Hands OnAdvising patients about acidic exposure and dental erosion
Section snippets
Background
Dental erosion can occur after exposure to acids either in the diet or as a result of physical conditions. Extrinsic dietary acids come from foods or beverages that are consumed. Exposures to these acids can be increased by specific behaviors such as holding liquids in the mouth or swishing with them. In contrast, teeth are exposed to intrinsic acids when the patient has disorders such as anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. The science supporting
Science Supporting Erosive Factors
Patients who suffer from certain physical disorders that involve vomiting behaviors can experience significant exposure of their dental structures to intrinsic acids (Box 1). Usually vomiting from bacterial or viral infections of the gastrointestinal tract are of short duration and do not contribute to erosion. However, people who have chronic, untreated gastroesophageal reflux can develop erosion of the tooth structures. In addition, physical conditions such as pregnancy, obesity, and
Recommentations for Clinicians
Left untreated, patients with eating disorders, rumination syndrome, and gastroesophageal reflux can have deleterious effects on the dentition. In addition, patients with xerostomia, which puts tooth structures at higher risk for erosion, often consume sour candies to encourage salivary flow, but this behavior also contributes to erosion. Clinicians need to be able to screen their dental patients for such conditions and behaviors to protect the tooth structures involved.
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Marshall TA: Dietary assessment and counseling for dental erosion. J Am Dent Assoc 149:148-152, 2018
Reprints available from TA Marshall, Dept of Preventive and Community Dentistry, Univ of Iowa College of Dentistry, N335 DSB, Iowa City, IA 52242; e-mail: [email protected]