Treatment of dental erosion at home. What is dental erosion and how to overcome it? Differential diagnosis of tooth erosion

Human tooth enamel is one of the hardest substances on the planet. Every day it is exposed to a lot of stress: the effects of food, drinks, periodic injuries. Erosion of tooth enamel is quite common. With this pathology, the sensitivity of the teeth is significantly increased in the patient, which is often accompanied by the development of caries, in some cases, complete destruction of the tooth is possible.

The concept of enamel erosion

Erosion of tooth enamel is a pathological condition of the hard tissues of the tooth, in which enamel and dentin are destroyed. It begins with damage to the upper layer and gradually penetrates deep, reaching the bone tissue. Dentists refer to this disease as non-carious lesions. The disease is common mainly among middle-aged women and lasts a long time.

Erosion of teeth is not only a cosmetic defect, but also a significant one. dental problem who needs urgent treatment. The external manifestation of the pathology is an oval or round spot on the surface of the tooth. As a rule, the most protruding part of the tooth is affected first, after which the pathological area increases and spreads to deeper tissues.

Often the disease is recognized quite late, when erosion penetrates deep into the tooth, completely corroding its coating. Then painless treatment is no longer possible. To prevent this from happening, you need to contact the dentist in time and treat your teeth. Often people do not attach much importance to this pathology, considering it a purely aesthetic defect. In fact, this is a real dental disease that threatens with a complete loss of enamel.

Causes

Tooth enamel is composed of minerals, so it is not easy to destroy it. Erosion is a slow process that can take several years before making itself felt. An exhaustive list of causes of tooth enamel erosion has not been defined.

There are 3 main factors that can lead to the disease:

1. mechanical - the use of aggressive pastes and powders, frequent whitening of enamel with trays and whitening preparations, as well as bruxism (involuntary grinding of teeth, often at night, often leading to abrasion of the tooth shell);
2. chemical factor - excessive consumption of acidic foods (citrus fruits, undiluted freshly squeezed juices, vinegar marinades), carbonated drinks (Coca-Cola, Fanta);
3. the endocrine cause of erosion is a violation of the thyroid gland (often due to thyrotoxicosis, changes in the composition of saliva occur, which leads to damage to the surface of the teeth).

Other culprits for the onset of the disease include excessive use of ascorbic and folic acid, malocclusion, various bacterial diseases of the oral cavity and upper respiratory tract. Occasionally there is a congenital predisposition to abrasion of the shell of the tooth.

Stages of the pathological process and their symptoms

The onset of the disease can be missed if you do not have an examination at the dentist twice a year, since at the initial stage there are practically no obvious changes.

Dentists distinguish the following stages of development of enamel erosion:

• Initial. The surface area is affected, which is almost invisible during examination.
• Average. The defect penetrates into the inner layers of the teeth, which causes an increase in their sensitivity.
• Deep. The disease leads to the complete destruction of the enamel, the bone substance is gradually affected.

The symptoms of the disease are different and may not appear at all until the damage to the inside of the tooth. This largely depends on the stage of erosion.

Initially, erosion has a rounded cup-shaped shape. Its bottom is hard, smooth and shiny. Over time, the defect expands and deepens, the enamel is erased, and the dentin is exposed. At the initial and middle stages of development, erosion has a whitish tint, with a deep degree, the color changes to light yellow or brown.

At the initial stage, there is a slight darkening of the tooth coating, loss of gloss. You can see the changes only when the surface of the tooth is completely dried with air or a drop of iodine tincture is applied to it. The affected area is stained in the color of iodine. In this case, pain is absent.

The average degree is characterized by the appearance of discomfort in the patient when eating hot or cold food and drinks. The shade of the teeth changes to a darker one.

Phases of enamel erosion and associated symptoms

The following phases of the disease are distinguished:

1. Active - a pronounced clinical picture is characteristic. The disease develops quickly, affects almost all teeth at once - their color changes, unpleasant sensations appear, sensitivity becomes aggravated.
2. Stabilized - the absence of pronounced symptoms. The disease progresses slowly. Tertiary dentin is formed on the teeth, produced by the pulp. It creates a protective shell and suppresses excessive sensitivity.

Diagnostic methods

Treatment of dental erosion begins only after a thorough examination and consultation with a dentist. With self-examination of the oral cavity and self-treatment, there is a high chance of making a mistake in making a diagnosis and choosing a method of therapy. Erosion must be differentiated from enamel hypoplasia, wedge-shaped defect, superficial caries. Diagnostics consists of:

• Examination of the oral cavity, thanks to which the doctor will identify the problem and establish possible reasons erosion of tooth enamel.
• Drying the damage with an air jet, followed by the application of iodine. This method helps to identify the localization of the lesion.
• A blood test for hormones and an ultrasound of the thyroid gland. This is necessary to exclude endocrine pathology.

Features of the treatment of erosion of hard tissues of the tooth

At the dentist

Treatment of such a defect as tooth erosion requires integrated approach. During the active phase of the disease, the dentist tries to minimize the destruction of hard tissues, stabilize the patient's condition and stop destructive process. It is necessary to achieve the transition of the active phase to the stabilized one. The patient is prescribed a course of vitamins and microelements, including calcium and phosphorus.

Within 15-20 days, local remineralization is carried out (daily applications with fluoride and calcium preparations). After that, the surface of the teeth is covered with fluorine varnish.

Physiotherapeutic methods are also used, such as electrophoresis with a 10% calcium solution. The duration of such treatment is 10-15 procedures. It is advisable to repeat the course in a year.

With a pronounced lesion of the hard tissues of the tooth and an obvious cosmetic defect, an artistic restoration of the crown is performed. For these purposes, a photopolymer composite or microprostheses (veneers, inlays, crowns) are used.

In the stabilized stage, it is necessary to continue taking vitamins and minerals. The patient undergoes depigmentation of the affected surfaces. To do this, brush your teeth with an abrasive toothpaste with a high fluoride content for several days. After treatment, it is recommended to apply Ftorgel or Ftorlak to the teeth for 2 days.

At home

Sometimes treatment can be carried out at home, but only with the consent of the attending physician and only at an early stage in the development of the disease. The main principle of home therapy is strict adherence to hygiene rules:

• use a toothbrush with medium bristles - it does not lead to injury to the enamel;
• after brushing your teeth, rinse your mouth with antiseptics;
• use fluoride toothpastes, as they strengthen the shell of the teeth;
• if a defect is detected, the teeth should not be brushed twice a day, but after each meal - this is a temporary measure, and after the end of therapy, you should return to the usual mode.

If the cause of the disease was bacterial infection you need to fix it first.

Enamel destruction can be provoked by lactic acid bacteria and staphylococcus aureus living in the oral cavity with chronic tonsillitis and stomatitis. In this case, antibiotic therapy is carried out, after which the procedures described above are performed.

Preventive measures

Enamel erosion does not occur when the following preventive measures are taken:

• Refusal to eat acidic foods. It is better to drink carbonated drinks through a straw to avoid contact with the enamel.
• Do not eat very hot and very cold food at the same time. A strong temperature fluctuation provokes the appearance of cracks in the enamel.
• After eating, rinse your mouth with mouthwash or warm water.
• Use for brushing your teeth with a soft brush and toothpaste without abrasive particles. It is necessary to start cleaning from the inner surface, without pressing too hard on the bristles in order to avoid injury to the enamel.
• Visiting the dentist twice a year. This will allow detection of pathology in early stage and prevent unwanted consequences.

Tooth erosion is a progressive loss of tooth tissues (enamel and dentin) of insufficiently elucidated etiology. Some authors believe that tooth erosion, like a wedge-shaped defect, arises solely from the mechanical action of a toothbrush and powder. Others believe that the occurrence of erosion is due to the consumption of large amounts of citrus fruits and their juices. Yu. M. Maksimovsky (1981) assigns an important role in the pathogenesis of erosion of hard tissues of teeth to endocrine disorders and, in particular, hyperfunction of the thyroid gland.

According to him, one of the symptoms of this disease is an increase in saliva secretion and a decrease in the viscosity of the oral fluid, which cannot but affect the condition of the hard tissues of the tooth. It was established that tooth erosion in patients with thyrotoxicosis occurred 2 times more often than in persons with normal thyroid function. Even with an increase in the duration of the disease by 1 year (from 3 to 4 years), the number of patients with erosions of hard tissues increases by 20%. Yu. A. Fedorov et al. (1990) also found that tooth erosion in more than 40-50% of cases is detected against the background of an increase in the thyroid gland and a violation of its function.

Erosions of the hard tissues of the teeth appear mainly on the symmetrical surfaces of the central and lateral incisors. upper jaw, as well as on canines and small molars of both jaws. There are practically no erosions on the incisors and large molars of the lower jaw. The lesion is observed mainly in middle-aged people and is characterized by a long course - up to 10-15 years. With age, there is an involvement in the process of a large number of teeth. Currently, due to the impact of adverse environmental factors, including the Chernobyl disaster, the number of cases of dental erosion in young people (18-25 years old) is increasing.

The cause of enamel erosion has not been finally established, however, undoubtedly, an important role belongs to the chemical factor in combination with mechanical action. At the same time, it is impossible to exclude the weakening of the remineralizing effect of the oral fluid.

Clinical picture of tooth erosion

Erosion is an oval or rounded enamel defect located in the transverse direction of the most convex part of the vestibular surface of the tooth crown. The bottom of the erosion is smooth, shiny and hard. The gradual deepening and expansion of the boundaries of erosion leads to the loss of the entire enamel of the vestibular surface of the tooth and part of the dentin. Sometimes erosion takes on a less regular shape, which is compared to a grooved chisel, i.e. the element of the lesion is slightly concave, and the edges of the erosion gradually pass to the intact surface of the tooth crown. This form of enamel damage is due to the fact that the dentin of the central part of the crown is erased faster, since it is limited from the edges by the preserved enamel of the contact surfaces of the tooth crown.

There are two stages of the lesion: initial (enamel erosion) and severe (enamel and dentine erosion).

According to the depth of the lesion, three degrees of erosion are distinguished:

degree I, or initial, - damage to only the surface layers of enamel;

degree II, or average,- damage to the entire thickness of the enamel cover of the tooth up to the enamel-dentin junction;

degree III, or deep,- when the superficial layers of dentin are also affected.

E. V. Borovsky et al. (1978), as well as Yu. M. Maksimovsky (1981) propose to distinguish between two clinical stages of erosion - active and stabilized, although in general any erosion of enamel and dentin is characterized by a chronic course.

For active stage a rapidly progressive loss of hard tissues of the tooth is typical, which is accompanied by an increased sensitivity of the affected area to various external stimuli (the phenomenon of hyperesthesia).

Stabilized erosion stage characterized by a slower and more calm course. Another sign is the absence of plaque and tissue hyperesthesia. The preservation of the shiny surface of the enamel in the affected area is noted. The transition of the stabilized stage of erosion to the active one is possible.

Enamel erosion, unlike other types of abrasion, in most cases is characterized by severe pain sensations under the influence of various factors, especially cold air and chemical irritants. There are more complaints in the active stage than in the stabilized one.

Pathological anatomical picture of tooth erosion

Microscopic examination of the area with enamel erosion shows changes in the surface layer. Polarizing microscopy revealed changes in the form of a dark strip on the surface of the enamel without any changes in the subsurface layer, characteristic of caries. Electron microscopic studies established the presence of an organic film on the surface of the lesion, the loss of a clear crystalline structure of the enamel and the appearance of significant amorphous areas.

Polarizing microscopy reveals a significant difference in the nature of focal demineralization during initial caries and erosions. So, if caries in the stain stage is characterized by partial subsurface demineralization, then during erosion it is precisely the surface, as it were, layer-by-layer demineralization of the enamel.

Changes in dentin are also localized in the superficial layers of the affected area. The dentinal tubules are filled with crystalline structures, the correct orientation of crystals is disturbed in the intertubular areas, and the size of unstructured areas is increased.

Differential diagnosis of tooth erosion

Enamel erosion should be differentiated from superficial caries and wedge-shaped defect. Erosions differ from caries in localization, the shape of the lesion, and most importantly, in their surface (with erosion it is smooth, and with caries it is rough). A wedge-shaped defect differs from erosion in the form of the lesion, localization at the neck on the border of enamel with cement, often when the root is exposed.

Treatment of dental erosion

Treatment for erosion of tooth tissues should be carried out taking into account the activity of the process and the nature of the concomitant somatic disease. In complex dental treatment, one should not forget about the general treatment, which involves the administration of calcium and phosphorus preparations orally with a decrease in their level in the blood of patients. Vitamins alone or in combination with trace elements are also useful.

Treatment for a stabilized stage of tooth erosion, which is often accompanied by a change in the color of the enamel in the affected area, should consist of several procedures aimed at tissue depigmentation. For this purpose, it is necessary to treat the affected surface with an abrasive paste, also containing up to 1.23% fluorine, for two or three visits. In the next two visits, fluoride gel or fluorine varnish should be applied to erosion.

In the active stage of the disease, the task is to stabilize the pathological process. This can be achieved with additional mineralization of hard dental tissues by application or calcium electrophoresis. To replenish tooth tissues with calcium and phosphorus salts, patients with erosions of hard tooth tissues are prescribed 3-4 daily (or every other day) applications of the paste with a procedure duration of 15-20 minutes. In the next three visits, an acidified fluorine gel in a 0.1 M solution of phosphoric acid is applied to the erosion area for 2-3 minutes. The treatment is completed by coating the affected surface with fluoride varnish. If several teeth are affected by erosion, it is more convenient to apply fluoride gel using an individually made spoon, and in case of single lesions, you can use a soft brush. Also, in case of erosion of hard dental tissues, it is proposed to use a 10% solution of calcium gluconate and a 2% solution of sodium fluoride for the purpose of remineralization. With the application method, the number of visits is 15-20. For remineralization of hard tissues, a two-component remineralizing solution consisting of 10% solutions of calcium nitrate and ammonium acid phosphate can be recommended.

Electrophoresis of a 10% solution of calcium gluconate on the area of ​​erosion is carried out after isolation of the teeth from saliva, release from plaque and drying of the tooth crown. The active electrode is placed in place of erosion, and the passive electrode is clamped in the hand. When carrying out this procedure, you can also use an apparatus for electric pain relief (ELOS-1) with a current value in the range of 30-50 μA and a duration of the Procedure of 5-10 minutes. After electrophoresis, a swab moistened with a 2% solution of sodium fluoride should be applied to the area of ​​erosion for 2-3 minutes. The course of treatment of erosion by electrophoresis is 10-15 procedures.

According to Yu. M. Maksimovsky (1981), dental filling in case of erosion is often ineffective due to the often occurring violation of the marginal fit of the fillings and the formation of a defect around the filling. In this regard, it is recommended to carry out remineralizing therapy according to one of the above methods before filling the erosion. Composite materials should be used as filling materials. With a significant area affected by erosion of the tooth crown, it is more advisable to manufacture an artificial crown.

Erosion of tooth enamel is a fairly common problem and, contrary to the opinion prevailing among many people, is not harmless: in addition to an unpleasant cosmetic effect, pathology negatively affects the condition of the teeth and requires immediate dental care.

In this article, we will talk about the causes of erosion on the teeth and about the methods for solving the problem offered by modern dentistry.

Causes of erosion and consequences of pathology

Erosion of tooth enamel is a type of non-carious lesion. The first signs of the disease are the appearance of small, slightly protruding areas on the surface of the teeth, the course at the initial stage is without obvious symptoms. However, over time, the susceptibility of enamel to temperature factors increases, the spots gradually darken, unpleasant and even painful sensations appear, hard tissues begin to wear out very quickly.

Important! on the this moment the causes of the development of pathology are not exactly known!

However, experts call a number of factors that can provoke the appearance of erosion. Among them:

• disruption of the endocrine system;
• causing mechanical damage (including the use of home methods of whitening tooth enamel, hygiene with a hard brush, abuse (constant use) of dental layers with abrasive particles, etc.)
• exposure to certain chemicals (eg, vinegar, acidic drinks, citrus fruits);
• uneven chewing load (standard causes are malocclusion, loss of a single dentition without timely recovery);
• constant exposure to chemicals, contact with mineral or metal dust (usually associated with professional activities).
• long-term use of potent pharmaceutical drugs.

Delaying the appeal to the dentist, you risk waiting for the stage when the broken top layer leads to damage to the dentin.

Symptoms and prevention

The asymptomatic nature of the course of the disease at the initial stage leads to the fact that treatment usually begins too late. The only way to prevent the danger is regular preventive examinations at the dentist: the doctor will recognize the signs of erosion at a very early stage and take measures to prevent its further development.

Without treatment, progressive destruction of the enamel is observed. Modern classification enamel erosion:

initial stage

superficial layer affected

with a cursory visual inspection, protruding areas may not be noticed

middle stage

penetration of erosion to deeper layers

the appearance of hypersensitivity

deep stage

almost complete destruction of the outer layer, gradual destruction of dentin.

In addition, it is customary to distinguish 2 phases:

1. active phase - a vivid manifestation clinical picture, a rapid change in the shade of the enamel and the spread of the lesion, the appearance of severe pain
2. stable phase - the course is calm, symptoms practically do not appear

Why You Can't Ignore the Problem

If the problem is not recognized in time and treatment is not started, very serious complications are possible, namely:

• the spread of dark spots on the entire surface of the tooth;
• violation of the uniformity of the color of the enamel (up to the transparency of the cutting edge);
• increased enamel abrasion, accelerated tooth wear;
• increased susceptibility to temperature effects, the appearance of painful sensations.

When the lesion spreads to the dentin, there is a rapid destruction of the hard tissues of the tooth, as a result, the development of various dental diseases.

The widest risk group by age is people of the middle age category, however, pathology is often found in children.

Erosion on baby teeth

In children, the most common cause of non-carious lesions is excessive consumption of liquids with a high content of sugar and acids (milk and juice). Therefore, if the baby refuses to fall asleep without a bottle, it is better to pour ordinary water into it. It is also important to take care of oral hygiene: regularly cleaning them from bacterial plaque will help prevent the development of erosion on milk teeth.

Other problems leading to erosion in children are crowded teeth and malocclusion.

Carefully monitor the condition of the tooth enamel in children, contact the dentist immediately when the first signs of the disease appear!

Diagnosis of erosion treatment

To make a diagnosis in the early stages, differential diagnosis is necessary, taking into account various manifestations - from increased sensitivity of the teeth to problems with the pronunciation of whistling sounds. If the stains on the teeth have already appeared, a visual inspection is sufficient.

The clinical picture of erosion of tooth enamel is similar to the manifestations of superficial caries (the disease is also characterized by a rough surface of the teeth) and erosion with a wedge-shaped defect (characterized by a lesion along the neck of the tooth). The correct diagnosis can only be made by a dentist!

After diagnosing erosion, treatment is prescribed, which usually includes a number of procedures:

• electrophoresis with calcium (restoration of the mineral composition of enamel, saturation of tooth tissues with useful microelements and minerals);
• remineralization (2-3-week course of applications with F and Ca, followed by application of fluorinated varnish on the enamel);
• general strengthening therapy (vitamin complexes, preparations with a high content of F and Ca).

Elimination of aesthetic effects is provided by professional cleaning of enamel with whitening and protection of the tooth surface with fluoride-containing varnishes and gels.

In case of serious damage to the enamel, they resort to prosthetics with veneers (ultra-thin pads fixed on the outer side of the teeth perfectly hide defects); the most advanced cases may require the installation of crowns.

Do not get carried away with tips on erosion control means traditional medicine: self-treatment in this case is dangerous, it is impossible to stop the thinning of the enamel by such means, and aggravate the situation - as easy as shelling pears!

The time and complexity of treatment directly depends on how deeply the erosive processes have spread. Proper hygiene and regular preventive examinations will allow you to avoid long exhausting therapy and expensive prosthetics.

The best treatment is prevention

To avoid the problem, follow these simple guidelines:

• do not forget to brush your teeth twice a day, but do not do it immediately after eating acidic foods (postpone the procedure for 30-60 minutes);
• choose toothbrushes with natural bristles, soft or medium hardness;
• make the choice of toothpaste conscious: avoid the constant use of whitening pastes containing abrasive particles; give preference to fluoride-containing pastes that provide enamel strengthening and mineralization;
• leave at the end of the meal foods with neutralizing properties (a piece of hard cheese, a glass of milk, etc.);
• reduce the amount of foods containing aggressive acids in the diet.

A responsible approach to maintaining the health of the oral cavity and teeth is a guarantee of reliable protection against dental problems!

Erosion of tooth enamel is a serious dental disease that is subject to 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 imperceptibly for the patient, but is easily diagnosed by the dentist during the 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 tooth erosion.

Who adheres to this rule has 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 of the surface of the teeth are found everywhere in modern dentistry. With this disorder, tooth enamel is destroyed, and in rare cases, dentin is affected. Visually, the erosion of tooth enamel appears as an oval defect on the outer surface.

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

Often, patients consider tooth erosion as an aesthetic disadvantage. In reality, this is a disease that requires proper diagnosis, treatment, leading to the destruction of enamel on the teeth.

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

Erosion of teeth is classified as follows: primary, intermediate, severe.

The disorder often extends to premolars, anterior teeth. The disease rarely manifests itself at an early stage, it is during this period that it is easy and painless to treat. You need to visit the dentist regularly.

Causes

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

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

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

• Medical preparations, potions, uncoated tablets, powders side effects on the patient's body.
• Multiple missing teeth or create excessive stress when eating. Enamel wears out, does not have time to recover.

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

The causes of tooth erosion may differ, it is important to diagnose the disease in time and start treatment in order to avoid irreversible processes.

Risk factors

The work of all human organs is interconnected. Based on this, doctors believe that stomach ulcers or hyperacidity 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 destruction of enamel.

The likelihood of erosion is increased by such 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. Work with a computer and other devices with a weak degree of protection.
• Work in enterprises with harmful working conditions.
• Acidic drinks and juices are consumed without a straw.

Effects

In children, enamel erosion is rare. Middle-aged people belong to the main category of patients. Treatment of the disease should not be postponed, because the development of enamel erosion leads to negative consequences:

• teeth are quickly erased or worn out;
• dark spots appear, capturing an increasing area over time;
• the color of the edge of the teeth becomes transparent, thinned;
• the patient feels pain when eating hot or cold food.

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

The disease can proceed for some time without causing discomfort. With an inexperienced eye, the change in enamel can be overlooked. When the hard part of the tooth collapses, pronounced signs of the disease will appear. The disease is not evident. Dull dark spots of rounded 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 distinct. At the last stage, the hard tissue begins to collapse, discomfort and pain appear.

Diagnostics

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

Erosion must be able to distinguish from a mild form and a wedge-shaped defect. Erosion from caries is distinguished by localization, the shape of the lesion and a smooth surface; with caries, the surface becomes rough and uneven. The wedge-shaped defect will stand out in shape and localization at the root. After an accurate diagnosis is established, treatment begins.

This disorder is manifested as a result of exposure to harmful microbes in the body. They interact with the remnants of food remaining between the teeth after dinner. Organic acids formed as a result of decomposition adversely affect tooth enamel. As a result, calcium salts are washed away by aggressive acid, 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 may be a deterioration in immunity, gastrointestinal disorders, poor diet. In modern medicine, there are about 400 theories for 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 a stable one. This prevents the destruction of hard dental tissues.

With worn enamel, local therapy is offered, including additional treatment with minerals, daily procedures for the application of fluorine-containing and calcium-containing products. The course of treatment lasts 2-3 weeks. In conclusion, the surface of the teeth is smeared with fluorinated 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 with a light-cured composite, veneer, or crown.

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

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

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

Treatment of dental erosion is considered effective if the pain disappears during meals 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 follow simple rules:

• reduce the consumption of foods and drinks with high acidity;
• remember that hot drinks and food adversely affect tooth enamel;
• after a meal, use sugar-free chewing gum;
• rinse your mouth immediately after eating;
• hygienic procedures in the oral cavity should be performed with a soft toothbrush, alternate with an abrasive one;
• regularly conduct dental examinations;
• do not use pastes with an abrasive or bleaching effect.
• do not drink sparkling water or use 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 by timely and high-quality treatment. After the transition from the active to the stable phase of the development of the disease, the patient should undergo regular monitoring by a specialist.

• limit the use of ballast products;
• take vitamins;
• eat properly;
• lead a healthy lifestyle;
• control the intake of hormonal drugs;
• monitor the endocrine and digestive systems.

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

The doctor about the erosion of tooth enamel - video

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

Often there is a disease such as erosion of tooth enamel. We will provide a photo, talk about the causes and treatment, as well as the consequences of this defect. And although many people think that this is just a cosmetic problem, in fact, erosion is a serious disease.

It should not be ignored, since the consequences can affect not only the appearance of a smile, but also the safety of the dentition. During regular visits to the dentist, detect this problem it is possible even at the initial stages, when there are neither painful sensations nor obvious darkening.

What is tooth enamel erosion?

This defect applies to . The history of the disease at first does not manifest itself in any way other than small raised areas on the surface and increased sensitivity to cold and hot foods and drinks.

And only when the disease is neglected, you can notice an increasing spread of dark spots, pain, significant hard tissues, etc. If you ignore the problem and decide that this is just a minor nuisance, then you can wait for a deeper lesion not only enamel, but also dentin.

Causes

Doctors have not yet established the exact factors for the occurrence of this disease, since it can manifest itself in almost any person. Even compliance with hygiene procedures does not protect against erosion. And yet, in search of reasons why such a defect appears on healthy teeth, experts settled on the following options:

• Any mechanical damage to the enamel surface. For example, if you use abrasive pastes too often or get carried away with whitening products at home, you can scratch the tooth, which will lead to erosion.
• Chemical effects in the form of acidic drinks, food, the use of vinegar, citrus fruits, etc. With the frequent influence of various aggressive acids on the surface of the tooth, it can be damaged.
• The presence of problems in the work of the endocrine system is also a frequent companion and, most likely, the cause of such a defect.
• Increased load on the dentition, when, with an incorrect bite or the absence of individual units, the chewing function is performed unevenly.
• Some medications can also cause enamel erosion as a side effect.
• In industries with metal or mineral dust, as well as when working with chemicals.

Whatever the reasons, diagnosis and treatment should be carried out in a timely manner.

A photo

Effects

It is noticed that this disease is more common in adult patients, especially in the middle age category. But in a child, enamel erosion occurs much less frequently. But whenever the first symptoms appear, they need to be eliminated in time, since the consequences can be quite serious:

1. The wear of the teeth is significantly accelerated, that is, their abrasion increases.
2. Over time, dark spots will appear, and then the surface may darken completely.
3. Sensitivity brings patients to significant pain.
4. Changes in the shade of the enamel will also result in an uneven distribution of color and the edge of the unit may become translucent.

If erosion reaches the destruction of dentin, then the obvious consequence will be the complete destruction of hard tissue and the appearance of other dental problems.

Stages of the disease

If you do not visit the dentist, then the first stages can be viewed, since almost no visible changes occur during this period. Doctors distinguish the following classification of enamel erosion:

1. The initial stage, when the damage affects the superficial area and is almost imperceptible on a cursory examination.
2. Medium - the lesion reaches the inner layers and causes.
3. A deep stage in which erosion has almost completely destroyed the enamel and began to affect the dentin.

In addition, it is possible to determine the phases of the disease. It:

• Active, in which the clinic manifests itself quite quickly and brightly. The rapid development of erosion covers most of the dentition, causes discomfort for the patient and for quite a long time. short period changes the color of the enamel.
• The stabilized phase is much calmer and almost does not show any symptoms. It usually occurs due to the formation of tertiary dentin, which creates a protective barrier and blocks discomfort.

How does erosion of tooth enamel manifest itself?

Symptoms of the disease look different, and may not give themselves away at all until the destruction reaches the inside of the tooth. Everything largely depends on the phase and stage of erosion.

1. At the initial stages, there is only a slight darkening of the enamel shade, loss of luster in some places. Changes can be noticed only when the surface is completely dried or a drop of iodine is applied to the tooth. Then the affected area immediately becomes highlighted. Erosion looks like a whitish oval convex formation.
2. With an average level of damage, the patient may feel discomfort when drinking hot and cold drinks and food.
3. And only at the last stage, the symptoms of the disease manifest themselves quite clearly. The shade of the teeth changes, there is a noticeable pain even with hygienic treatment.

Diagnostic steps

The doctor during the examination should conduct a differential diagnosis, which will help to make an accurate diagnosis. After all, enamel erosion is in many ways similar in appearance to and, from which it must be distinguished. Only with the correct diagnosis can we talk about successful treatment. Carry out the following procedures:

• To find spots in the initial stage, it is enough to use iodine, which will color the defect in a bright shade.
• From the mentioned diseases, erosion is distinguished by the shape and location, as well as a smooth surface.
• In addition to dental, it is necessary to conduct a diagnosis with a gastroenterologist and an endocrinologist, who can establish malfunctions in the thyroid or other endocrine glands.

The earlier the disease is, the more difficult it is to recognize, but the easier it is to eliminate.

Treatment Methods

Only by establishing the correct diagnosis, you can decide what to do next. Your doctor will usually prescribe one of the following procedures:

• The most important is the remineralizing therapy in the form of applications with fluorine and calcium on the affected parts of the tissue. Such a course can last 2-3 weeks, after which the surface is covered with fluorinated varnish.
• With a similar goal of restoring the mineral composition of the tooth, calcium electrophoresis is performed.
• If the units are severely damaged and hard tissue correction is needed, the physician may recommend veneers, light-cured composite, or crown prosthetics.
• A general strengthening course is carried out, in which preparations with a high content of fluorine and calcium, as well as multivitamin complexes are prescribed.
• To correct darkening or appearing pigment spots, surfaces are polished with special pastes, bleaching procedures, as well as coated with varnishes or gels with fluorine.

The duration, complexity and characteristics of the treatment will depend on the degree of damage to the enamel by erosive processes. In some cases, the doctor may decide on a filling. But this method of treatment can only be used in combination with remineralizing therapy so that the filling material can be well fixed.

Video: dentist talks about tooth enamel.

Preventive measures

The appearance of enamel erosion is associated with internal diseases and some aggressive external influences. Therefore, oral hygiene as a preventive measure is ineffective. In order to prevent the possible formation of such a defect, you should follow simple rules:

• Avoid foods and drinks that contain a particularly high concentration of various acids. If this is difficult to do, then at least try to drink such a drink through a straw, without holding it in your mouth for a long period.
• Stop eating hot food heat more likely to have a negative impact than too low.
• To neutralize the acidity in the mouth, you can use chewing gum that does not contain sugar or a piece of hard cheese.
• After taking sour food, you should not immediately start brushing your teeth. It is better to wait about an hour and only then process the surface.
• And immediately after eating, be sure to rinse your mouth with an antibacterial solution or plain water.
• to do with a soft brush, without affecting the surface too hard.
• If for any purpose you use pastes with abrasive particles, then after two or three weeks, replace it with a regular one, and take a significant break.
• Don't get carried away folk remedies for teeth whitening.
• Periodically use cleaning pastes with a high content of fluorine and calcium.
• Regular visits to the dentist will help to identify the defect in the very initial stage and treat it with the least consequences.

Additional questions

ICD-10 code

AT International classification enamel erosion is under the code K03.2 and refers to other diseases of the hard tissues of the teeth.