Dental Erosion

Ask children and adults to name a dental problem, and tooth decay would almost certainly be the top answer. Tooth decay or dental caries occurs "due to acid-causing bacteria in combination with carbohydrate-rich foods and insufficient health practices. It presents initially as isolated chalky white areas which spreads out to become wider and deeper cavities if not treated accordingly," warns Dr. Tess Oliveros-Villarico, who is the president of the Philippine Pediatric Dental Society (PPDSI).

She explains that in contrast, dental erosion initially involves a wider area of tooth surface and engages a more uniform presentation in the affected teeth. "It is an irreversible loss of tooth structure, which usually results from frequent exposure to the acidic content of food, drink, medications and gastric acid. Enamel, which is the white outermost layer of teeth, is primarily dissolved until the more yellow underlying dentin shows through. When this happens, teeth become more sensitive to hot or cold beverages and even sour food and drinks. If not managed immediately, the symptoms may subsequently lead to pain and infection."

The culprits

According to Oliveros-Villarico, the following fare can cause dental erosion:

1. sodas and other carbonated drinks

2. fruits and its juices

3. some vitamins

4. sour and vinegar-based Filipino favorites like adobo, sinigang, green mangoes and kalamansi

5. Additionally, situations which involve exposure of the teeth to gastric acids such as gastric reflux in early pregnancy and digestive disorders, plus eating dysfunctions like bulimia can contribute to dental erosion.

Good intentions and comforting habits are to blame too. "Many parents, in their intent to provide complete "baon" and snacks to their kids, would likely include orange and apple juices in their menus and the occasional sodas paired with the popular burger and fries. It is also likely that Vitamin C and other viscous, sticky supplements are prescribed on a daily basis by the well-meaning pediatrician. Even babies and toddlers who are still given pacifiers may not only find milk in the feeding bottle but also acid-rich colored drinks which remain in the mouth for a considerable amount of time thereby submerging the teeth in harmful fluid and altering the oral balance in a negative way. Adults who are fitness buffs may be regularly taking in sports and energy drinks; working personnel resort to coffees and teas for the usual perk-me-ups and a round or two of wine to go with lunch or dinner. With all these various acid-containing sources and their frequent consumption, it is not surprising that dental erosion is now considered a common chronic disease among children and can be a serious dental health problem also affecting a lot of adults," observes Oliveros-Villarico.

The signs

Someone suffering from dental erosion would have:

1. teeth that shows a dissolution of the hard tissue cover or enamel

2. teeth or parts of it that appear more yellow because of a more translucent enamel showing off the darker colored underlying dentin

3. sensitivity reactions to eating and drinking hot, cold, and/or sour food and drinks

4. discomfort during mealtimes and when brushing the teeth

"Children would usually lose appetite and reject food and toothbrushing altogether. Difficulty in cleaning the teeth would become a negative reinforcer - discouraging further brushing and if not managed would likely lead to avoidance of touching the sensitive areas, and a total dislike of oral hygiene measures, therefore causing worse consequences like dental caries, pain and abscess formations," says Oliveros-Villarico.

Prevention and solution

For optimum diet and dental health, the American Academy of Pediatric Dentistry offers these tips:

1. Ask your pediatric dentist to help you assess your child's diet.

2. Provide a balanced diet and save foods with sugar or starch for meal times.

3. Limit the number of snack times. Choose nutritious snacks.

4. Shop smart. Do not routinely stock your pantry with sugary or starchy snacks. Buy "fun foods" just for special times.

5. Do not put your child to bed with a bottle of milk, formula or juice.

6. If your child chews gum or sips soda, select products that are sugar-free. Recent evidence suggests the use of xylitol chewing gum can decrease a child's caries rate.

Oliveros-Villarico points out, "There are many food and drink types belonging to the nutritious part of the food pyramid that contribute to acid erosion. Eating a well balanced meal would definitely include them. It is important to remember some key points to enjoy mealtimes and get the full benefit of a nourishing diet." Here are some of them:

1. Eat and drink in moderation.

2. Water is a most ideal drink.

3. A straw can help decrease exposure of the teeth to acidic drinks.

4. Cheese, milk or vegetable sticks can help neutralize an acidic oral environment.

5. Smoking and alcohol consumption contribute to acidity.

6. In the absence of brushing and flossing, rinsing with water after a meal is good practice.

7. Brush using sufficient fluoride-containing toothpaste. Ask your dentist for an individualized oral hygiene regimen based on your specific needs.

8. Preventing dental erosion may mean choosing an alkaline, water-based and colorless mouthwash preferably with baking soda.

9. Have a sugar-free gum readily available with you. Chewing gum stimulates salivary flow thereby washing away any acid challenge.

Lastly, Oliveros-Villarico reminds families to make visits to the dentist a regular part of their calendar. "It is unwise to seek dental professionals only when there is a pressing problem already. A complaint-based dental visit takes more time to manage and is usually more expensive, not to mention the greater stress and anxiety that your body has to endure. Living daily with the convenience of smiling, laughing and talking to people without the hassle of any health concerns like sensitive teeth, dental cavities or even bad breath is a good enough incentive to really focus on a healthy mouth. Oral health is a worthwhile investment as it truly equates to a pleasant quality of life."

Dr. Tess Oliveros-Villarico is the president of the Philippine Pediatric Dental Society or PPDSI. Her clinic is located at Unit 202 Medical Towers Makati, V.A. Rufino Street, Legaspi Village, Makati City with contact numbers 840-4267 or 0915-5871635.