Prevention Of Dental Erosion Research Articles

A Systematic Review Evaluating Methods for Diagnosis, Treatment and Prevention of Dental Erosions.

The aim of this systematic review was to investigate the quality of evidence for methods used to diagnose, restore and prevent dental erosions, by evaluating and summarising clinical controlled studies and insitu studies covering this field. Three databases, PubMed, Embase and Cochrane database, were searched for studies published until October 2023. Studies fulfilling the selection criteria were selected, and the risk of bias of the included studies was assessed. Two authors independently reviewed the studies, evaluated their risk of bias and extracted data from the included studies. The certainty of evidence of the findings in the studies was determined using GRADE. The literature search identified 7176 records. Out of these, 19 studies were included in this review, three revolving diagnostics, three revolving treatment and 13 revolving prevention. However, due to the fact that only few studies with a small number of participants have investigated the same methods on the same outcome, the studies do not constitute any body of evidence. This systematic review highlights the shortage of data on methods used for diagnostics, restorative treatment and prevention of dental erosions. More knowledge is needed to strengthen the scientific evidence regarding methods used for dental erosions.

Effect of silver diamine fluoride/potassium iodide treatment on the prevention of dental erosion in primary teeth: an in vitro study

IntroductionDental erosion has a great effect on oral health, when diagnosed it is irreversible, this sets the importance of different preventive measures being investigated against dental erosion.AimThis in vitro study aims to evaluate the effectiveness of silver diamine fluoride and Potassium iodide (SDF-KI) in comparison to casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) varnish, sodium fluoride (NaF) varnish, silver diamine fluoride (SDF) alone and deionized water as a control group in the prevention of dental erosion in primary teeth and assessing its staining effect.Materials and methodsForty deciduous teeth enamel specimens were randomly allocated into the five study groups. Tested materials were applied. An erosive challenge was done by immersing the specimens in a citric acid-containing soft drink with pH 2.85, for 5 min, 4 times/day, for 5 days. Changes in surface microhardness, mineral loss, and color change were evaluated besides recording of the surface topography and surface roughness for selected specimens.ResultsThe highest decrease in surface microhardness was recorded in the control group (−85.21 ± 10.60%), with a statistically significant difference (p = 0.002). SDF-KI group (−61.49 ± 21.08%) showed no statistically significant difference when compared to CPP-ACPF, NaF, and SDF groups. For calcium and phosphorous loss, control group was statistically significantly higher compared to the treatment groups (p = 0.003) and (p < 0.001) respectively, while there was no statistically significant difference between the tested treatment groups. The highest mean value for color change was recorded in SDF group (26.26 ± 10.31), followed by SDF-KI group (21.22 ± 12.87) with no statistically significant difference between groups.ConclusionsSDF-KI is as effective as CPP-ACPF, NaF varnishes and SDF in the prevention of dental erosion in primary teeth, there was no statistically significant difference regarding its staining potential.

Prevention of Dental Erosion Caused by Fermented Milk: An In-vitro Study.

This study aimed to assess the efficacy of three techniques for preventing dental erosion and thereby identify effective methods. The three techniques were: 1) adding calcium to fermented milk (2% Ca and 0.5% Ca); 2) topical application of fluoride to the teeth before exposure to fermented milk (acidulated phosphate fluoride [APF] gel and 0.05% NaF); and 3) a combination of the two techniques (APF gel + 0.5% Ca, 0.05% NaF + 0.5% Ca). pH cycling was performed on bovine-tooth specimens alternately immersed in experimental solutions and artificial saliva. After treatment, the microhardness and roughness of the enamel surfaces were measured, and changes in the surface morphology were observed using atomic force microscope images. Microhardness did not differ statistically significantly between the 2% Ca and mineral water (negative control) groups (2% Ca: 295.34 ± 11.50; mineral water group: 294.76 ± 10.67; p > 0.05). Surface roughness did not differ statistically significantly between the 2% Ca, 0.05% NaF + 0.5% Ca, and mineral water groups (2% Ca: 16.81 ± 7.23; 0.05% NaF + 0.5% Ca: 15.77 ± 2.86; mineral water group: 13.35 ± 5.53; p > 0.05). The surface morphology did not change in the mineral water and 2% Ca groups. Considering that 2% calcium is a high concentration, adding a low concentration of calcium to fermented milk and applying a low concentration of fluoride daily decreased the reduction of surface microhardness and reduced the increase in surface roughness without causing marked changes in surface morphology. This confirms that combining the two techniques is an effective strategy to prevent dental erosion in-vitro.

Prevention of dental erosion in early dental caries by application of remineralizing substance to fermented beverage

Prevention of dental erosion in early dental caries by application of remineralizing substance to fermented beverage

Novel insights on the etiology, diagnosis and prevention of dental erosion

Dental erosion is a progressive loss and damage of tooth hard tissues caused by contacting acidic substances. It is an occupational disease for workers who make acidic products such as acids, vinegar, etc. In the past decades, a rising of prevalence rate of dental erosion, especially in the youth groups, along with the change of dietary habits and the increased consumption of sweet and acidic diets, has attracted public's attention. This article reviews and analyzes the literature on the prevalence, etiology, prevention and treatment of dental erosion, so as to provide guidance for early diagnosis and treatment of dental erosion and support for making occupational disease prevention strategies.

DIETARY HABITS AND ORAL HYGIENE PRACTICES AMONG UNDERGRADUATE DENTAL STUDENTS, NAGPUR.

Background: Dental erosion is becoming increasingly prevalent especially among young generations and its damaging effect is emerging as a serious public health problem. Dietary habits and oral hygiene practices play an important role in dental erosion. So current study was aimed to study the prevalent dietary habits and oral hygiene practices among undergraduate dental students of VSPM dental college and research center Nagpur, Maharashtra.&#x0D; Materials and methods: A cross-sectional study was carried out among 357 undergraduate dental students using pre-structured close-ended self-administered questionnaire. Data regarding dietary habits and oral hygiene practices were collected and analyzed using STATA vs.13.&#x0D; Result: Out of 357 dental students, majority (82.4%) were female and mean age was 19.3 years (SD: ±0.98). More than half (57.1%) were using medium type of toothbrush and majority (73.1%) students were using normal type of tooth paste. Around one-third (35.6%) students were used to consume soft-drink once or twice per day. Majority (73.1%) students were using normal toothpaste and most of them (84%) did not brush tooth after having soft-drinks. Conclusion: Dental students are not following standard dietary habits and oral hygiene practices required for prevention of dental erosion.&#x0D; Keywords: Dietary Habits, Oral Hygiene , Dental Students, India.

Comparative Evaluation of Casein Phosphopeptide&amp;ndash;Amorphous Calcium Phosphate&amp;ndash;Fluoride Paste and Sodium Fluoride Mouthwash in the Prevention of Dental Erosion: An In Vitro Study

To compare the efficacy of casein phosphopeptide-amorphous calcium phosphate-fluoride (CPP-ACP-F) paste and 0.2% sodium fluoride mouthwash in the prevention of dental erosion using profilometer. The buccal surfaces of 36 premolar sound teeth were ground and polished to achieve a flat surface with silicone disks. Samples were allocated in three groups randomly. Group I was pretreated for 5 days four times a day with CPP-ACP-F paste. Group II was pretreated for 5 days with 0.2% sodium fluoride mouthwash four times a day. Group III remained as the control group without any pretreatment. In the next step, all the samples were exposed four times a day for 3 days to carbonated beverages. The samples were rinsed with saline after each erosive cycle and stored in artificial saliva. The profilometer was used to determine the surface loss. The data collected were evaluated using one-way analysis of variance (ANOVA) along with post hoc test. The erosion of group I (CPP-ACP-F paste) and group II (0.2% sodium fluoride mouthwash) was significantly less than that of group III (control group). The erosion in group II was significantly lower than in group I. Both sodium fluoride mouthwash and CPP-ACP-F paste are effective in the prevention of dental erosion. Sodium fluoride mouthwash shows higher reduction in dental erosion when compared with CPP-ACP-F paste. This study contributes to the understanding of the efficacy of CPP-ACP-F paste and 0.2% sodium fluoride mouthwash in the prevention of dental erosion.

Evaluation of the Effectiveness of Olive Oil on the Prevention of Dental Erosion: An In vitro Study

Aim: The aim of this study was to explore the anti-erosive effect of olive oil against citric acid on bovine teeth and to compare the effectiveness with that of fluoride varnish. Materials and Methods: An observational analytical cross-sectional study among forty recently extracted bovine incisor teeth. From each tooth, a cubic of 4 mm × 4 mm was cut. Five surfaces of the cubic were coated by nail varnish leaving only the enamel window uncovered. The specimen was divided into four groups randomly: Group 1: five teeth (control group) nothing used, Group 2: five teeth immersed in olive oil for 6 h, Group 3: five teeth immersed in olive oil for 48 h, and Group 4: 10 teeth immersed in fluoride varnish 48 h. Then, each specimen was immersed in citric acid (pH: 2.3) for 15 and 30 min. The amount of calcium dissolved was measured by atomic absorption spectrophotometer. Different variables were statistically compared by t-test and ANOVA test with the level of significant set at P≤ 0.05. Results: The mean of calcium dissolution among the control group at 15 min was 2.8 mg/dl, while dissolution in 30 min was 6.1 mg/dl. When comparing the effect of exposure time duration of all specimens in citric acid, it was found that calcium dissolution increased in 30 min exposure than in 15 min exposure. Emersion of teeth in olive oil for 6 h was effective in reducing enamel erosion when exposed to citric acid 1% at 15 min, while in 30-min exposure to citric acid was less effective and to a lesser degree than fluoride varnish (sodium fluoride). Conclusion: Bovine teeth immersed in olive oil for 6 h resist the erosive effect of citric acid exposure for 15 min. Olive oil has less effect on the prevention of erosive tooth wear when compared to fluoride varnish.

Stannous chloride and stannous fluoride are inhibitors of matrix metalloproteinases

ObjectivesMatrix metalloproteinases (MMPs) in dentin and saliva can degrade collagen. Divalent metals are known inhibitors of MMPs, but stannous – such as in the form of stannous chloride (SnCl2) or stannous fluoride (SnF2) – is yet to be tested for a possible inhibitory effect. In this study, we tested the inhibitory effect on the proteolytic activity of MMP-2 and MMP-9. MethodsSodium chloride (NaCl), sodium fluoride (NaF), and chlorhexidine (CHX) were used as controls. Gelatin zymography was performed with recombinant human MMP-2 and MMP-9. SnCl2, SnF2, NaF, NaCl, and CHX were included either in the incubation buffer (M1) or added to the recombinant MMPs (M2) before the MMPs were analyzed using zymography. Furthermore, the effect of SnCl2, SnF2, and NaF on the enzymatic activity of MMP-2 and MMP-9 was measured in human dentin either before or after acid etching using 37%phosphoric acid. The effect of SnCl2, NaF, and CHX on the viability and of SnCl2 and NaF on the proliferation of human gingival fibroblasts and L929 mouse fibroblasts was also determined. ResultsFor M1, inhibitory concentrations (w/v%) of SnCl2 0.5% and 0.5%, SnF2 0.25% and 0.12%, NaF 0.12% and 0.5%, CHX 0.012% and 0.05%, were observed for MMP-2 and MMP-9, respectively. NaCl had no inhibitory effect. For M2, SnCl2 0.007% and 0.12%, and SnF2 0.03% and 0.5%, inhibited MMP-2 and MMP-9, respectively. NaF, NaCl and CHX had no effect. The enzymatic activity was slightly reduced when SnCl2 and NaF were applied on dentin before the acid attack. Regarding cell viability and proliferation of the cells after stimulation with the respective substances, NaF showed almost no effect, SnCl2 appeared to increase viability and proliferation of the cells, and CHX decreased the viability of cells. ConclusionsStannous ions caused a direct inhibition of the matrix metalloproteinases, whereas F− only had an inhibitory effect when added to the zymography buffer. Clinical significanceInhibition of MMPs using SnCl2 and SnF2 could play an important role in the prevention of dental erosion and caries. However, the clinical relevance of these findings needs to be proven.

Effect of CPP-ACP or a Potassium Nitrate Sodium Fluoride Dentifrice on Enamel Erosion Prevention.

To investigate in situ/ex vivo the effect of remineralizing agents in the prevention of dental erosion in permanent and primary teeth. A randomized, controlled, double-blind study with crossover design with three treatment phases: Control, ProNamel® and Tooth Mousse™. Twenty adults and children wore removable palatal appliances containing two insets of permanent and primary human enamel and used the corresponding assigned toothpaste twice daily for 10 days. The enamel samples were then removed, mounted on acrylic bases and acid-challenged in demineralizing solution. Enamel surface microhardness (SμH) was measured pre and post acid challenge. Data were analyzed using two-way ANOVA and Tukey's post hoc test (P < 0.05). The mean SμH values (Vicker's unit) prior to acid challenge were: Permanent teeth (Control 366.16 ± 12.28, ProNamel® 372.18 ± 14.75, Tooth Mousse™ 370.19 ± 11.88) and Primary teeth (Control 325.31± 11.90, ProNamel® 327.34 ± 9.90, Tooth Mousse™ 331.63 ± 10.55). Following the acid challenge, the mean %ΔSμH (±SD) were: Permanent (79.72 ± 1.59, 66.52 ± 2.45, 60.13 ± 4.98) and Primary (81.09 ± 2.90, 76.50 ± 3.13, 69.02 ± 4.23). The application of remineralizing agents reduced the significantly softening by acidic attack of enamel especially in the permanent dentition.

ÇOCUKLARDA DENTAL EROZYON VE KORUYUCU UYGULAMALAR

Dental erosion is irreversible and progressive destruction of dental hard tissues without bacterial relationship. Internal and external acid sources that causes the formation of acidic pH in the oral environment, plays a role in the formation of dental erosion. While dietary acidic drinks and foods and drugs used are creating external acid sources, gastrooesophageal reflux and vomiting causes of internal acid source reach the oral cavity. In addition , bavarage intake with baby bottle, drinking can of carbonated beverages by foaming at the mouth and following acidic food consumption brushing teeth with an abrasive featured toothpaste and excessive force, increase the risk of dental erosion formation. The most common erosion areas are occlusal surface of the molars and palatal and incisal surfaces of the incisors. Dentin involvement of erosion in primary teeth is faster than permanent teeth, due to morphological differences and thinner enamel structure. In the prevention of dental erosion, firstly, patients and parents should be informed about food and beverages which has high erosive potential. Consumption of acidic foods and beverages should be limited and only at meal time. Patients who has dental erosion risk, should be recommended use of low abrazive toothpaste with high fluoride content and a soft-bristled toothbrush. In primary dentition, restorative treatment of erosion lesions is not indicated if the child does not have any symptoms. In the case of tooth sensitivity, small areas of erosion observed can be covered with resin materials. Depending on the etiologic factors, severity and progressive pattern of disease, all patients with dental erosion should be checked regularly

Alternatives to fluoride in the prevention and treatment of dental erosion.

In recent years, different agents have been discussed as potential alternatives to fluoride in the prevention of dental erosion. These agents are intended to form acid-resistant layers on the surface, to induce repair of eroded lesions by mineral precipitation or to prevent the enzymatic degradation of demineralised collagen. The application of adhesives and/or fissure sealants is considered to be an effective alternative to fluoride, but requires professional application and, depending on the product used, a re-sealing of the surface every several months. Studies testing film-forming products, such as polymers, have suggested the potential effectiveness of some of these approaches, such as chitosan, although further studies are needed to confirm the effectiveness of this approach. Other studies have demonstrated that products designed to deliver calcium and/or phosphate have not been successful at providing a significant anti-erosive effect. In advanced erosive lesions, the demineralised collagenous dentine matrix can be degraded by host enzymes such as matrix metalloproteinases (MMPs). As well as fluorides, epigallocatechin gallate and chlorhexidine have been identified as effective MMP inhibitors, with the potential to reduce the progression of dentine erosion. While fluoride compounds have been shown to have an anti-erosive potential, particularly those containing tin, alternative approaches that provide even greater protective capacity still need to be developed and proven to be effective.

Effect of Titanium Tetrafluoride, Amine Fluoride and Fluoride Varnish on Enamel Erosion in vitro

This study aimed at evaluating the effect of 1 and 4% titanium tetrafluoride (TiF₄) gels, amine fluoride (AmF) 1 and 0.25% and a fluoride varnish (FP) on the prevention of dental erosion. Two experimental groups served as controls, one with no pretreatment and another one pretreated with a fluoride-free varnish (FP-blanco). Dental erosion was modelled using bovine enamel samples submitted to alternate cycles of acid exposure in citric acid and remineralization in artificial saliva. Calcium loss of all samples involved in the study was quantified by atomic absorption spectroscopy and erosion depths were estimated. Two samples of each experimental group were also analyzed by white light confocal microscopy. The cumulative erosion depth (in µm) after 72 min was: TiF₄ gel 1% 8.29 ± 0.39; TiF₄ gel 4% 8.27 ± 0.55; AmF 1% 8.69 ± 0.66; AmF 0.25% 8.86 ± 0.33; FP 3.43 ± 1.07; FP-blanco 14.86 ± 1.59 and control 9.77 ± 0.49. A statistically significant protective effect (p ≤ 0.001) was found only for the group pretreated with the fluoride varnish. Within the limitations of an in vitro study it may be concluded that topical applications of the fluoride varnish tested have a protective effect on the prevention of dental erosion.

Erosion — chemical and biological factors of importance to the dental practitioner

The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.

Effects from pretreatment of stannous fluoride versus sodium fluoride on enamel exposed to 0.1 M or 0.01 M hydrochloric acid

Preventing enamel erosions caused by acidic soft drinks or from vomiting during eating disorders is a challenge in current dental research. The aim of this study was to examine whether pretreatment of dental enamel with a solution of 0.4% SnF2 could prevent dissolution of human enamel exposed to solutions of 0.1 M HCl, pH 1.2 or 0.01 M HCl at pH 2.2. Human enamel was pretreated for 18 h with a solution of 0.4% SnF2 and with control solutions of 2% NaF or distilled water, and then exposed to HCl solutions. Similar experiments were performed with teeth treated for 2 min SnF2 and then 4 min HCl. The effect was monitored by scanning electron microscopy (SEM) and by chemical analysis. At pH 2.2, NaF and water treatments showed minor inhibition of enamel dissolution, whereas SnF[Formula: See Text] inhibited demineralization significantly also after 2 min pretreatment and 4 min HCl exposure. At pH 1.2, SEM showed severe dissolution of the enamel surfaces regardless of pretreatment. As pH of stomach vomit is usually >1.5, SnF2 may be an interesting agent for use in the treatment and prevention of dental erosions even in patients with frequent vomiting episodes.