Dental erosion in children is a growing concern for many parents today. It happens when the enamel, the outer layer of your child’s teeth, wears away due to acidic foods, drinks, or stomach acids. This can lead to sensitivity, pain, and other dental issues if not addressed early. Understanding the causes, signs, and ways to prevent dental erosion can help keep your child’s smile healthy and bright. Today, our Brisbane dentist will explore how you can protect your child’s teeth from this common problem; be with us.

Definition of Dental Erosion

Dental erosion is the gradual wearing away of the enamel, which is the hard outer layer of the teeth. This occurs when acids from foods, drinks, or stomach acids repeatedly attack the enamel. Unlike tooth decay, which is caused by bacteria, dental erosion is directly linked to acidic substances. Over time, the enamel becomes thinner and can expose the underlying dentin, leading to sensitivity and pain. It’s important to understand that dental erosion is a preventable condition, and knowing what causes it is the first step in protecting your child’s teeth.

Causes of Dental Erosion

Dental erosion happens when the enamel on your teeth wears away due to acids. These acids can come from what you eat and drink or from your stomach. Here are some common causes of dental erosion:

Dietary Habits

Acidic Foods and Drinks: Regular consumption of citrus fruits, soft drinks, sports drinks, and fruit juices can lead to enamel erosion.

Sugary Foods: Foods high in sugar can create an acidic environment in your mouth, contributing to enamel wear.

Frequent Snacking: Constant snacking, especially on acidic or sugary foods, increases the risk of dental erosion because it prevents saliva from neutralising acids.

Medical Conditions

Gastroesophageal Reflux Disease (GERD): This condition causes stomach acids to flow back into the mouth, which can erode enamel.

Frequent Vomiting: Conditions like bulimia or chronic vomiting can expose teeth to stomach acid, leading to erosion.

Lifestyle Factors

Dehydration: Reduced saliva production due to dehydration can increase acid levels in the mouth.

Dry Mouth (Xerostomia): Saliva helps protect teeth from acids. A dry mouth, whether from medications or conditions like Sjögren’s syndrome, increases the risk of erosion.

Brushing Habits

Brushing Too Hard: Using excessive force while brushing can wear down enamel, especially if done immediately after consuming acidic foods or drinks.

Environmental Factors

Exposure to Industrial Acids: Certain work environments with high acid exposure can contribute to dental erosion.

Differentiation from Other Types of Tooth Wear

To understand dental erosion better, it’s useful to differentiate it from other types of tooth wear. Here are the main types of tooth wear and how they differ from each other:

Dental Erosion

• • Cause: Acidic substances (foods, drinks, or stomach acids) dissolve the enamel.
  • Appearance: Smooth, shiny surfaces; often cupped or cratered areas on the teeth.
  • Common Sources: Soft drinks, citrus fruits, sports drinks, and gastroesophageal reflux disease (GERD).

Dental Abrasion

• Cause: Mechanical wear from external objects or habits.
• Appearance: V-shaped notches at the gum line.
• Common Sources: Brushing too hard, using a hard toothbrush, biting nails, chewing on pens, or using toothpicks​.

Dental Attrition

• Cause: Tooth-to-tooth contact, usually from grinding or clenching.
• Appearance: Flat, worn surfaces on the chewing edges of the teeth.
• Common Sources: Bruxism (teeth grinding), which can occur during sleep or due to stress.

Dental Abfraction

• Cause: Flexural forces that cause the enamel to crack.
• Appearance: Deep, narrow V-shaped notches near the gum line.
• Common Sources: Heavy biting forces and bruxism, although the exact cause is still debated.

Prevalence and Epidemiology

Understanding the prevalence and epidemiology of dental erosion helps us grasp how widespread this issue is among children and adolescents. Here’s a detailed look at the global and local statistics, as well as age and gender distribution.

Global and Local Statistics

• Global Prevalence: The worldwide prevalence of dental erosion in children and adolescents varies significantly. Studies show a range from as low as 7.2% to as high as 95%. This wide range is due to differences in study methods, population groups, and diagnostic criteria used across different regions​.
• Local Statistics: In the UK, over 50% of 5-year-olds show signs of dental erosion, and nearly 40% of 15-year-olds are affected. This indicates a significant presence of dental erosion in young populations, necessitating local public health interventions.

Age and Gender Distribution

• Age Distribution: Older children and adolescents tend to have a higher prevalence of dental erosion compared to younger children. This is because dental erosion is a cumulative condition, and the longer teeth are exposed to acidic environments, the more likely they are to erode.
• Gender Distribution: Some studies suggest that boys might have a slightly higher prevalence of dental erosion than girls. However, the difference is not always significant, and both genders are at risk depending on lifestyle and dietary habits​.

Signs and Symptoms of Dental Erosion

Dental erosion is the gradual loss of enamel caused by acid. Here are the key signs and symptoms to watch for:

• Tooth Sensitivity: Increased sensitivity to hot, cold, or sweet foods and drinks.
• Discolouration: Teeth may appear yellow as the enamel wears away, exposing the dentin underneath.
• Rounded Teeth: Edges of teeth may become more rounded and smooth.
• Transparency: Front teeth may start to look transparent near the edges.
• Cracks and Cupping: Small dents or cupping on the chewing surfaces of teeth.

Diagnostic Criteria

Diagnosing dental erosion involves a thorough examination of the teeth and understanding the patient’s habits and medical history. Here are the key steps and criteria used:

• Visual Inspection: Look for signs like smooth, shiny enamel, rounded teeth, or cupping on chewing surfaces.
• Patient History: Check for dietary habits involving acidic foods and drinks or medical conditions like GERD.
• Clinical Tests: Use tools like dental loupes or microscopes to detect early erosion not visible to the naked eye.
• Questionnaires: Assess risk factors by asking about oral hygiene habits, diet, and health issues.
• Monitoring: Take photographs or impressions to compare over time for any progression in erosion.

Aetiology and Risk Factors

Dental erosion in children and adolescents is a complex condition with multiple causes. Understanding these can help in prevention and treatment.

Extrinsic Factors

• Dietary Acids: Consuming foods and drinks high in acids, such as citrus fruits, soft drinks, and sports drinks, can erode tooth enamel.
• Medications: Some medicines, including chewable vitamin C tablets and certain syrups, contain acids that contribute to dental erosion.
• Environmental Factors: Exposure to industrial acids or chlorinated swimming pools can also cause enamel erosion.

Intrinsic Factors

• Gastroesophageal Reflux Disease (GERD): Stomach acids coming into contact with teeth due to reflux can wear down enamel.
• Vomiting: Frequent vomiting, as seen in eating disorders like bulimia, exposes teeth to harsh stomach acids.
• Dry Mouth (Xerostomia): Reduced saliva flow, which can be caused by certain medications or health conditions, decreases the mouth’s ability to neutralise acids.

Modifying Factors

Several factors can modify the impact of acids on dental enamel:

• Saliva: Saliva helps neutralise acids and provides minerals to repair enamel. Conditions that reduce saliva flow increase the risk of erosion.
• Tooth Structure: Variations in enamel thickness and composition can influence how susceptible teeth are to erosion.
• Oral Hygiene Practices: Brushing teeth immediately after consuming acidic foods or drinks can accelerate enamel wear. It’s better to rinse with water and wait before brushing.

Prevention and Management

Preventing and managing dental erosion involves a combination of clinical strategies, preventive measures, and effective communication with both patients and parents.

Clinical Management Strategies

Topical Fluoride Treatments: Applying fluoride varnishes can help strengthen enamel and reduce sensitivity. Fluoride helps to remineralise the enamel, making it more resistant to acid attacks​​.

Restorative Treatments: For teeth that have already experienced significant erosion, dentists might use composite resins, veneers, or crowns to restore the tooth’s structure and function. These restorations protect the remaining enamel and improve the tooth’s appearance.

Regular Monitoring: Regular dental check-ups allow dentists to monitor the progression of erosion. They can use tools like photographs or models to track changes over time and adjust treatment plans accordingly.​

Preventive Measures

Dietary Changes: It is crucial to limit the intake of acidic foods and drinks. Encourage children to drink water instead of soft drinks or fruit juices. When consuming acidic beverages, using a straw can help reduce contact with teeth.

Good Oral Hygiene: Encourage brushing with a soft-bristled toothbrush and fluoride toothpaste. It’s important to wait at least 30 minutes after consuming acidic foods or drinks before brushing to avoid further enamel wear.

Increase Saliva Flow: Chewing sugar-free gum can help stimulate saliva production, which naturally neutralises acids in the mouth. Saliva is crucial for maintaining the pH balance and providing minerals to repair enamel.

Patient and Parent Counseling

Education: Explain the causes and effects of dental erosion to both the child and their parents. Use simple, clear language to ensure they understand the importance of prevention and the steps they can take.

Behavioural Tips: Provide practical advice on reducing acidic exposure, such as rinsing with water after eating or drinking acidic substances and choosing non-acidic snacks.

Support and Encouragement: Encourage parents to model good dietary and oral hygiene habits. Positive reinforcement can help children adopt these practices as part of their daily routines.

The Importance of Regular Dental Check-Ups

Regular dental check-ups are crucial for maintaining your child’s oral health and ensuring their overall well-being. Here are the key reasons why these visits are important:

Early Detection of Issues

• Identifying Problems Early: Regular dental visits allow dentists to catch small issues before they become big problems. This includes spotting early signs of cavities, gum disease, and orthodontic issues like misaligned teeth.
• Less Invasive Treatments: Early detection often means simpler and less expensive treatments. A small cavity can be filled before it requires a more serious procedure like a root canal.

Prevention of Dental Problems

• Professional Cleanings: Even with good brushing and flossing habits, plaque and tartar can build up in hard-to-reach areas. Professional cleanings during check-ups help remove these deposits, reducing the risk of cavities and gum disease​.
• Fluoride Treatments and Sealants: Dentists can apply fluoride treatments to strengthen enamel and use sealants to protect the chewing surfaces of molars from decay​.

Building Positive Habits and Attitudes

• Education on Oral Hygiene: Dentists can teach children proper brushing and flossing techniques and the importance of a healthy diet for maintaining good oral health.
• Reducing Anxiety: Regular visits help children become comfortable with the dentist’s office, reducing anxiety and fear associated with dental visits. This positive experience encourages lifelong dental care habits.

Monitoring Growth and Development

• Tracking Development: Regular check-ups allow dentists to monitor the development of your child’s teeth and jaw, ensuring they grow correctly and spotting any potential orthodontic issues early.
• Guidance for Future Needs: Dentists can provide advice on whether your child might need braces or other orthodontic treatments in the future, helping plan for these needs early.

Regular dental check-ups play a vital role in maintaining your child’s oral health and setting the foundation for healthy habits that last a lifetime. These visits ensure early detection and prevention of dental issues, provide professional cleanings and educate both children and parents on maintaining good oral hygiene​.

Frequently Asked Question About Dental Erosion i Children