditions among German battery factory workers.
Petersen P E; Gormsen C Institute for Community Dentistry and Graduate Studies, Royal Dental College,
Copenhagen, Denmark Community dentistry and oral epidemiology (1991), 19(2), 104-6. Journal code:
The purpose of the study was to evaluate the oral health situation of workers in a modern battery factory; in
particular, to describe the prevalence and the severity of dental erosion and attrition in relation to exposure of
airborne acids in the work environment. Measurements of the work environment at a German battery factory
showed that the workers were exposed to sulfuric acids (0.4-4.1 mg/cm3). All workers at the factory were included
in the survey and a total of 61 dentate individuals completed a questionnaire on their work environment, dental
health, and symptoms from the mouth, nose, and throat. Information on oral health status, erosion, and attrition
was collected by clinical examinations. Nearly all workers reported exposure to etching substances in their work
environment: 56% complained of sharp and thin teeth and 29% of short teeth. Poor dental health conditions were
observed (e.g. mean D-T = 3.8); the mean number of teeth with crown restoration was 5.3. The prevalence of
erosion was 31% and 92% were affected by attrition. Erosion was found only in front teeth while attrition also
                                             RETURN to Titles
 Risk factors in dental erosion.
Jarvinen V K; Rytomaa I I; Heinonen O P Department of Cariology, University of Helsinki, Finland Journal of
dental research (1991), 70(6), 942-7. Journal code: 0354343. ISSN:0022-0345. Journal; Article; (JOURNAL
Dental erosion and factors affecting the risk of its occurrence were investigated with a case-control approach. One
hundred and six cases with erosion and 100 randomly selected controls from the same source population were
involved in the study. All cases and controls were evaluated by the recording of structured medical and dietary
histories and by examination of the teeth and saliva. Erosion was classified according to pre-determined criteria.
The relative importance of associations between factors and erosion was analyzed by a logistic multivariable
model. Adjusted odds ratios (AOR) were estimated. There was considerable risk of erosion when citrus fruits were
eaten more than twice a day (AOR 37), soft drinks were drunk daily (AOR 4), apple vinegar was ingested weekly
(AOR 10), or sport drinks were drunk weekly (AOR 4). The risk of erosion was also high in individuals who vomited
                                                   RETURN to Titles
 Prevalence of pathological tooth wear in patients with chronic alcoholism.
Robb N D; Smith B G Dental School, Framlington Place, Newcastle upon Tyne British dental journal (1990),
169(11), 367-9. Journal code: 7513219. ISSN:0007-0610. (COMPARATIVE STUDY); Journal; Article;
Although chronic alcoholism is a very common condition, with potentially harmful consequences for the sufferer,
there has been little emphasis in the literature on its effects on the teeth. This study of 37 alcoholic patients
showed that their teeth had significantly more wear than age and sex matched controls. The tooth wear was most
marked in males, and those whose alcohol consumption was continuous rather than in the form of episodic binges.
 The wear appeared to be erosive in nature, and in 40% of the sample it affected the palatal surfaces of the upper
anterior teeth.
                                             RETURN to Titles
 Pilot study on dental erosion in a Norwegian electrolytic zinc factory.
Skogedal O; Silness J; Tangerud T; Laegreid O; Gilhuus-Moe O Community dentistry and oral epidemiology
(1977), 5(5), 248-51. Journal code: 0410263. ISSN:0301-5661. Journal; Article; (JOURNAL ARTICLE)
In 12 workers in a Norwegian factory using electrolytic methods to extract zinc, a relationship was found to exist
between degree of erosion, number of teeth affected and the length of service. The prevalence of caries, abrasion
and attrition was not higher than in comparable population groups.
The correlation between diagnosis of erosion based on clinical examination, and diagnosis based on evaluation of




                                          RETURN to Titles
Dental erosion – changing prevalence? A review of British national childrens’ surveys
J. H. NUNN 1 , P. H. GORDON 2 , A. J. MORRIS 3 , C. M. PINE 4 & A. WALKER 5 1 Public and Child Dental
Health, School of Dental Science, Trinity College, Dublin, Ireland, 2 Department of Child Dental Health, Dental
School, Newcastle upon Tyne, 3 Dental Public Health, Dental School, Birmingham, 4 Department of Clinical
Dental Sciences, University of Liverpool, Liverpool, 5 Social Survey Division, Office for National Statistics,
London, UK International Journal of Paediatric Dentistry 2003; 13: 98–105
Objectives. To investigate the change in the prevalence of dental erosion, over time, by a review of the
data from the published national dental surveys of young people in the UK. A subsidiary objective was
to investigate the relationship between erosion and possible associated risk factors. Design. The review
was based on cross-sectional prevalence studies incorporating a clinical dental examination and
structured interviews. Sample. The data were collated from the 1993 UK childrens’ dental health survey
and the dental report of the two National Diet and Nutrition Surveys (NDNS) of children aged 1 1 / 2 - 4 1
/ 2 in 1992/3 and 4–18 years in 1996/7. The criteria used for data collection were comparable between the
three different studies. Results: Comparing the data from the different studies, the prevalence of
erosion was seen to increase from the time of the childrens’ dental health survey in 1993 and the NDNS
study of 4–18-year-olds in 1996/7. There was a trend towards a higher prevalence of erosion in children
aged between 3 1 / 2 and 4 1 / 2 and in those who consumed carbonated drinks on most days compared
with toddlers consuming these drinks less often.
Drinks overnight were associated with an increased prevalence of erosion. More 4–6-year-olds with
reported symptoms of gastro-oesophageal reflux had erosion
compared with symptom- free children. On multivariate analysis, the strongest independent association
                                             RETURN to Titles
Dental Erosion and Aspirin Headache Powders: A Clinical Report
Michael McCracken, DDS, PhD,1 and Sandra Jean O’Neal, DMD2 J Prosthod 2000;9:95-98.
The causes of tooth erosion are varied, but all are associated with a chemical attack on the teeth and
resulting loss of tooth structure. Etiologic factors related to erosion cited in the literature include
bulimia, eating acidic foods, soft drink consumption, acid reflux, and swimming, among others. This
clinical report suggests that chronic use of headache powders can also be a factor leading to tooth
                                                RETURN to Titles
Dental erosion and soft drinks: a qualitative assessment of knowledge, attitude and behaviour using
focus groups WATERHOUSE Department of Child Dental Health, The Dental School, University of Newcastle
J. MAY & P. J. of schoolchildren. A preliminary study
upon Tyne, Newcastle, UK International Journal of Paediatric Dentistry 2003; 13: 425–433
Objectives. This qualitative study was designed to record the perception by Newcastle children of the
influences on their choice of drinks and their knowledge of the dental health problems caused by acidic
drinks. Methods. Four focus groups, each involving 8 Newcastle schoolchildren (4 boys and 4 girls)
formed the basis of the study. Two age groups, 13–14-year-olds and 8–9-yearolds, and two socio-
economic groups were investigated, using state schools in Newcastle upon Tyne. A moderator guided
the children to discuss their choice of drink and its dental effects amongst themselves. Results. In total,
32 children participated in the focus groups and the results suggested that 8–9-year-olds preferred still,
fruit-flavoured drinks whilst 13–14-year-olds preferred carbonated drinks. Taste was the most important
influence on drink choice in all age groups. Parents and friends were more influential in younger
children, whilst cost, availability and thirst were more important to older children. Younger children did
not believe advertisements whilst older children thought they might work if seen enough times. Dental
                                                RETURN to Titles
Dental erosion Clinical diagnosis and case history taking
Adrian Lussi Department of Operative, Preventive and Pediatric Dentistry, University of Bern, School of Dental
Medicine, Bern, Switzerland, Eur. J Ord Sci 1996; 10.1: 191-198
Dental erosion is not a very rare condition. Early correct diagnosis of this damage of dental hard tissue
consequently is of clinical importance. The aim of this paper is to present an easy-to-learn rating
scheme for the assessment of the severity of dental erosive lesions with high inter- and intra-examiner
agreement. It differentiates between facial, occlusal and oral surfaces of a tooth and has already been
used successfully in epidemiological studies. Further, anamnestic risk factors are discussed with
                                              RETURN to erosion. Guidelines are given for the clinician on
respect to their relevance for the development of dental Titles
Dental erosion in schoolchildren and socioeconomics
Dental erosion in a group of British 14-year-old, school children. Part I: Prevalence and influence of differing
socioeconomic backgrounds. by Y. H. Al-Dlaigan, L. Shaw and A. Smith, Br Dent J 2001; 190: 145-149
The aims of the study were to establish the prevalence of erosion in a cluster random sample of 14-year-
olds in Birmingham, UK and to determine whether socioeconomic group influences the prevalence of
erosion. • 418 children were examined from 12 different schools; 209 were male and 209 female. The
level of tooth wear was recorded using a modification of the (TWI) index of Smith and Knight (1984). The
ACORN classification was used to assess the socioeconomic status of all children. • 48% of the children
had low erosion, 51% had moderate erosion and only 1% had severe erosion. Statistically significant
differences were seen between males and females; more males had erosion than females. Significantly
more erosion was observed in teenagers in the lowest socioeconomic categories. • Moderate levels of
                                            RETURN to Titles
Effects of toothbrushing on eroded dentine
Carolina Ganss1, Nadine Schlueter1, Martin Hardt2, Judith von Hinckeldey2, Joachim Klimek1 1Department of
Conservative, Preventive Dentistry, Dental Clinic, and 2Central Biotechnology Unit, Electron Microscopy
It is an established assumption that erodedGermany, EurtissuesSci 2007; 115: 390–396 to toothbrush
Laboratory, Justus-Liebig-University Giessen, dental hard J Oral are particularly prone
abrasion. Only a few studies have aimed to show this for dentine and, if so, disregarded the complex
histological structure of this tissue. Therefore, the present study sought (i) to investigate the effects of
toothbrushing on eroded dentine and (ii) to analyze how the organic matrix influences the outcome of
established methods for quantifying dental hard tissue loss. The effects of brushing were investigated
by optical (P-O) and mechanical (P-M) profilometry, by longitudinal microradiography (LMR), and by
scanning electron microscopy (SEM). The SEM images showed that a demineralized organic layer had
developed, which was unaffected by brushing. For substance loss, there was no significant difference
between eroded and eroded/abraded samples. Considerable differences occurred, however, when
results from the different methods were compared. P-O yielded the lowest (7.0 ± 3.4 lm) and LMR the
highest (109.8 ± 10.7 lm) substance loss values. When the organic material was removed enzymatically,
all methods gave comparable results. The results of this study do not lend support to the notion that
brushing increases substance loss of eroded dentine.
                                               mineral to Titles
Profilometry was not suitable for measuringRETURNloss, unless the organic material was removed.
Enamel Erosion by Some Soft Drinks and Orange Juices Relative to Their pH, Buffering Effect and
M.J. Larsen B. Nyvad Department of Operative Dentistry and Endodontics, Royal Dental College, Faculty of
Health Sciences, Aarhus C, Denmark, Caries Res 1999;33:81–87
The capability of a soft drink or a juice to erode dental enamel depends not only on the pH of the drink,
but also on its buffering effect. As the latter is the ability of the drink to resist a change of pH it may add
to the effects of the actual pH. The aim of the present study was to compare the pH and the buffering
effect of various soft drinks with their erosive effects and the solubility of apatite. In 18 soft drinks,
mineral waters and juices available on the Danish market, pH and the concentrations of calcium,
phosphate and fluoride were determined. The buffering effect was determined by titration with NaOH.
Human teeth (n = 54) covered with nail varnish except for 3E4-mm windows were exposed to 1.5 liters of
the drink for either 7 days or 24 h under constant agitation. The depth of the erosions was assessed in
longitudinal sections. The depth was found to vary greatly from 3 mm eroded by the most acidic drinks
and fresh orange juice to only slightly affected surfaces by most of the mineral waters. The dissolution
                                                RETURN to Titles
Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England.
Part 2: The association of diet and habits
A. Milosevic,1 P. F. Bardsley2 and S. Taylor3,1*Honorary Senior Lecturer and Consultant in Restorative
Dentistry, Dept of Restorative Dentistry, Liverpool University Dental Hospital 3Research Associate, Centre for
Medical range of foods and drinks wereUniversity of Liverpool,2Consultant, Dept. of Restorative Dentistry, of
● Wide Statistics and Health Evaluation, associated with tooth wear & dental erosion but the strengths
association (Odds Ratios) were generally low.
● Dentists should question patients, even teenagers, with dental erosion about heart burn, reflux and
any positive family history of reflux disease.
                                              RETURN to thus
● Teenagers know little about acids and dental erosion, Titlesdentists need to educate parents and
Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England.
Part 1: The relationship with water fluoridation and social deprivation
P. F. Bardsley,1 S. Taylor2 and A. Milosevic3 1Consultant, Dept. of Restorative Dentistry, Birmingham Dental
Hospital, 2Research associate, Centre for Medical Statistics and Health Evaluation, University of Liverpool,
3*Honorary Senior Lecturer and Consultant in Restorative Dentistry, Dept of Restorative Dentistry, Liverpool
University Dental Hospital *Correspondence to: A. Milosevic, Dept of Restorative Dentistry, Liverpool University
● This is the first study to show that water fluoridation protects from dental erosion/toothwear in 14-year-
old children.
● The benefits of water fluoridation as a public health measure is strengthened.
● This particular study shows that dental erosion/toothwear is a ‘disorder of affluence’.
                                               RETURN to Titles
Erosion of deciduous and permanent dental hard tissue in the oral environment
M.L. Huntera,*, N.X. Westb, J.A. Hughesb, R.G. Newcombec, M. Addyb aDental Health and Development,
University of Wales College of Medicine Dental School, Heath Park, Cardiff CF4 4XN, UK bRestorative
Dentistry, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY, UK cMedical Computing
and Statistics, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, UK, Journal of Dentistry
Objectives: The objectives of this study were two-fold: (1) to determine (by surfometry) loss of
deciduous and permanent enamel and dentine following consumption of a single low pH orange drink
for 15 days; and (2) to determine (by surfometry) loss of deciduous and permanent enamel and dentine
following consumption of the product 2 versus 4 times per day for 15 days.
Methods: Sixteen healthy volunteers participated in a single centre, single blind, 2-phase crossover
study, conducted according to Good Clinical Practice, and employing the validated model described by
West and co-workers (Journal of Dentistry 1998; 26:329–335).
Results: In all tissues, erosion was progressive over time, the pattern being more linear in enamel than
in dentine. In general, erosion of deciduous enamel was greater than that of permanent enamel, though
this difference was significant only for those specimens exposed to 4 drinks per day. Conversely,
erosion of dentine was generally greater in the permanent tissue, though differences rarely reached
conventional levels of statistical significance. Increasing frequency of consumption resulted in
increased loss of tissue, but this difference was neither proportional nor consistently statistically
                                                 RETURN to Titles
Evaluation of a profilometrical method for monitoring erosive tooth wear
Schlueter N, Ganss C, De Sanctis S, Klimek J. Evaluation of a profilometrical method for monitoring erosive
tooth wear. Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig- University
Giessen, Germany Eur Jof erosive wear is difficult because lesions mostly progress relatively slowly and
The in vivo monitoring Oral Sci 2005; 113: 505–511.
reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of
erosive loss have been described, which either require extensive equipment or do not provide sufficient
sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a
procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable
observation periods. The method is the profilometric measurement of erosive tissue loss using acid-
resistant markers, which represent both a reference area and a structure for the defined retracing of a
given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the
precision was < 4 lm, and the repeatability was good (95% limits of repeatability ranging from )4.7 to 5.2
                                               RETURN to Titles
Gastroesophageal Reflux Disease, Tooth Erosion, and Prosthodontic Rehabilitation: A Clinical Report
Ned B. Van Roekel, DDS, MSD, Consultant in Prosthodontics, Department of Dental Specialties, Assistant
Professor of Dentistry, Mayo Medical School, Rochester, MN, J Prosthodont 2003;12:255-259.
The in vivo monitoring of erosive wear is difficult because lesions mostly progress relatively slowly and
reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of
erosive loss have been described, which either require extensive equipment or do not provide sufficient
sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a
procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable
observation periods. The method is the profilometric measurement of erosive tissue loss using acid-
resistant markers, which represent both a reference area and a structure for the defined retracing of a
given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the
                                              RETURN to Titles
Impact of modified acidic soft drinks on enamel erosion
T Attin, K Weiss, K Becker, W Buchalla, A Wiegand, Department of Operative Dentistry, Preventive Dentistry
and Periodontology, Georg-August-University Go¨ttingen, Go¨ttingen, Germany, Oral Diseases (2005) 11, 7–12
OBJECTIVE: To evaluate the enamel erosive potential of modified acidic soft drinks under controlled
conditions in an artificial mouth.
MATERIALS AND METHODS: From each of 144 bovine incisors one enamel sample was prepared. Labial
surfaces of the samples were ground flat, polished and covered with adhesive tape, leaving an exposed
area. The samples were distributed among four (A–D) groups for treatment with A: Coca-Cola, B: Sprite;
C: Sprite light, D: orange juice. Either 1.0 mmol l)1 calcium (Ca) or a combination (comb.) of 0.5 mmol l)1
calcium plus 0.5 mmol l)1 phosphate plus 0.031 mmol l)1 fluoride was added to the beverages. Samples
of each group were subdivided into three subgroups (-original; -Ca and -comb.) for treatment with
original and modified drinks. De- and remineralization cycles were based on a standard protocol
described earlier. Surface loss of the specimens was determined using profilometry after test procedure.
RESULTS: In all subgroups, loss of enamel was observed. The enamel loss recorded for the samples
rinsed with original Sprite and original orange juice was significantly higher compared with all other
solutions (P ¼ 0.001). Lowest enamel loss was recorded for the original Coca-Cola
                                              RETURN to Titles
Influence of diet on dental erosion in 14-year-olds - Dental erosion in a group of British 14-year-old
Y. H. Al-Dlaigan, L. Shaw and A. Smith Br Dent J 2001; 190: 258-261
• The aims of the present study were first to investigate the dietary intake pattern of UK teenagers and
secondly to determine the relationship, if any, between dental erosion and dietary intake in these
children. • Data on the rate and frequency of consumption of drinks, foods, and fruits were obtained
from a self-reported questionnaire supplemented by a structured interview to 418 children (209 male, 209
female). • Over 80% of the teenagers regularly consumed soft drinks, but approximately half of these
children had a relatively low weekly consumption. Almost a quarter of these 14-year-olds had alcoholic
                                               RETURN to Titles
Is there a relationship between asthma and dental erosion? A case control study
Y. H. AL-DLAIGAN1, L. SHAW1 & A. J. SMITH2 1Unit of Paediatric Dentistry and 2Unit of Oral Biology, The
University of Birmingham, Dental School, Birmingham, UK, International Journal of Paediatric Dentistry 2002; 12:
Objectives. The aims of this study were firstly to assess and compare the prevalence of dental erosion
and dietary intake between three groups of children; children with asthma, those with significant tooth
erosion but with no history of asthma, and children with no history of asthma or other medical problems.
Secondly, to discover whether there was a relationship between medical history and dietary practises of
these children and the levels of dental erosion. Thirdly, to measure and compare their salivary flow
rates, pH and buffering capacity.
Methods. The study consisted of 3 groups of children aged 11–18 years attending Birmingham Dental
Hospital: 20 children with asthma requiring long-term medication, 20 children referred with dental
erosion, and 20 children in the age and sex matched control group. Tooth wear was recorded using a
modification of the tooth wear index (TWI) of Smith and Knight. Data on the medical and dietary history
were obtained from a self-reported questionnaire supplemented by a structured interview. The salivary
samples were collected under standard methods for measurements.
Results. Fifty percent of the children in the control group had low erosion and 50% moderate erosion.
However, high levels were recorded in 35% of children in the asthma group and 65% in the erosion
group. There appeared to be no overall differences in diet between the groups. There was
an association between dental erosion and the consumption of soft drinks, carbonated beverages and
                                               RETURN to Titles
Lessening dental erosive potential by product modification
Grenby TH, Department of Oral Medicine & Pathology, U M D S, Guy's Hospital, London SEI 9RT, UK, Eur J
Oral Sci 1996; 104: 221-228
Current interest in dental erosion has led to increasing attention to ways in which potentially erosive
products might be modified. Information on how this could be achieved has been hard to gather, and
has focused chiefly on possibilities in reformulating soft drinks. The bulk of the work published on this
relates to calcium and phosphate supplementation, ranging from early experimentation on saturation of
a demineralising medium with tri-calcium phosphate, through tests of more soluble phosphates and
other calcium salts providing various levels of Ca2+ and PO4", to a calcium citrate malate additive
specially formulated to curb erosion by soft drinks. Opinions on the effectiveness of citrate, the
practicability of reducing the acidity levels of soft drinks, and the possible applications of fluoride,
bicarbonates and certain constituents of milk products are also included. Finally, an attempt has been
                                               RETURN to Titles
Methods of assessing erosion and erosive potential
Crenb!. TH, Department of Oral Medicine & Pathology, United Medical & Dental Schools, Guv’s Hospital, London
Methods UK, Eur J vitro are reviewed first, classified under the examination of extracted teeth, chemical
SE1 9RT, for use in Orul Sci 1996; 104: 207-214.
and physical methods, digital image analysis, scanning electron microscopy and other potentially useful
techniques. Methods for recording erosion in laboratory animals are dealt with next, including
techniques that can also be used in vitro, Restarski’s system and various modifications of it, and digital
image analysis. Thirdly the main systems and indices that have been designed for clinical use are
arranged under case histories and clinical examination. scales of severity and indices of diagnosis of
                                                RETURN to Titles
Oral pH and drinking habit during ingestion of a carbonated drink in a group of adolescents with dental
R. Moazzez, B.G.N. Smith, D.W. Bartlett* Division of Conservative Dentistry, Guy’s, King’s and St Thomas’
School of Dentistry, King’s College, London SE1 9RT, UK, Journal of Dentistry 28 (2000) 395–397
Objectives: To investigate the relationship between dental erosion, oral pH and drinking habit in a group
of adolescents. Methods: Oral pH was measured simultaneously at the surface of four teeth in 11
patients, aged 10–16 years, with erosion and in 10 controls subjects without erosion using antimony
electrodes. Measurements were made before, during and after drinking 330 ml of a carbonated drink.
The method and timing of drinking the beverage, reported dietary intake of acidic foods and flow rate
and buffering capacity of saliva were recorded. Results: The erosion patients reported drinking more
carbonated drinks .p , 0:01. and drinking directly from a can more frequently than the controls .p , 0:05.:
They also drank twice as quickly .p , 0:05.: The pH at the buccal surface of a molar remained lower for
longer in the erosion patients than in the patients without erosion .p , 0:01.; whilst the labial surface of
                                                RETURN to Titles
Pathogenesis and modifying factors of dental erosion
Meurrnan JH, ten Care JM, 'Faculty of Dentistry, University of Kuopio. P0.B. 1627, FIN-7021 1 Kuopio, Finland:
'Academic Centre for Dentistry Amsterdam, Louwesweg 1, NL-1066 EA Amsterdam, The Netherlands, Eur J
Oral Sci 1996; 104: 199-206. acidic solutions which come into contact with the teeth. Because the critical
Dental erosion is caused by
pH of dental enamel is approximately 5.5, any solution with a lower pH value may cause erosion,
particularly if the attack is of long duration, and repeated over time. Saliva and salivary pellicle
counteract the acid attacks but if the challenge is severe, a total destruction of tooth tissue follows.
Ultrastructural studies have shown that erosive lesions are seen in prismatic enamel as characteristic
demineralization patterns where either the prism cores or interprismatic areas dissolve, leading to a
honeycomb structure. In aprismatic enamel the pattern of dissolution is more irregular and areas with
various degrees of mineral loss are seen side by side. In dentin the first area to be affected is the
peritubular dentin. With progressing lesions, the dentinal tubules become enlarged but finally disruption
is seen also in the intertubular areas. If the erosion process is rapid, increased sensitivity of the teeth is
the presenting symptom. However, in cases with slower progression, the patient may remain without
                                                may become severely damaged.
symptoms even though the whole dentition RETURN to Titles
Prevention of progression of dental erosion by professional and individual prophylactic measures
Thomas lmfeld Clinic of Preventive Dentistry, Periodontology and Cariology, Dental institute, University of Zurich,
CH-8028 Zurich, Switzerland, Eui J Ord Sci 1996; 104: 215-220.
The key elements for the establishment of a preventive program for patients suffering from erosion are
described on pathophysiologic grounds. These elements aim 1) to diminish frequency and severity of
acid challenge, 2) enhance salivary flow, 3) to enhance acid resistance, remineralization and rehardening
by fluoride application, 4) to offer chemical protection by buffering substances, 5) to minimize abrasion,
                                              RETURN to prophylactic measures are made as a
6) to offer mechanical protection. Recommendations forTitles
Restorative therapy for erosive lesions
Larnhrechts P, Van Meerbeek B, Perdig60 J, Gladys S, Braeni M, Vanherle G, 1BIOMAT, Department of
Operative Dentistry and Dental Materials, Catholic University Leuven, U.Z. St. Rafael, Leuven, Belgium. 2School
of Dentistry, lnstituto Superior de Ciencias da Salide, Monte da Caparica, Portugal and 3Dental propedeutics,
RUCA, University of Antwerp, Antwerp,etiology ofEur J Orallesions before they can be accurately diagnosed,
More needs to be learned about the Belgium . erosion Sci 1996: 104: 229-240
confidently treated and, more importantly, prevented. The treatment is dependent on the location and
the degree of erosion. The decision to treat an erosion lesion should be based on careful consideration
of the etiology and progression of the condition. Reasons for restoring noncarious enamelidentin
lesions are discussed and various therapeutic measures are provided. Preventive and restorative
therapeutic measures for noncarious abrasive/ erosive lesions are proposed such as: a change of
dietary or behavior patterns; application of desensitization products; intensive fluoride therapy with or
without iontophoresis; brushing with desensitizing dentifrices; adhesive penetration with dentin
                                                 RETURN to Titles
The erosive potential of flavoured sparkling water drinks
CATRIONA J. BROWN, GAY SMITH, LINDA SHAW, JASON PARRY & ANTHONY J. SMITH School of
Dentistry, University of Birmingham and Birmingham Dental Hospital, Birmingham, UK, International Journal of
Objective. The potential role of acidic drinks in the aetiology of dental erosion is well recognized. Whilst
the wide-scale consumption of bottled waters is unlikely to contribute significantly to erosion, the role of
flavoured sparkling water drinks is unclear. The aim of this study was to determine the pH, titratable
acidity and in vitro erosive potential of a selection of these drinks drawn from the UK market to identify
what dietary advice would be appropriate in relation to their consumption.
Methods. pH was measured using a pH electrode and titratable acidity recorded by titration with 0.1- M
NaOH. Erosive potential was assessed using an in vitro dissolution assay with hydroxyapatite powder
and electron microscopic examination of surface enamel of extracted human teeth, following exposure
to the flavoured sparkling waters for 30 min.
Results. All of the flavoured waters tested showed appreciable titratable acidity (0.344–0.663 mmol) and
low pH (2.74–3.34). In the hydroxyapatite dissolution assay, all of the waters demonstrated erosive
potential (89–143%) similar to or greater than that of pure orange juice, an established erosive drink.
                                                 RETURN to Titles
The progression of tooth erosion in a cohort of adolescents of mixed ethnicity
C. R. DUGMORE 1 & W. P. ROCK 2 1 Melton, Rutland and Harborough NHS Trust, Pasley Road Dental Clinic,
Leicester and 2 Birmingham Dental School, St. Chad’s Queensway, Birmingham, International Journal of
Paediatric Dentistry 2003; 13: 295–303
Objectives. To establish the prevalence of tooth erosion in a sample of 12- year-old children and to
monitor changes over the subsequent 2 years.
Methods. A random sample of 1753 children aged 12 years was drawn from all 62 state maintained
schools in Leicestershire. A total of 1308 were re-examined 2 years later. Erosion was recorded on
incisors and first molars using an erosion index based upon that from the Children’s Dental Health in the
United Kingdom 1993 survey. A score was also allocated to each subject according to the most
advanced lesion in the mouth.
Results. Erosion was present in 56•3% of subjects at age 12 and 64•1% at age 14. Deep enamel or
dentine was eroded in 4•9% and 13•1% of subjects, respectively, at the same ages. One hundred and
sixty-one (12•3%) children who were erosion-free at 12 years of age developed erosion over the
                                                  than girls, Titles
subsequent 2 years. Boys had more erosionRETURN to as did white compared to Asian children.
The relationship between erosion, caries and rampant caries and dietary habits in preschool children in
M. I. AL-MALIK, R. D. HOLT & R. BEDI Department of Transcultural Oral Health, Eastman Dental Institute,
University College London, UK, International Journal of Paediatric Dentistry (2001), 11: 430–439
Objectives. The aim of this study was to investigate the possible association between dental erosion and
caries, and variables including socio-economic status, reported dietary practices and oral hygiene
behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental
examination and questionnaire survey was carried out at a number of kindergartens.
Sample and methods. A sample of 987 children (2–5-year-olds) was drawn from 17 kindergartens.
Clinical examinations were carried out under standardized conditions by a trained and calibrated
examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires
distributed to the parents through the schools. These were completed before the dental examination.
Results. Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of
the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of
carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child
was a baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also
related to caries but                        RETURN to Titles
Using partial recording to assess tooth wear in older adults
Steele JG, Walls AWG: Department of Restorative Dentistry, Dental School, Newcastle upon Tyne, UK
Community, Dent Oral Epidemiol 2000; 28: 18–25.
Objectives: To establish whether partial recording can be used for the measurement and reporting of
tooth wear data in samples of adult populations, whilst maintaining the usefulness of the index.
Methods: Using whole mouth coronal tooth wear data from a large random population sample of 1200
dentate older adults in England, several different partial recording systems were investigated to
establish which teeth would maintain a high level of sensitivity for the most economic use of codes and
index teeth. Tooth wear data were recorded on a surface-by-surface basis on all teeth in sample using
the tooth wear index.
Results: Five different partial mouth recording systems were assessed, including half-mouth scoring,
assessment of just upper or just lower anterior teeth, assessment of all anterior teeth and use of six
index teeth. The 12 anterior teeth were the ones most often affected by moderate or severe wear, and
when all 12 teeth Key words: abrasion; epidemiology; index; tooth wear were used as the index teeth
few wear cases were missed, and all the most exten- sive and severe cases of coronal wear were
classified as having some wear. A James G. Steele,
Department of Restorative Dentistry, Dental School, Framlington Place, limited index of only six anterior
                                              RETURN to Titles
Dental erosion. Definition, classification and links
Thomas lmfeld, Clinic of Preventive Dentistry, Periodontology and Cariology, Dental Institute, University of
Zurich, CH-8028 Zurich, Switzerland Eur J Ortil Sci 1996:104: 1.5-155.
An overview of tooth wear, i.e. of non-carious destructive processes affecting the teeth including
abrasion, demastication, attrition, abfraction, resorption and erosion is presented. The nomenclature
and classification of dental erosion commonly used in the dental literature are summarized. They are
based on etiology (extrinsic, intrinsic, idiopathic), on clinical severity (Classes I to III), on pathogenetic
activity (manifest, latent) or on localization (perimolysis). Interactions, between erosion and abrasion,
                                                RETURN to and low salivary flow rate are highlighted.
demastication, attrition, and abfraction as well as cariesTitles
Etiology of dental: extrinsic factors erosion
Zero DT, Eastman Dental Center, Eur J Oral Sci 1996. 104: 162-177.
The extrinsic causes of dental erosion can be grouped under the headings of environmental, diet,
medications and lifestyle. Environmental factors mainly involve exposure to acid fumes by workers in
factories without proper safeguards. Swimming pools with low pH due to inadequate maintenance have
also been implicated. Dietary factors have received the most attention and are likely to affect the
broadest segment of the population. Most acidic foods and drinks have the potential to cause dental
erosion in the human mouth. The total acid level (titratable acid) of dietary substances is considered
more important than their pH because it will determine the actual H+ available to interact with the tooth
surface. Other constituents of foods and beverages will also have a modifying effect including the
calcium, phosphate and fluoride concentration the acid type and physical and chemical properties that
influence the clearance rate from the mouth. It is not appropriate to assign relative degrees of risk to the
different dietary substances except in general categories, because of the many human biological and
behavioral factors that influence the clinical expression of dental erosion.

				
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