Erosion of the tooth neck. Erosion of tooth enamel: causes and treatment

Erosion of tooth enamel is a process of destruction of dental tissues with the appearance of destroyed areas in the form of rounded cavities. The defect resembles a caries infection, but in fact has nothing to do with caries.

The process begins with the formation of a small cavity in the cervical area of ​​the tooth, which gradually increases in size. At the initial stage, the problem is difficult to notice, since it is close to the color of the tooth enamel and does not manifest itself in any way. Symptoms begin to appear as the cavity deepens, causing discomfort and tooth sensitivity. The patient feels sharp pain when mechanical irritation, contact with sweet or sour food on the tooth, as well as under the influence of high or low temperature. An independent visual examination is perplexing, since there are no signs of caries. In this case, the cause of discomfort may be erosion of tooth enamel.

Risk factors

There are several main reasons that can trigger erosion.
These include:

mechanical pressure;

teeth grinding (bruxism);

abuse of sour foods;

gastrointestinal diseases.

Uneven load distribution

Wearing braces can be one of the factors that creates favorable conditions for the occurrence of such a defect on the teeth as erosion of tooth enamel.

When a person is missing one or more teeth, not everyone is in a hurry to get dentures. Patients are not always willing to resort to orthodontic treatment, even when there are clear indications. Some people are scared by the prospect of wearing braces, as well as the cost of the corrective structure. These circumstances can become favorable conditions for the occurrence of a defect such as erosion on the teeth.
The fact is that when chewing food, a person does not think about how this load will be placed on his teeth. It may seem that only 2-3 teeth are involved in the process, on which a particular piece of food falls, but this is not so. In fact, the stability of the dentition and high-quality grinding of food is achieved by a uniform load on the entire dentition. This is ensured by the presence of all teeth that support each other, providing support for the neighboring ones.

Important! Often a person, having several teeth removed on one side, uses mainly the other side for chewing, thereby causing it to be double overloaded. This is fraught with weakening of teeth and, in particular, the occurrence of erosion.

Mechanical pressure

Brushing your teeth is in itself an uneven mechanical pressure on the tooth enamel in order to remove the plaque that has formed. And using a toothbrush with hard bristles can aggravate the impact, leading to mechanical damage.

Many people are surprised by the fact that you can damage your teeth with a regular toothbrush. When buying a tool for daily cleaning of the oral cavity, you must pay attention to the specified stiffness of the bristles. For regular hygiene, you should give preference to products with medium-hard bristles. Some buyers do not pay attention to the labels on the packaging, while others deliberately choose a brush with high hardness, considering it the most effective. However, such a brush will not help you achieve the best results; on the contrary, it will have a negative effect on your teeth. Hard bristles can wear off the enamel, and the sensitive cervical area can be easily injured.

Important! Teeth brushing technique is also of great importance. A common mistake is intense movements in the horizontal plane along the outside of the dentition. Such cleaning is not effective and, in addition, can cause injury to the tooth enamel in the cervical area.

Dentists never tire of repeating that brush movements should be vertical, in the direction from the gums to the edge of the tooth. Thus, contaminants are effectively swept away from the enamel surface.
When using a toothbrush, you should not forget about the force used. Don't think that pressing too hard on the brush handle will help clean your teeth properly. In fact, this does not improve the quality of cleansing at all, and the risk of injury increases many times over. A sign of excessive zeal is rapid wear of the brush. If the product becomes disheveled after a few weeks, you should think about changing the procedure technique.
The key to good hygiene is careful, correct technique and regular implementation of procedures. It is recommended to brush your teeth twice a day.

Teeth grinding

Bruxism is periodically occurring paroxysmal contractions of the masticatory muscles during sleep, which are accompanied by clenching of the jaws and grinding of teeth; attacks are repeated many times and may be accompanied by breathing problems, changes in blood pressure, and heart rate.

Dentists call involuntary jaw clenching and teeth grinding the term “bruxism.” It is quite difficult to notice such a problem on your own. During the daytime, teeth grinding occurs infrequently. But if you observe yourself, you will notice that in emotional moments there is an involuntary clenching of the jaw with noticeable force. This is precisely the phenomenon called bruxism.

Attention! At night, bruxism is more pronounced. During REM sleep, the jaw tenses and the sound of teeth grinding can be heard. A person himself is unlikely to notice it; rather, his loved ones who are nearby in the bedroom will help to do so.

There are also external signs of bruxism. If you carefully examine the surface of the teeth, you will notice horizontal stripes and cracks located longitudinally on their crowns. This sign is indirect, but indicates the possible presence of teeth grinding.
This habit is not a serious medical problem. Bruxism, to one degree or another, is observed in many modern people, since the rhythm of life is often associated with emotional overload. However, this habit is not entirely harmless, because strong mechanical stress on the teeth can lead to damage, including erosion.

Acidic environment

Eating a large amount of vegetables and fruits can provoke the maintenance of a constant acidic environment in the oral cavity, which leads to erosive destruction of tooth enamel.

Currently, one of the fashionable trends is the raw food diet and other diets that involve the consumption of large amounts of raw vegetables and fruits. It should be understood that in addition to vitamins and nutrients, such products often contain large amounts of acids, which can negatively affect teeth.
If you have increased tooth sensitivity and a tendency to erosion, you should be careful about the products you eat.

Attention! Many folk recipes for teeth whitening involve the use of substances that are highly acidic. You should not get carried away with applications made from fresh strawberries, lemon and similar products, otherwise, instead of the expected result, you may get increased sensitivity and erosion of tooth enamel.

It is unlikely that such bleaching will please you.

Gastrointestinal diseases

Gastrointestinal disease can lead to disruption of the integrity of tooth enamel; gastric juice entering the oral cavity disrupts the acid-base balance and leads to zero protective function of the produced saliva.

The condition of the gastrointestinal tract has a direct impact on dental health. The oral cavity is located in close proximity to the stomach and is directly connected to it through the esophagus. To carry out the process of digesting food, gastric juice is constantly present in the stomach, which is an acidic medium. Various types of diseases can lead to acid imbalance and acid entering the oral cavity. As mentioned above, an acidic environment can have a detrimental effect on teeth, causing erosion. In addition, chronic gastritis can change the composition of saliva produced, disrupting its protective function.

Important! Erosion that appears on teeth as a result of gastrointestinal diseases often has a characteristic brownish color.

A separate category is occupied by patients with eating disorders. Anorexia and bulimia, accompanied by constant vomiting, lead to a pathology of such magnitude that the patient’s smile turns into a continuous brownish erosion.

Therapeutic measures

To keep your teeth healthy, hygiene is not enough; you need to eliminate “food waste”, which impairs the functioning of the body as a whole, destroying its protective reactions.

Before you begin to eliminate the consequences of the resulting erosion, you need to get rid of the reason why it arose. Thus, the main therapeutic measures are:

• Restoration of missing units of the dentition using prosthetics or implantation technologies.
• Correction of bite defects using orthodontic structures.
• Monitoring proper compliance with hygiene rules. Dental care should be regular, and teeth should be brushed carefully using a properly selected toothbrush. Toothpastes should be selected taking into account individual characteristics, while products labeled “whitening” should not be used at all.
• Conducting an examination of the gastrointestinal tract and necessary treatment of identified diseases.
• Proper nutrition, including foods rich in minerals and vitamins. Eliminating highly acidic foods from your diet, limiting fast food and sweets, and avoiding excess coffee - all this helps maintain a healthy smile.
• Solution to the problem of teeth grinding. In this case, complex work of a dentist and a neurologist is required.

To help the patient, natural sedative complexes of plant origin can be prescribed, which promote relaxation before bed. Fighting stress and controlling your own emotions help reduce the occurrence of bruxism during the daytime. If all efforts are in vain, then you can use individual mouthguards made of silicone. These products are worn at night and protect teeth from injury by acting as a soft buffer between the upper and lower jaws.

Attention! If erosion has already formed, then it is impossible to restore lost dental tissue naturally. The defect requires treatment in a dental office using modern filling techniques.

Most often, light-curing composite materials are used for these purposes, which are matched to the shade of tooth enamel.
Such a filling solves not only the aesthetic problem of erosion, it also eliminates the patient’s discomfort caused by increased sensitivity in the affected area of ​​the tooth. To ensure complete painlessness, local anesthesia is used. It is worth noting that the use of a drill in the case of erosion treatment is minimal, since the tissue surrounding the defect is not infected, as happens with caries.
Proper treatment will restore the naturalness of your smile, but do not forget that it will not protect against the risk of relapse of the disease if the cause of tooth enamel erosion is not eliminated.

Treatment and prevention of tooth enamel erosion

Tooth erosion is a destructive non-carious process inside the oral cavity. Erosion of tooth enamel is accompanied by the appearance of increased sensitivity of the incisors to sweet, sour, salty and hot. As the disease progresses, the destruction process reaches the internal tissues, exposes the hard dentinal part, and causes pain. The tooth becomes thinner and breaks off.

What factors lead to the formation of enamel erosion, and what methods are most effective for treatment and prevention? You will find answers to these and other questions in this article.

Tooth erosion begins with uncomfortable sensations. On hard surfaces of tissues that do not show signs of caries, dull, rounded areas appear. Discoloration occurs due to loss of mineral composition (demineralization). More often, erosion forms on the surface of the front teeth and canines symmetrically, that is, on the teeth of the same name (on the two front ones or on two thirds, fourths, counting from the center). There is practically no erosive destruction on the lower molars. Often occurs on the upper front incisors.

Microscopic examination of eroded areas confirms that the enamel loses its crystalline structure and becomes amorphous at the site of stain formation. At the same time, the stain retains a smooth surface, which distinguishes erosion from caries with characteristic roughness.

With further development of destruction, a small depression is formed. Over time, it increases in depth and breadth, takes on the appearance of a recess, and reaches the hard tissues of the tooth. Erosion becomes brown in color and widespread. Necrosis (death) of hard dental tissues develops.

If erosion occurs on the cutting edge of a tooth, as it develops, the edge becomes transparent, thin, and breaks off under chewing load. Chips form.

Dentists divide the disease into three stages:

• first degree dental erosion: only the upper layers of enamel are affected, which is manifested in loss of shine in some areas of the surface;
• tooth erosion of the second degree: the entire thickness of the tooth enamel is affected;
• erosion of the third degree: deep damage to the enamel, reaching hard tissues (dentin).

Timely treatment prevents the spread of spots and depressions. In this case, not only measures inside the oral cavity are important, but also treatment of the underlying disease, which is accompanied by enamel erosion.

Conducted medical studies allow us to conclude that enamel erosion is related to metabolic disorders. Destruction of enamel and its spread into the space of hard tissues often occurs in middle-aged and elderly people with diseases of the thyroid gland and gonads.

Also, tooth erosion occurs when the enamel is frequently exposed to acid. Acid that destroys the surface of the enamel can be contained in foods or can be thrown into the oral cavity from the stomach (gastric juice).

The composition of saliva in a healthy body should have a weak alkaline reaction. This provides protection to tooth and oral tissues. In case of digestive disorders, the normal composition of the salivary secretion changes, sometimes it acquires an acidic reaction and itself becomes the cause of the destruction of hard tissues. In this case, dental treatment is ineffective; complex therapy is necessary, aimed at normalizing the functioning of the digestive system.

Erosion is possible with daily exposure to low-quality tooth powder or paste (for example, with a whitening effect).

Separate statistics on erosion destruction identify athletes who regularly swim in a chlorinated pool as a risk group. Among them, the frequency of enamel destruction as a result of constant exposure to bleach on the surface of the tissues of the front teeth is also increased.

Risk factors

Erosion of tooth enamel often accompanies the following painful conditions:

• hormonal disorders;
• diseases of the thyroid gland (hypothyroidism, thyrotoxicosis) and other endocrine glands;
• osteoporosis (erosion may indicate the initial stage of the formation of this disease);
• diseases of the digestive system (gastritis, peptic ulcers, acidity disorders).

Also, the reasons that increase the likelihood of erosion are the following external factors:

• vegetarian diet with lots of sour fruits;
• pregnancy (if accompanied by intoxication);
• frequent drinking of alcohol;
• work in hazardous industries associated with inhalation of vapors of aggressive acids (nitric, sulfuric, acetic, lactic);
• radioactive radiation (territories near nuclear power plants or the condition after a course of radiation therapy);
• electromagnetic radiation (often when exposed to computer screens with a weak degree of protection).

Treatment of the disease in the early stages is performed with fluoride (fluoride gel or fluoride varnish). Enhanced vitamin and mineral complexes are prescribed. Calcium glycerophosphate is used separately as the main supplier of building material for restoring tooth enamel. In order to provide calcium to tooth enamel, electrophoresis with calcium gluconate is prescribed.

Deeper destruction is filled (similar to caries), covered with crowns or veneers (plates made of porcelain, composite).

In the early stages, effective treatment of surface tissues is carried out using tooth remineralization. What it is?

Remineralization provides an artificial analogue of a natural process that should occur in the human body constantly. The mineral composition of teeth must be replenished from food and not destroyed by aggressive environmental factors (whitening paste, polluted air, artificial food). During remineralization, teeth are treated with a chemical compound (gel) containing phosphates and calcium. These substances are responsible for the health of dental tissues.

The gel is applied into special trays that are placed on the teeth. Primary treatment is carried out by a dentist. In the future, you can perform it yourself by putting the aligners on your teeth and keeping them for a given amount of time (from 15 to 30 minutes).

As a result of remineralization, the sensitivity of the enamel is stabilized and the size of erosive spots is reduced. The procedure also increases the resistance of the tooth surface to caries.

Home remedies for preventative remineralization include mouthwashes and fluoride toothpastes. The greatest effectiveness of the procedure is achieved in children and pregnant women.

Prevention

Prevention of erosion and maintaining the enamel and hard tissues of the tooth in a healthy state includes limiting the use of ballast products, taking vitamins and a balanced diet. As well as a healthy lifestyle, monitoring the intake of hormonal medications (possibly refusing them), timely treatment of the endocrine and digestive systems of the body.

Foods to limit when early signs of dental erosion appear:

• sour juices (you can drink through a straw if the condition of the gastrointestinal tract allows);
• sweet carbonated drinks;
• preserves, marinades, fermented products.

An acid reaction should not persist in the oral cavity after eating. It is recommended to end your meal with an alkaline food (for example, eat a piece of cheese or drink milk at the end of the meal).

Tooth surface erosion is a disease shrouded in many myths, but this is not a death sentence. It can be treated and prevented, it can be prevented, its development can be stopped at an early stage, or the surface of the tooth can be protected in case of deep erosive destruction.

Finally: watch a short video about fluoridation of teeth:

Read also:

Treatment of white spots on teeth

Restoring tooth enamel at home

The reasons why enamel erosion occurs are not fully understood, however, the main risk factors for the occurrence of the disease can be identified:

The consequences of erosion are dire

Erosion affects mainly middle-aged people. This process is characterized by a long-term course and can last from 10 to 15 years. The following consequences of damage to tooth enamel can be identified:

1. Tooth wear accelerates.
2. As dentin is exposed, the color of the teeth changes and they become darker.
3. As the enamel wears away, the sensitivity of the teeth on the inner and outer surfaces worsens, that is, touching the tongue and lips brings discomfort. Dentin is a soft tissue, so pain will inevitably occur when exposed to air, chewing and exposure to food acid contained in food.
4. The edges of the front teeth may appear more translucent.

Stages and phases of destruction development

The disorder is classified not only by stages of development, but also by phases:

It is very important that in some cases the disease may transition from one phase to another.

There are 3 stages of disease development:

• initial, there is damage to the purely upper layer of enamel;
• medium, the enamel is affected so deeply that erosion reaches the dentin;
• deep, the enamel is completely affected, and the upper layer of dentin is also affected.

Manifestations of erosion depending on the stage

The process of development of the disease is very rapid and dangerous, since along with erosion, pathological abrasion of the hard tissues of the tooth develops.

The disease is chronic, which progresses more and more over time and affects healthy teeth.

Symptoms as the destruction progresses:

1. At the primary stage, there is a loss of shine of tooth enamel in the area of ​​a certain area of ​​the tooth surface. At this time, it is almost impossible to identify the process of erosion development. This can only be done by drying the tooth surface with an air stream or by applying iodine to the affected area, in which case the erosive area will turn brown. Initially, the erosive defect will have an oval or round shape with a smooth bottom. The erosion is whitish in color. There is no pain.
2. At the second stage, discomfort and a change in color of the affected area begin to appear.
3. At the last stage, noticeable pain appears during eating and brushing teeth. The pigmentation of the affected areas changes. Brown spots on the surface of the tooth become noticeable.

Three stages of diagnosis

Diagnosis is carried out during a dental examination:

1. The location of the erosive defect is identified by drying the tooth surface with an air jet and applying iodine.
2. The process of differentiating erosion from a wedge-shaped defect and primary stage caries. Erosion from caries will be distinguished by the location and shape of the lesion, as well as a smooth surface; with caries, the surface becomes rough. The wedge-shaped defect will also differ in shape and location. It is found in the area of ​​the tooth root.
3. In order to identify concomitant pathologies of the endocrine system, an examination is carried out by an endocrinologist and gastroenterologist, an ultrasound of the thyroid gland is prescribed, and a hormonal analysis of the thyroid gland is performed.

Rehabilitation therapy

Treatment for erosion of tooth enamel involves the appointment of local and general procedures in order to transition the disease from the active phase to the stable one. At the same time, the loss of hard dental tissues will be stopped.

If the enamel has already been worn away, then the following are prescribed:

In case of erosion, filling a tooth will not always be effective, since a violation of the adherence of the filling material may occur, which can lead to the formation of a defect around the filling itself.

It's easier to prevent than to stop later

Unlike caries, the formation of erosion is not associated with non-compliance with hygienic measures for oral care.

However, this disease can lead to the development of a carious process.

For prevention purposes, you should follow some rules:

To prevent the development of tooth enamel erosion, treatment must be timely and of high quality. After the transition from the active to the stabilized phase of the disease, the patient should undergo systematic monitoring by a specialist.

Wedge-shaped defect causes

We have figured out how the disease develops, but this cannot be its main cause. After all, all people’s teeth are subject to stress and wear, and dentists do not often discover a wedge-shaped defect; treating this defect is not an easy task. The main cause of the disease, it turns out, is impaired occlusion, or malocclusion. Only a few of those who have it turn to dentists with a problematic bite and a desire to correct it. The rest (and this is more than 90% of the world's population) live to a ripe old age, not even suspecting that they have imperfect occlusion. Almost everyone cares about the appearance of their teeth, but few worry about whether they are functioning properly. It all starts with the bite: due to deviations in its structure when chewing, the load on different teeth can vary significantly. Teeth that are exposed to heavy loads wear out faster and flat areas form on their surface. When food gets onto these areas, it cannot be cut, but must be crushed, which means greater effort and subject the enamel to more serious stress. The enamel cannot withstand the increased load, cracks and chips, and as a result a wedge-shaped defect, wedge-shaped caries, is formed.

Clinical manifestations of dental hyperesthesia

Severe pain in the teeth can occur when eating sour, sweet, cold or hot foods, as well as drinks. During an exacerbation, outbreaks of acute toothaches can be caused even by a flow of cold air. The nature of the pain varies greatly, from mild and insignificant (such pain does not interfere with normal life), to severe discomfort during the active manifestation of the syndrome.

With a slight level of hyperesthesia, the teeth react only to extreme cold, for example, when drinking ice cream or cold drinks. With an average degree of complexity, irritability begins to manifest itself not only during exposure to temperatures, but also from various chemical irritants. At this stage the pain is still not very strong. Deep damage to tooth enamel leads to hypersensitivity; at this stage, dental nerves begin to actively react to anything: chemical reagents, temperature changes, and even tactile influence. The pain is severe and can last for quite a long period. Also, at this stage there is increased salivation; the patient can experience an unpleasant sensation not only when eating, but even when talking simply. The patient tries to prevent his cheeks from touching his teeth, which makes his face look awkward.

Brushing your teeth in the last stage of hyperesthesia is extremely painful, so normal oral hygiene becomes simply impossible. Lack of proper care leads to plaque, in turn, plaque provokes the active development of caries, gum inflammation, etc. Thus, if the disease is not cured at its initial stages, then the advanced form can lead to the progression of other diseases of the teeth and oral cavity.

A dentist examines the oral cavity to determine the degree of sensitivity of tooth enamel to various irritants, and based on the results of this analysis, a specific treatment regimen will be prescribed. If it turns out that tooth hypersensitivity arose as a result of mechanical damage, then treatment (filling, installation of dental crowns, etc.) is guaranteed to lead to the disappearance of all painful symptoms. At the same time, it is necessary to carry out professional treatment of the entire surface of the mouth, as well as localization of carious lesions.

One of the methods for treating this disease is the use of drugs that compact or rebuild the dentin structure. They form compounds that clog the dentinal tubules and strengthen them. Such products are used by applying (available in the form of varnishes or gels) to the surface of the tooth. The procedure must be repeated daily, due to which a high degree of fluoridation of hard tooth tissues is achieved. As a result, the response to various external stimuli becomes much less pronounced.

The second method of treatment is therapy aimed at reducing the overall sensitivity of the nerve endings located in the dentin tubules. In this case, drugs with a high content of calcium salts are used; as a result of their action, calcium ions diffuse into the tubules, and they suppress the sensitivity of nerve endings. A kind of protective shell is created around them, which prevents further transmission of nerve impulses.

Oral care for dental hypersensitivity

To care for the oral cavity, you can purchase special products that, when used regularly (daily), can suppress or completely eliminate unpleasant sensations, as well as prevent the further development of hyperesthesia with a more pronounced pain syndrome. Most often, these are special medicated toothpastes. Be sure to consult your dentist!

Additionally read:

Why teeth are sensitive: pain mechanism

To explain why sensitivity occurs, we need to understand a little about the structure of the tooth. There is enamel on its surface, it is very durable and reliable. Enamel protects dentin. It contains microtubules with passing nerve endings. As long as the tubes are closed, you do not feel any discomfort. But if the enamel is damaged or thinned, the dentinal tubules are no longer adequately protected and the nerve endings become exposed, causing increased sensitivity. Sometimes the tooth reacts not only to temperature changes and aggressive food, but even to pressure changes and just air. Receding gums and exposed roots can also increase sensitivity.

The severity of discomfort depends on the degree of damage to the enamel and access to nerve endings, as well as on the personal characteristics of the body.

Causes of sensitivity

Dental problems. Caries, the presence of cracks, erosion, increased abrasion of the enamel, wedge-shaped defects, gum atrophy with root exposure, periodontitis - all this can lead to the development

sensitive

Endocrine diseases. Metabolic disorders and thyroid disease can lead to hyper

sensitive

Other diseases. Diseases of the gastrointestinal tract, infectious diseases, and psychoneuroses can lead to discomfort.

Pregnancy, menopause. Changes in hormonal levels can also cause disturbances in the metabolism of minerals in the body. The problem can be solved by taking dietary supplements and mineral and vitamin preparations.

Nutrition. Due to an unbalanced diet, the body may not receive important vitamins and minerals. Also

increase

sensitive

This may include eating too acidic foods or carbonated drinks. Very cold or hot food is harmful. Eating cold and hot food at the same time can lead to cracks in the enamel.

Improper oral hygiene. Wrong selection of toothbrush and toothpaste. Poor cleaning quality

ov. Using traumatic elements to remove food particles.

Mechanical damage. Chewing/biting off excessively hard objects or foods (nuts, seeds, habit of chewing stationery pens, etc.).

Sensitivity may also occur after visiting the dentist. This condition can be caused by mild inflammation of the pulp. If the discomfort does not go away after one week, you should definitely visit a doctor. In this case, alarming signals are prolonged sensitivity of only one tooth (which was manipulated).

Diagnosis of the causes of the disease

Increased sensitivity is usually just a symptom. For therapy, it is necessary to determine the exact causes of occurrence. First, the dentist conducts a thorough examination of the oral cavity. If there is damage to the enamel, erosion, caries and other dental causes, the doctor will immediately detect this. In the absence of these, the reasons must be sought in the general condition of the patient. To do this, the doctor may advise you to contact a therapist or endocrinologist to conduct an examination for the presence of diseases. A course of treatment is prescribed after the causes have been established.

Increased tooth sensitivity: treatment

Treatment is complex and depends on the picture of the disease. Typically therapy includes several components:

therapeutic measures to restore the processes of mineralization of enamel and dentin (taking vitamin and mineral complexes: phosphorus, calcium, fluorine, magnesium);

restoration of phosphorus-calcium metabolism in the body (normalization of nutrition, intake of dietary supplements, mineral complexes);

the use of specialized varnishes, gels that act as a protective film on the enamel,

increases

its protective functions;

use of personal hygiene products at home (special toothpastes, rinses, mineralizing gels) until normal

sensitive

As mentioned above, the cause of sensitivity is first determined and, based on it, treatment is carried out. The price of therapy in Moscow varies depending on the chosen method. In some cases, treatment consists solely of restoring the enamel and integrity of the tooth, while in others it requires treatment of internal diseases of the body.

Prevention of tooth sensitivity

Selecting a brush of medium hardness that will not injure tooth enamel and gums.

Avoiding toothpastes with

elevated

the amount of abrasive particles that leaves scratches on the enamel.

Usage

special

pastes and mouth rinses with fluoride and calcium.

without any extra effort, using the correct cleaning technique.

Getting rid of the habit of chewing objects (pencils, pens, cocktail straws, etc.).

You should not crack nuts, crack seeds, avoid all overly hard foods.

Regular oral hygiene (cleaning

ov twice a day, use

thread, mouth rinse after meals).

Adjustment of nutrition, avoidance of excessive diet

x and cold dishes, sour, sweet.

Preventive examination by a dentist every six months, professional oral hygiene.

Our clinic in Moscow offers highly effective procedures to restore normal tooth sensitivity at reasonable prices. The price of treatment depends on the clinical picture of the disease and the necessary measures. Detailed information on the procedure, as well as prices, can be obtained from the managers of our company. Contact us!

What interesting things can you learn in the section about dentistry?

Modern dental medicine is constantly developing; new products, medicines, and devices for treatment and diagnostics are introduced every year. The situation even 20-30 years ago cannot be closely compared with modern achievements in dentistry. Going to the dentist is less and less associated with something unpleasant; on the contrary, patients all over the world are increasingly aware of how important healthy teeth are today.

Now it has become possible to make the most accurate diagnosis using the latest diagnostic equipment, to increase or completely restore a lost tooth, to solve complex problems of the jaw and facial bones, to get rid of periodontal disease and other painful problems. In addition, even pets now have their own dentists - clinics dealing with oral diseases of our little brothers are opening all over the world. You can find out about the news of advanced trends in modern dentistry, new inventions, how to treat and who to contact in case of pathologies on the pages of our portal.

Types of dental care

There is a wide range of dental specialties, each of which treats a specific type of pathology. Among these areas:

• therapy;
• orthopedic dentistry;
• orthodontics;
• periodontics;
• surgery (including maxillofacial);
• aesthetic medicine.

The goal of restorative dentistry is to combat widespread dental problems using non-surgical methods. Such diseases include:

1. non-carious enamel lesions (including, for example, tissue necrosis, enamel erosion, dental trauma, abrasion due to malocclusion, hypoplasia and many others);
2. caries and all carious complications;
3. diseases of the mucous membrane, the most common of which is stomatitis in various forms.

Caries is the most common dental disease. To prevent it, you need to regularly follow the rules of oral hygiene. If dental care is insufficient, and the body is subject to stress, if too many foods are consumed that destroy tooth enamel, dark spots appear on the teeth. If they are not removed in a timely manner, holes and holes may appear, and the lesion will gradually grow, touching new areas.

Dentists treat all forms of caries, but treatment in more advanced stages, when depulpation is required, is much more difficult.

Periodontal problems and tartar removal

Periodontitis and tartar are two more serious problems that can worsen a person’s quality of life. In the case of periodontitis, the normal tissue structure is destroyed, which leads to bleeding and possible tooth loss. With tartar, plaque, which accumulates on the walls of the teeth, hardens and turns into a fossilized form. These diseases have a very serious impact on well-being; they make the oral cavity open to the emergence and rapid development of a number of infections. By the way, today these diseases, which once traditionally tormented people of mature age, have become noticeably “younger”.

However, modern medicine offers many ways to eliminate these problems. Laser treatment and ultrasound treatment are available today. In addition, by observing basic hygiene rules every day and leading a healthy, fulfilling lifestyle, you will minimize the risk of such ailments.

Orthodontists specialize in correcting oral problems and typically treat children as their patients, but more and more adults are now seeking this treatment. Bite correction and teeth correction are effective and efficient. The use of braces and removable aligners in the best clinics is carried out after careful diagnosis and computer modeling of the correction process.

Orthopedics deals with the restoration of natural beauty using artificially created prostheses. In modern orthopedics, not only old (and not always effective) methods are used, such as installing bridges and crowns, but also implantation, which can be one-stage or stage-by-stage.

Also used, for example, are clasp dentures, veneers, removable dentures, which are strengthened by various devices, including special ointments.

Aesthetic dentistry

The most popular type of aesthetic dentistry today is teeth whitening. To get that same “Hollywood smile,” laser therapy is used today, providing painless teeth whitening in just a few short sessions.

Other types of aesthetic correction also include shape restoration and extensions, the addition of veneers, onlays, as well as such special types of procedures as decoration with rhinestones or jewelry.

ID: 2016-06-5-A-6685

Original article (loose structure)

Aidemirova M.A., Petrova A.P.
Scientific supervisor: candidate of medical sciences, associate professor Firsova I.V., associate Lebedeva S.N.

GBOU VPO Saratov State Medical University named after. IN AND. Razumovsky Ministry of Health of Russia Department of Pediatric Dentistry and Orthodontics.

Summary

Summary. This article discusses the factors contributing to the development of erosive dental defects, their pathogenesis, as well as the impact of erosion on the quality of life of patients.

Keywords

Key words: erosion, non-carious lesions of teeth, abfraction.

Article

Introduction. Currently, dental erosion occupies a significant place among diseases of hard dental tissues. There are many opinions about the origin of erosive defects, and this issue has not been fully studied. This topic gives rise to a lot of controversy and questions among scientists and doctors, and therefore requires more attention. Research results indicate a significant increase in the prevalence of dental erosion in the last 10 years. Thus, when examining a population group, 47.2% of people with dental erosion were identified, while 10-15 years ago there were no more than 5-7% of such patients. When analyzing the frequency of non-carious dental lesions, based on patients’ visits to the dental clinic, 29.5% of people with dental erosion were identified. Meanwhile, 10-15 years ago there were only 24 such patients. Moreover, the disease was observed mainly in women (84.9%) aged 25-30 years. The combination of erosions with hormonal disorders (including dysfunction of the thyroid and gonads) accounted for more than 75% of cases.

Objective: to analyze literature data on the etiology of erosive defects and their impact on the quality of life of patients.

1) characterize the hypotheses of the origin of erosions of hard dental tissues

2) to study the mechanism of occurrence of erosions of enamel and dentin

3) assess the quality of life of patients with erosive dental defects

4) create a draft treatment plan for patients suffering from erosive dental changes.

Materials and methods: scientific articles and works, domestic and foreign scientific literature on dentistry were analyzed, clinical cases of erosion of hard dental tissues of varying severity of the pathological process were analyzed.

Results and discussions. Erosion of hard tissues (erosion) (from the Latin erosio - “corrosion”) is the progressive loss of tooth enamel and dentin. In foreign literature, both narrow terms are used: “attrition”, “abrasion”, “erosion”, “abfraction”, and broader ones: “toothwear” and “tooth surface loss”. In European literature, the most common point of view is that erosion is a more important factor in the loss of hard dental tissues than abrasion due to contact of tooth surfaces. Occurs after teething. The affected area can be located on the vestibular and palatal surfaces and has a round, cup-shaped shape with dense, smooth, flat edges. This is a differential diagnostic feature when making a diagnosis. The upper incisors are primarily affected, less commonly the canines and premolars. It is extremely rare that erosions occur on the teeth of the lower jaw. Probing and percussion are painless. EDI 2-4 µA. The oral mucosa is without visible pathological changes.

2. The causes of erosion have not been clearly established.

According to ICD-10, the pathological condition of hard dental tissues is divided into two large groups:

· “Disorders of development and teething”

· “Other diseases of dental hard tissues.” K03

Tooth erosion refers to diseases of the hard tissues of teeth. K03.2

K03.2 Tooth erosion:

K03.20 Professional;

K03.21 Caused by persistent regurgitation or vomiting;

K03.22 Due to diet;

K03.23 Caused by drugs and medications;

K03.24 Idiopathic;

K03.28 Other specified dental erosion;

K03.29 Dental erosion, unspecified.

The first four causal factors of this classification reflect the chemical theory of the development of dental erosion present in the medical literature of previous years, which in turn considers the impact of aggressive chemical agents on the enamel as the leading causes:

I. External factors:

1) type of diet: consumption of acid-containing foods and drinks (marinades, pickles, citrus fruits, fruit and berry juices, sweet carbonated drinks, etc.)

2)work in hazardous industries associated with inhalation of acid fumes, metal and mineral dust particles

3) The effect of a number of medications on tooth enamel, for example, acid (acetylsalicylic and ascorbic), gastric juice preparations, hydrochloric acid.

II. Internal factors:

4) Dental erosion can be caused by chemically aggressive contents of the stomach and duodenum with a low pH content in chronic gastroesophageal regurgitation that occurs with gastroesophageal reflux disease, as well as with combined duodeno-gastroesophageal reflux disease. Erosive lesions are observed in individuals with hiatal and diaphragmatic hernias and those suffering from bulimia.

Damage from internal factors usually occurs on the palatal surfaces, and from external factors - on the buccal surfaces.

D. A. Entin saw the cause of erosion in neurodystrophic processes that cause decalcification of hard tooth tissues. However, no one can explain why erosions occur in some cases and wedge-shaped defects in others. Their occurrence may be associated with a violation of mineral metabolism due to endocrine or other disorders in the body and, accordingly, in the dental pulp. This is confirmed by the results of clinical observations and data from radioimmunological studies, which indicate the presence of clear preceding and concomitant dysfunctions of the thyroid gland in patients with erosions of dental enamel. Thus, Yu. M. Maksimovsky et al., analyzing the causes of erosions, assign an important role to endocrine disorders and, above all, hyperfunction of the thyroid gland. It was noted that dental erosions in patients with thyrotoxicosis were detected 2 times more often than in persons with normal thyroid function; a direct connection was established between the intensity of dental damage and the duration of thyrotoxicosis. As the duration of the disease increases by 1 year, the number of patients with erosion of hard dental tissues increases by 20%.

Dr. Kim McFarland, a dental surgeon and professor at the College of Dentistry at the University of Nebraska Medical School in Lincoln, USA, notes an increase in the number of patients with erosion of tooth enamel over the past 25 years, which is associated with uncontrolled consumption of carbonated sugary drinks.

A number of researchers (Baume, Port and Eidler) associate tooth erosion with excessive mechanical stress on the enamel, namely the use of hard toothbrushes, whitening toothpastes and powders with increased abrasiveness, as well as improper brushing techniques - the predominance of horizontal movements.

The combination of several predisposing factors accelerates the course of erosion and aggravates its severity. For example, drinking large amounts of very low pH drinks causes tooth surface loss when combined with brushing immediately after an acid attack on the teeth.

Yu. M. Maksimovsky details the clinical manifestations of erosions and distinguishes three degrees of damage, based on the depth of the hard tissue defect:

I degree (superficial, initial) - with damage to only the upper layer of enamel

II degree (medium) - with damage to the enamel throughout the entire depth up to the enamel-dentin border.

III degree (deep) - with damage to the entire enamel and the upper layer of dentin.

E.V. Borovsky et al., distinguish two stages of damage: initial (enamel erosion) and severe (enamel and dentin erosion).

In degrees 1 and 2, the lesion is white with a shiny surface; in degrees 3, brown or light yellow pigmentation appears.

Dental erosion is usually characterized by a chronic course, but there are two clinical stages of erosion: active and stabilized.

The active stage is characterized by a progressive course and loss of tooth tissue, accompanied by hyperesthesia and the disappearance of the shine of the erosion surface. In the active phase, changes in the size of erosion occur every 1.5-2 months.

The stabilized form of erosion of hard tooth tissues is characterized by a calmer, slower course, and the shiny surface of the enamel in the affected area is preserved. There is no change in its size for 9-11 months. A transition from a stabilized form of erosion to an active one is possible, especially if the background pathology worsens.

3. Pathogenesis

Unlike dental caries, where there is superficial, subsurface demineralization of the enamel, during erosion, superficial foci of demineralization are formed, which gradually cover the tooth enamel layer by layer. The microhardness of the enamel in the area of ​​erosion is significantly reduced, and foci of demineralization of the enamel surface are noted. When studying the ultrastructure of enamel during tooth erosion using a scanogram, it was noted that the enamel in the area of ​​erosion and in adjacent areas is characterized by a reduced degree of mineralization and the presence of destructive changes: in some areas, enamel prisms are clearly visible, interprismatic spaces are pronounced, and in others, enamel prisms and interprismatic spaces indistinguishable due to demineralization. Hydroxyapatite crystals of various shapes. In areas adjacent to erosion, they do not have clear boundaries or have a regular shape, but are large. Crystals of enamel hydroxyapatite with varying densities are visible on the surface of the enamel, indicating uneven mineralization. There are also distinct changes in dentin during tooth erosion: areas with a dense arrangement of crystals are observed. Dentinal tubules can be obliterated or non-obliterated. The structure of the substance that obliterates the dentinal tubules is specific and close to that during abrasion, however, along with the indicated areas of demineralization, accumulations of bacteria were found that mask the contours of the enamel prisms.

Comparative electron microscopy (SEM) of the central erosion zone also showed the presence of significant structural changes in both the superficial and deeper layers of damaged dental tissue. The active stage of the process is characterized by the loss of both enamel substance and dentin in large areas that have undergone destructive changes.

In the cervical region of teeth with erosive defects, an intermittent but quite clearly visible boundary between the crown and root is visible. In all studied cases, the crown enamel was layered on the root cement.

4.Quality of life of patients with dental erosion.

Enamel is the protective shell of the tooth. The process of enamel erosion is irreversible and creates problems for a person for life.

Patients complain of aesthetic defects, the presence of a defect in the cervical area, tooth sensitivity, and tissue loss.

According to our data (based on the number of visits to the clinic), about 15% of patients are aged 16-42 years.

We observed 3 patients with varying degrees of dental erosion.

1) Patient A., 23 years old; preliminary diagnosis: dental erosion, stabilized form; mild severity according to ICD-10 K03.2. Complaints about dissatisfaction with the color of teeth. Objectively: on the vestibular surface in the cervical area of ​​1.1 and 2.1 teeth there is a defect affecting only the upper layer of enamel, the oral cavity is sanitized, the oral mucosa is without pathological changes, IG - 1.7 (satisfactory).

History: consumption of freshly squeezed citrus juices, professional cleaning with Air-flow 2 times, tried to use whitening toothpastes.

2) Patient K., 28 years old; preliminary diagnosis: active stage of dental erosion, moderate to severe degree according to ICD-10 K03.22

Complaints about tooth sensitivity, aesthetic defects, yellow teeth.

Objectively: on the vestibular surface in the cervical region of 1.1 teeth there is a pronounced defect within the enamel and 2.1 teeth with damage to the entire enamel and the upper layer of dentin. The oral cavity is sanitized, the oral mucosa is without pathological changes IG-2.2 (unsatisfactory).

History: consumption of citrus fruits, incorrect selection of oral hygiene products and items, incorrect method of brushing teeth with a predominance of horizontal movements.

3) Patient L., 42 years old; preliminary diagnosis: active form of dental erosion, severe degree according to ICD-10 K03.21

Complaints about the presence of defects in the cervical area, tooth sensitivity and aesthetic defects.

Objectively: erosive defects in the frontal group of teeth of the upper and lower jaw, in the cervical area there are lesions of brown pigmentation. The oral cavity is sanitized, the oral mucosa is without pathological changes, IG-1.6 (satisfactory)

History: occupational hazards, chronic gastroesophageal regurgitation, traumatic occlusion, crowded teeth.

Thus, regardless of the severity of erosion, the quality of life of these patients suffers to one degree or another. Even if practically nothing bothers the patient at first, in the future, in the absence of correction of etiological factors and specialist interventions, the symptoms increase like an avalanche (according to patients with more pronounced defects), which forced us to try to create an algorithm for treatment and preventive measures (draft treatment plan) for this group patients.

Enamel erosion is not just an external problem, but a serious disease, and therefore the attitude towards treatment is no less serious.

• A thorough ascertainment of the patient’s history and current condition with the involvement of related specialists (therapist, gastroenterologist, endocrinologist, pediatrician, etc.), gastronomic preferences, and characteristics of professional activity will significantly identify the possibility of correcting patient-dependent factors or, at a minimum, recording them in the outpatient dental record. sick.
• Treatment of patients with erosion should be comprehensive and long-term.
• Strict diet (except citrus fruits, berries, sweets, carbonated drinks, fresh juices containing vitamin C, canned foods). Include protein in your diet to strengthen the protein matrix of enamel and collagen fibers.
• Select products (pastes containing organic calcium, with hydroxyapatite) and hygiene items (correction of the rigidity and structure of the brush bristles, excluding the use of toothpicks), as well as teach the correct method of brushing teeth (vertical movements).
• Remineralizing therapy (Rocs medical minerals gel, Remars gel, Clinpro™ White Varnish,) Tooth Mousse, “Belagel Sa/R” “VladMiVa”) in a clinical setting in the form of applications and mouth guards (preferably individually). At home daily, possibly constantly, but necessarily regularly, depending on the degree - in-office in combination with fluoride applications to prevent concomitant caries and to strengthen the crystal lattice of hydroxyapatite.
• Avoid ultrasonic teeth cleaning, home and professional whitening, and Air-Flow teeth cleaning.
• For professional hygiene, use pastes with minimal abrasiveness “fine”.
• Restoration if necessary, after complex treatment. It is possible to use the Icon technique, as well as the use of a desensitizer (SHIELD FORCE PLUS).
• clinical examination with photographic recording of the result.

1. In the etiology of erosion of hard dental tissues, the following factors interact: exogenous (occupational hazards, dietary habits) and endogenous factors (metabolic disorders, endocrinopathies, bruxism, diseases of the gastrointestinal tract) in combination with improper oral care.

2.The main mechanism is demineralization of the enamel.

3. Regardless of the severity of erosion, the quality of life of these patients suffers to one degree or another. Even if at first there is practically nothing bothering the patient, in the future, in the absence of correction of etiological factors and specialist interventions, the symptoms increase like an avalanche.

4. The algorithm of treatment and preventive measures for this group of patients should include:

Correction of both external and internal etiological factors;

Specialized treatment by a dentist before the required restoration with the use of remineralizing and fluoride-containing drugs up to restoration (using filling materials from the group of compomers or GIC);

Your rating: No

Tooth erosion is the gradual abrasion and destruction of tooth tissue of unknown etiology.

Some scientists believe that the cause of tooth erosion is purely mechanical, others - the influence of acidic foods and drinks, and thyroid dysfunction. But they all agree on one thing - this is not just a cosmetic defect, but a disease. And since this is a disease, it needs to be treated. What is dental erosion? This is damage to the enamel and dentin (the bone material that forms the basis of the tooth). Erosion of tooth enamel looks like a rounded or oval notch, located in the center of the tooth. It is simply necessary to treat erosion, otherwise the tooth will lose all its enamel and even part of its bone tissue. Over the past 20 years, this disease has become much younger and has begun to progress. It is important to visit the dental office regularly, because... At first, tooth erosion does not cause pain.

Causes of tooth erosion

Often, tooth erosion is a consequence of diseases of the endocrine system (increased thyroid function, diffuse toxic goiter, thyrotoxicosis). This is when, with very strong salivation, the thickness of the liquid in the oral cavity is greatly reduced.

Also, tooth erosion can be caused by mechanical factors (for example, too hard a toothbrush), frequent consumption of juices and citrus fruits, pickles and marinades. The risk group also includes people who work in hazardous industries where there are acid fumes or metal dust in the air. Long-term use of medications high in vitamin C can also cause dental erosion.

Symptoms of tooth erosion

Erosion is a rounded or oval damage to the enamel, which can be symmetrical, but over time the symmetry disappears. It may also have an irregular shape. It has a smooth, hard and shiny surface. Tooth erosion occurs slowly, sometimes lasting decades.

Dentists identify the following clinical symptoms of dental erosion:

• the appearance of increased sensitivity of teeth;
• the appearance of toothache when you brush your teeth, from cold, hot drinks or food;
• If the modified area of ​​the tooth is smeared with iodine, it will turn brown.
• the affected part of the tooth begins to become pigmented;

Several degrees of erosion can be distinguished:

1. Initial is when the upper layers of enamel suffer;
2. Medium – the entire thickness of the tooth enamel is affected;
3. Deep - not only the enamel is affected, but also the upper layers of dentin.

Erosion of hard dental tissues

Erosion of hard dental tissues is found equally symmetrically on the central and lateral incisors of the upper teeth, and in addition to this on the canines and small molars of the upper and lower jaws. Very rarely, erosion is located on the lower teeth.

Mostly middle-aged people suffer from dental erosion. The disease progresses very slowly. If you have caries, and then tooth erosion occurs, then caries will progress. Changes begin in the upper layer of enamel, where large hollow areas can be diagnosed. Treatment - a solution of 3% remodent, a course of 15-20 procedures. A type of erosion of hard dental tissues is hyperesthesia, which is when teeth react to temperature changes, chemical and mechanical influences. How to fight? Use 1-2% sodium fluoride solution. About ten sessions are required.

Treatment of tooth erosion

Of course, treating dental erosion is a rather lengthy process. The simplest thing you need to do is stick to a specific diet. For you, in general, you just need to reduce the use of citrus fruits, fruit juices, and soda. Try to take food and drink warm, not hot, because... low temperatures are less harmful to teeth. Every time after eating, rinse your mouth, use chewing gum, it will only freshen your breath, but also increase salivation. Buy fluoride toothpaste.

If tooth erosion has already gone too far, then you need to turn to drug treatment. In any case, the treatment of dental erosion will depend on the stage of the disease. If the stage of the disease is active, then the main task will be to stabilize the process. To do this, you need to mineralize your teeth. In order to replenish the hard tissues of the tooth with calcium and phosphorus, paste applications should be made for three or four days, lasting 15-20 minutes. For another three days, fluoride gel is applied to the affected area for 2-3 minutes. At the end of the procedures, fluoride varnish is applied. If you are prescribed the application method, you will need to undergo at least 15 procedures.

It is very good to carry out an electrophoresis procedure with a ten percent solution of calcium gluconate for tooth erosion. After the procedure, it is necessary to apply a tampon with 2% sodium fluoride solution. Treatment using electrophoresis will amount to twenty procedures.

During dental treatment the following is prescribed:

• calcium salt - 0.5 g 3 times a day for 1 month;
• klamin (1-2 tablets) or phytolon (30 drops) - 2-3 times a day 15 minutes before meals for 1-2 months;
• multivitamins kvadevit or complivit - 3-4 tables. a day after breakfast.

Many experts believe that filling is ineffective in case of tooth erosion, because... pathologies of the border adhesion often occur. If you decide to have a filling, pay attention to some points. Before the filling procedure, it is necessary to demineralize the hard tissues of the tooth with a solution of 10% calcium nitrate and aluminum acid phosphate. Composite substances should be used for filling. Calcium gluconate 0.5 g is prescribed orally three times a day for a month.

Surgical treatment of dental erosion

Long gone are the days when dental surgery only served to remove diseased teeth. Tooth extraction is now only part of the practice of dental surgery. Its main activity is aimed precisely at preserving the tooth. In modern clinics, much attention is paid to so-called tooth-preserving operations. These include removal of various formations in bone and soft tissues, removal of tooth roots. It is possible to treat dental erosion with laser. There is excess moisture in the affected teeth; with the help of a laser, excess moisture can be removed from the tooth, after this operation the enamel will be significantly thickened. The laser disinfects the tooth. With laser treatment, there is no possibility of affecting healthy tissue or causing infection. If you are allergic to anesthetics, laser treatment does not require pain relief.

Treatment of dental erosion in traditional medicine

Many people suffering from dental erosion prefer to turn to traditional rather than traditional medicine. Traditional methods can successfully eliminate pain, strengthen enamel and gums, but they rarely treat the very cause of the disease. Traditional medicine offers many different recipes. We present to your attention some of them.

Eggplant

We don't need the whole eggplant, but only its peel. It needs to be washed and dried well. Then grind into powder. 1 tbsp. pour 200 ml of powder. Boil water and let it brew. Store in the refrigerator, use to rinse the mouth every time after meals.

Oak bark

Oak bark is known as an excellent antimicrobial and tanning agent. 1 tbsp. crushed and dried oak bark is poured with a glass of boiling water and brought to a boil. Then reduce the heat and simmer the broth over low heat for 5-7 minutes. We rinse our mouth with the resulting decoction 2-3 times a day.

Tea tree oil

In addition to the fact that tea tree oil strengthens and reduces pain, your breath will become fresh. How to use: take a glass of warm water and dilute 3-4 drops of tea tree oil in it. You need to rinse your mouth 3 times a day.

Prevention of tooth erosion

First of all, it is necessary to establish the etiology of the erosion. If the main etiological factor is food, then it is necessary to reduce the consumption of foods that may contain acid. If you are a big fan of lemon water, soda, or fruit juices, then you need to drink them quickly or through a straw. Take note that among natural juices, blackcurrant juice is very harmful to teeth with erosion. The most gentle juice is apple juice.

• Choose the right oral hygiene products. Use 1% fluoride gels with a neutral pH 2 times a week.
• Eat cheese after meals because cheese neutralizes the acidity of food.
• You should not brush your teeth immediately after eating, wait about half an hour.
• Choose a toothpaste with a low grinding result.
• For oral hygiene, choose brushes with soft bristles, brush your teeth with light circular movements, the front teeth should be brushed from top to bottom, from the inside to the outside.
• Modern dental clinics have a wide selection of sealants that can protect against tooth erosion.
• Be sure to check with an endocrinologist. 75% of tooth erosion is caused by diseases of the thyroid gland with increased function.
• Refuse the whitening procedure, it violates the integrity of the enamel.
• Drink warm tea, not boiling water. Include fish dishes in your diet, because they are rich in phosphorus and calcium, which are good for tooth enamel.
• You shouldn't skimp on buying a quality toothbrush. New toothbrushes should be purchased every 2-2.5 months, so that the brush does not become a breeding ground for all kinds of infections.
• Visit your dentist every six months to have your teeth coated with fluoride film. It protects against further destruction of the enamel and also prevents the leaching of calcium.

Erosion of tooth enamel is a serious dental disease that requires mandatory treatment. First there is a change in the color of the enamel, then damage occurs. Erosion leads to the complete destruction of one or more teeth. The disorder develops unnoticed by the patient, but is easily diagnosed by the dentist during examination. For a preventive examination of the oral cavity, each person is recommended to visit the dentist 2 times a year to avoid the development of dental erosion.

Those who adhere to this rule have the opportunity to receive qualified dental care on time. Timely treatment, when tooth enamel erosion is just beginning to develop, often gives a positive result.

Non-carious lesions on the surface of teeth are found everywhere in modern dentistry. In this disorder, tooth enamel is destroyed and, in rare cases, dentin is affected. Visually, tooth enamel erosion appears as an oval defect on the outer surface.

Gradually, the neoplasm expands and destroys the lower layers of dental tissue. Hard tissue problems are often more serious than superficial erosion. Without qualified therapy, the disorder quickly spreads and destroys enamel.

Patients often consider dental erosion as an aesthetic defect. In reality, this is a disease that requires proper diagnosis and treatment, leading to the destruction of tooth enamel.

The disease spreads sequentially. At the initial stage, the enamel disappears quickly, sensitivity to hot and cold food increases, when brushing your teeth, pain occurs. In the next stage, teeth decay more slowly. Therefore, people have the illusion of recovery. Decayed teeth gradually darken.

Tooth erosion is classified as follows: initial, intermediate, hard.

The disorder often spreads to the premolars and front teeth. The disease rarely manifests itself at an early stage; it is during this period that treatment is easy and painless. You need to visit your dentist regularly.

Causes

Enamel erosion is diagnosed more often in people who do not observe the rules of personal dental hygiene. The exact provoking factors of the disease have not yet been established. Experts believe that the appearance of changes in enamel can be facilitated by:

• Strong mechanical impact on teeth. The habit of chewing seeds or nuts, nails, constant use of toothpastes with abrasive additives and teeth whitening with baking soda can lead to damage to the enamel.

• Eating highly acidic foods. An aggressive environment is created in the oral cavity, which destroys the enamel. This is a chemical effect.
• the body can also contribute to the weakening of the enamel.

• Medicines, medicines, uncoated tablets, powders have side effects on the patient’s body.
• Missing several teeth or create excessive stress when eating food. The enamel wears out and does not have time to recover.

• Bad ecology. In the workshops of some industries, the air is saturated with suspended particles of metal, acid or other harmful substances. When inhaling, all this passes through the workers’ mouth.

The causes of tooth erosion may vary; it is important to diagnose the disease in time and begin treatment to avoid irreversible processes.

Risk factors

The work of all human organs is interconnected. Based on this, doctors believe that gastric ulcers or high acidity are directly related to the occurrence of erosion on the enamel.

Hormonal disorders of the body and diseases of any endocrine glands lead to deformation of the tooth surface. Lack of calcium in the body leads to osteoporosis and enamel destruction.

The likelihood of erosion is increased by the following factors:

• Pregnancy, if there is a complication of intoxication.

• Radioactive background of the area or the consequences of radiation therapy.
• Addiction to alcohol.
• Vegetarian diet. When a large amount of sour citrus fruits and fruits are constantly consumed.

• Electromagnetic radiation. Working with a computer and other devices with a weak degree of protection.
• Work in enterprises with hazardous working conditions.
• Sour drinks and juices are consumed without a straw.

Consequences

Enamel erosion rarely occurs in children. Middle-aged people belong to the main category of patients. Treatment of the disease should not be delayed, because the development of enamel erosion leads to negative consequences:

• teeth quickly wear out or wear out;
• dark spots appear, covering an increasingly larger area over time;
• the color of the edges of the teeth becomes transparent and thinned;
• the patient feels pain when eating hot or cold food.

Erosion without treatment spreads in all possible directions. This leads to complete destruction of enamel and dentin. New dental diseases are emerging.

The disease may last for some time without causing any discomfort. With an inexperienced eye, the change in enamel may not be noticeable. When the hard part of the tooth is destroyed, pronounced signs of the disease will appear. The disease is not noticeable. Dull dark spots of round or irregular shape appear on the surface.

In most cases, small molars, incisors and canines are damaged.

Initially, it cannot be said that erosion is present. In the second stage, the disorder reaches the dentin but does not affect it. The defect becomes visually distinguishable. At the last stage, the hard tissue begins to break down, causing discomfort and pain.

Diagnostics

To identify the defect, the tooth enamel is dried with air, then a little iodine is poured onto it. To identify concomitant disorders, patients are offered a consultation with an endocrinologist and gastroenterologist, an ultrasound scan of the thyroid gland is prescribed, and a hormonal analysis is performed.

Erosion must be distinguished from a mild form and a wedge-shaped defect. Erosion is distinguished from caries by location, shape of the lesion and a smooth surface; with caries, the surface becomes rough and uneven. The wedge-shaped defect will be distinguished by its shape and location at the root. Once an accurate diagnosis is established, treatment begins.

This disorder occurs as a result of exposure to harmful microbes in the body. They interact with food debris remaining between the teeth after lunch. Organic acids formed as a result of decomposition negatively affect tooth enamel. As a result, calcium salts are washed away by aggressive acid, and demineralization of the tooth surface occurs after some time.

Tooth enamel is the hardest tissue in the body. It includes minerals, hydroxyapatites, which are sensitive to acids. Therefore, the destruction process starts at a pH level of 4.5.

Without noticeable reasons, caries does not appear. Often, pathological symptoms are the main link in the process of manifestation of carious formations. This could be a deterioration of the immune system, gastrointestinal disorders, or a poor diet. In modern medicine there are approximately 400 theories of the development of this disease, but the main reason is bad.

Therapy

Local and general procedures are prescribed to transfer the disease from the active phase to the stable phase. This prevents the destruction of hard dental tissues.

For erased enamel, local therapy is proposed, including additional treatment with minerals, daily applications of fluoride and calcium-containing products. The course of treatment lasts 2-3 weeks. Finally, the surface of the teeth is lubricated with fluoridated varnish. All these processes remove the increased sensitivity of the enamel to the action of irritants.

It is carried out using calcium electrophoresis. If the tooth is severely damaged, restoration is carried out using a light-curing composite, veneer or crown.

The patient is prescribed medications: calcium, fluorine, vitamins.

General therapy involves continued use of the vitamin complex. To restore color, the affected teeth are polished with a special paste, gently whitened, and fluoride-containing varnishes and gels are applied to the eroded areas.

Filling a tooth cured after erosion is not always effective due to poor fit of the restoration and the formation of a defect around the filling.

Treatment of dental erosion is considered effective if pain disappears during eating and after exposure to cold air.

It should be remembered that the appearance of enamel erosion is associated with internal diseases and aggressive external influences. Therefore, you must adhere to simple rules:

• reduce the consumption of foods and drinks with high acidity;
• remember that hot drinks and food have a negative effect on tooth enamel;
• after meals, use chewing gum without sugar;
• rinse your mouth immediately after eating;
• Hygienic procedures in the oral cavity should be performed with a soft toothbrush, alternating an abrasive one with a regular one;
• Carry out regular dental examinations;
• Do not use pastes with an abrasive or whitening effect.
• do not drink sparkling water or drink only through a straw;
• rinse your mouth after eating. You can use water or antibacterial agents.

It is possible to prevent the development of tooth enamel erosion with timely and high-quality treatment. After the transition from the active to the stable phase of the disease, the patient should undergo regular monitoring by a specialist.

• limit the consumption of ballast products;
• take vitamins;
• Healthy food;
• lead a healthy lifestyle;
• control the intake of hormonal drugs;
• monitor the endocrine and digestive systems.

Let's figure out what you shouldn't eat at the first signs of erosion: sour juices, carbonated drinks, canned food, marinades, fermented foods.

Doctor about tooth enamel erosion - video

Erosion of tooth enamel is an unpleasant disease, but not a death sentence. In medical practice, there are few cases of patients presenting at the initial stage. Timely visits to the dentist and prevention are the main methods of combating the disease. Following all the doctor’s advice helps to avoid severe forms of erosion.

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