Treatment of dental erosion at home. What is tooth enamel 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 she is exposed to great stress: exposure to food, drinks, periodic injuries. Erosion of tooth enamel is quite common. With this pathology, the patient's sensitivity of the teeth significantly increases, which is often accompanied by the development of caries, in some cases, complete destruction of the tooth is possible.

Enamel erosion concept

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 into the bone tissue. Dentists refer this disease to non-carious lesions. The disease is prevalent mainly among middle-aged women and lasts for a long time.

Tooth erosion is not only a cosmetic defect, but also a significant dental problemwho needs urgent treatment. The external manifestation of pathology is an oval or round spot on the surface of the tooth. As a rule, the most prominent part of the tooth is affected first of all, 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 go to the dentist on time and have your teeth treated. 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 the complete loss of enamel.

Causes of occurrence

Tooth enamel is composed of minerals, so it is not easy to break down. Erosion is a slow process that can take several years before it starts to make itself felt. An exhaustive list of the causes of tooth enamel erosion has not been determined.

There are 3 main factors that can lead to disease:

1. mechanical - the use of aggressive pastes and powders, frequent bleaching of enamel with mouth guards and bleaching agents, as well as bruxism (involuntary grinding of teeth, often at night, often leading to the erasure of the tooth shell);
2. chemical factor - excessive consumption of acidic foods (citrus fruits, undiluted fresh juices, vinegar marinades), carbonated drinks (Coca-Cola, Fanta);
3. the endocrine cause of erosion is a disruption 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 appearance 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 erasure of the tooth membrane.

Stages of the pathological process and their symptoms

The onset of the disease can be missed if you do not undergo a check-up with a dentist twice a year, since at the initial stage there are practically no obvious changes.

Dentists distinguish the following stages in the 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.

Symptoms of the disease are different and may not appear at all until the inner part of the tooth is damaged. 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 wears off, and 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 dental coating, loss of gloss. Changes can be seen only when the tooth surface is completely dried with air or a drop of iodine tincture is applied to it. The affected area is colored with iodine. In this case, there is no pain.

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 accompanying symptoms

The following phases of the disease are distinguished:

1. Active - characterized by a pronounced clinical picture. The disease develops quickly, affects almost all teeth at once - their color changes, discomfort appears, sensitivity is aggravated.
2. Stabilized - no pronounced symptoms. The disease progresses slowly. Tertiary dentin forms on the teeth, which is produced by the pulp. It creates a protective coating and suppresses oversensitivity.

Diagnostic methods

Treatment of dental erosion begins only after a thorough examination and consultation with a dentist. With an independent study of the oral cavity and self-treatment, there is a great chance of making a mistake in the diagnosis and choice of the 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 the occurrence of erosion of the enamel of the teeth.
• Drying the damage with an air jet followed by applying iodine. This method helps to identify the localization of the lesion.
• Blood test for hormones and ultrasound examination of the thyroid gland. This is necessary to exclude endocrine pathology.

Features of the treatment of erosion of hard tooth tissues

At the dentist

Treatment of such a defect as tooth erosion requires an 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 the 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 trace elements, including calcium and phosphorus.

Local remineralization is carried out within 15-20 days (daily applications with fluoride and calcium preparations). Then the surface of the teeth is covered with fluoride varnish.

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

In case of pronounced damage to 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 is depigmented 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 on 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 of the development of the disease. The basic principle of home therapy is strict adherence to hygiene rules:

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

If the cause of the disease was a bacterial infection, it is necessary to eliminate it first.

The destruction of enamel can be provoked by lactic acid bacteria and staphylococcus, which live in the oral cavity in chronic tonsillitis and stomatitis. In this case, antibiotic therapy is performed, after which the procedures described above are performed.

Preventive measures

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

• Avoiding acidic foods. It is best to drink carbonated drinks through a straw to avoid contact with the enamel.
• Do not eat very hot or very cold food at one time. Strong temperature fluctuations provoke the appearance of cracks in the enamel.
• After eating, rinse your mouth with mouthwash or warm water.
• Using a soft brush and toothpaste without abrasive particles for cleaning teeth. It is necessary to start cleaning from the inner surface, without pressing too hard on the bristles to avoid injury to the enamel.
• Visit the dentist twice a year. This will allow detecting pathology on early stage and prevent unwanted consequences.

Dental erosion is a progressive loss of dental tissue (enamel and dentin) of an insufficiently elucidated etiology. Some authors believe that tooth erosion, like a wedge-shaped defect, arises solely from the mechanical effect of a toothbrush and powder. Others believe that the occurrence of erosion is due to the consumption of large quantities 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 state of the hard tissues of the tooth. It was found that dental erosion in patients with thyrotoxicosis occurred 2 times more often than in those 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 is detected in more than 40-50% of cases against the background of an enlarged thyroid gland and dysfunction.

Erosion of the hard tissues of teeth appears mainly on the symmetrical surfaces of the central and lateral incisors of the upper jaw, as well as on the canines and small molars of both jaws. Erosion is practically not found 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, a large number of teeth are involved in the process. Currently, due to the impact of unfavorable environmental factors, including the Chernobyl disaster, the number of cases of tooth erosion in young people (18-25 years old) is increasing.

The cause of enamel erosion has not been completely established, however, undoubtedly, an important role belongs to the chemical factor in combination with mechanical stress. At the same time, weakening of the remineralizing effect of the oral fluid cannot be ruled out.

The 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 the erosion takes on a less regular shape, which is compared to a fluted bit, i.e. the element of the lesion is slightly concave, and the edges of erosion gradually pass to the intact surface of the tooth crown. This form of damage to the enamel is due to the fact that the dentin of the central part of the crown is erased faster, since from the edges it is limited by the preserved enamel of the contact surfaces of the tooth crown.

There are two stages of damage: initial (enamel erosion) and pronounced (enamel and dentin erosion).

Three degrees of erosion are distinguished according to the depth of the lesion:

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

grade II, or medium, - defeat of the entire thickness of the enamel cover of the tooth up to the enamel-dentin junction;

grade III, or deep, - when the surface layers of dentin are affected.

E. V. Borovskiy 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 typical rapidly progressive loss of hard tooth tissues, which is accompanied by increased sensitivity of the affected area to various kinds of external stimuli (the phenomenon of hyperesthesia).

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

Erosion of enamel, unlike other types of abrasion, in most cases is characterized by pronounced pain sensations under the action of various kinds of factors, especially cold air and chemical stimuli.In the active stage there are more complaints than in the stabilized one.

Pathological 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 enamel surface 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 crystal 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 the superficial, as it were, layer-by-layer demineralization of the enamel occurs.

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

Differential diagnosis of tooth erosion

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

Tooth erosion treatment

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 provides for the administration of calcium and phosphorus preparations inside while their level in the blood of patients decreases. Vitamins are also useful alone or in combination with trace elements.

Treatment for a stabilized stage of tooth erosion, which is often accompanied by discoloration of the enamel in the affected area, should consist of several procedures aimed at depigmentation of tissues. For this purpose, the affected surface should be treated with an abrasive paste containing up to 1.23% fluorine for two to three visits. On the next two visits, fluoride gel or fluoride 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 dental hard tissues by application or calcium electrophoresis. To replenish the 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 the duration of the procedure 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 fluorine varnish. If several teeth are damaged 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 10% calcium gluconate solution and 2% sodium fluoride solution for remineralization. With the application method, the number of visits is 15-20. It is possible to recommend a two-component remineralizing solution for remineralization of hard tissues, consisting of 10% solutions of calcium nitrate and acid ammonium phosphate.

Electrophoresis of a 10% solution of calcium gluconate on the erosion area is carried out after the teeth are isolated from saliva, free from plaque and the crown of the tooth has dried. The active electrode is installed in the place of erosion, and the passive electrode is clamped in the hand. When carrying out this procedure, you can also use an apparatus for electrical anesthesia (ELOZ-1) with a current value in the range of 30-50 μA and a procedure duration of 5-10 minutes. After electrophoresis, a swab moistened with 2% sodium fluoride solution should be applied to the erosion area for 2-3 minutes. The course of treatment for erosion by electrophoresis is 10-15 procedures.

According to Yu.M. Maksimovsky (1981), filling of teeth with erosion is often ineffective due to the often occurring violation of the marginal adherence of the fillings and the formation of a defect around the filling. In this regard, it is recommended to carry out re-mineralizing therapy using one of the above methods before filling erosion. Composite materials should be used as filling materials. With a significant area of \u200b\u200bthe erosion of the tooth crown, it is more expedient to make an artificial crown.

Erosion of tooth enamel is a fairly common problem and, contrary to what many people believe, 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 the methods of solving the problem offered by modern dentistry.

The causes of erosion and the consequences of pathology

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

Important! at the moment, the reasons for the development of pathology are not exactly known!

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

• disturbances in the work of the endocrine system;
• mechanical damage (including the use of home methods for whitening tooth enamel, hygiene with a hard brush, abuse (constant use) of dental layers with abrasive particles, etc.)
• exposure to certain chemicals (eg, vinegar, sour drinks, citrus fruits);
• uneven chewing load (standard causes are occlusion anomalies, loss of a unit of the dentition without timely restoration);
• constant interaction with chemicals, contact with mineral or metal dust (usually associated with professional activities).
• long-term use of potent pharmaceuticals.

By delaying the visit to the dentist, you run the risk of waiting for the stage when the damaged top layer will lead to dentin damage.

Symptoms and prevention

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

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

initial stage

the surface layer is affected

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

middle stage

penetration of erosion into deeper layers

the appearance of increased sensitivity

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 bright manifestation of the clinical picture, a rapid change in the shade of the enamel and the spread of the lesion, the appearance of pronounced painful sensations
2. stabilized phase - the course is calm, symptoms practically do not appear

Why the problem cannot be ignored

If you do not recognize the problem in time and do not start treatment, very serious complications are possible, namely:

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

When the lesion spreads to dentin, a rapid destruction of hard tooth tissues occurs, 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 milk teeth

In children, the most common cause of non-carious lesions is the excessive intake of fluids with a high sugar and acid content (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 the hygiene of the oral cavity: to exclude the development of erosion on milk teeth will help to regularly clean them from bacterial plaque.

Other problems that lead to erosion in children are crowding of teeth and malocclusion.

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

Diagnostics of the 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 spots on the teeth have already appeared, a visual examination is sufficient.

The clinical picture of tooth enamel erosion 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 damage along the tooth neck). 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 the enamel, saturation of tooth tissues with useful trace elements and minerals);
• remineralization (2-3-week course of applications with F and Ca followed by applying fluoridated varnish to the enamel);
• restorative therapy (vitamin complexes, drugs with a high content of F and Ca).

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

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

Don't get carried away by the tips for erosion control products traditional medicine: self-medication in this case is dangerous, the thinning of the enamel cannot be stopped by such means, and aggravating the situation is 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 help to avoid long-term debilitating 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 taking acidic foods (postpone the procedure for 30-60 minutes);
• choose toothbrushes with natural bristles, soft or medium hard;
• make your choice of toothpaste conscious: avoid the constant use of whitening pastes containing abrasive particles; give preference to fluorine-containing pastes, which strengthen and mineralize the enamel;
• leave foods with neutralizing properties at the end of the meal (a piece of hard cheese, a glass of milk, etc.);
• reduce the amount of foods containing corrosive 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 must be treated. First, the color of the enamel changes, 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 upon 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.

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

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

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

It is not uncommon for patients to view dental erosion as an aesthetic defect. In reality, this is a disease that requires correct diagnosis, treatment, leading to the destruction of the enamel on the teeth.

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

Dental erosion is classified as follows: initial, medium, severe.

The disorder often spreads to premolars, front 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 your dentist regularly.

Causes of occurrence

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 be facilitated by:

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

• Eating acidic foods... An aggressive environment is created in the oral cavity that destroys the enamel. This is a chemical attack.
• organism can also contribute to the weakening of the enamel.

• Medicines, medicines, uncoated tablets, powders render side effects on the patient's body.
• Several missing teeth or create undue stress on eating. The 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 on 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 enamel destruction.

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 large amounts of acidic citrus fruits and fruits are consumed constantly.

• Electromagnetic radiation. Working with a computer and other devices with a weak degree of protection.
• Work in enterprises with harmful working conditions.
• Sour 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. The treatment of the disease should not be postponed, because the development of enamel erosion leads to negative consequences:

• teeth wear out or wear out quickly;
• 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 enamel change can be overlooked. When the hard part of the tooth collapses, pronounced signs of the disease will appear. The disease is not conspicuous. Dull dark spots of a round or irregular shape appear on the surface.

In most cases, the 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 collapse, discomfort and pain appear.

Diagnostics

To identify a defect, tooth enamel dried with air, then a little iodine is poured onto 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 distinguished 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 location at the root. After establishing an accurate diagnosis, treatment begins.

This disorder manifests itself as a result of exposure to the body of harmful microbes. They interact with food leftovers between the teeth after dinner. The organic acids formed as a result of decomposition have a negative effect on tooth enamel. As a result, calcium salts are washed out 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 acid sensitive. Therefore, the degradation process starts at pH 4.5.

Caries does not manifest itself without noticeable reasons. Often, pathological symptoms are the main link in the process of manifestation of carious formations. This can be a deterioration in immunity, gastrointestinal disorders, a poor diet. In modern medicine, there are about 400 theories of the development of this disease, but the main reason is bad.

Therapy

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

For worn out enamel, local therapy is offered, including additional mineral treatment, daily procedures for the application of fluoride and calcium-containing agents. The course of treatment lasts 2-3 weeks. Finally, the surface of the teeth is smeared 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 affected, the restoration is carried out using 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 applied to the erosive areas with fluoride varnishes and gels.

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

Treatment of dental erosion is considered effective if pain disappears while eating and after getting 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 use of foods and drinks with high acidity;
• remember that hot drinks and food have a negative effect on tooth enamel;
• use sugar-free gum after a meal;
• rinse your mouth immediately after eating;
• hygiene procedures in the oral cavity should be performed with a soft toothbrush, alternating abrasive with a regular one;
• regularly conduct dental examinations;
• do not use pastes with an abrasive or bleaching effect.
• do not drink carbonated water or consume 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 an active to a 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;
• healthy food;
• live a healthy life;
• control the intake of hormonal drugs;
• monitor the endocrine and digestive system.

Let's figure out what you can't eat at the first signs of erosion: sour juices, carbonated drinks, preserves, pickles, fermented foods.

Doctor about the erosion of tooth enamel - video

Erosion of tooth enamel is an unpleasant disease, but not a death sentence. In medical practice, there are few cases 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, tell you 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.

You should not ignore it, since the consequences can affect not only the appearance of the smile, but also the safety of the dentition. With regular visits to the dentist, this problem can be detected even at the initial stages, when there are no painful sensations or obvious darkening.

What is tooth enamel erosion?

This defect applies to. The medical history initially does not show itself in any way, apart from small raised areas on the surface and increased sensitivity to cold and hot foods and drinks.

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

Causes of occurrence

Doctors have not yet established the exact factors of this disease, since it can manifest itself in almost any person. Even the observance of hygiene procedures does not protect against erosion. And yet, in search of the 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 your 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 must be carried out in a timely manner.

Photo

Effects

It has been 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 often. 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 completely darken.
3. Sensitivity causes patients to experience significant pain.
4. Changes in the shade of the enamel will also result in uneven color distribution and the edge of the unit may become transparent.

If the 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.

Disease stages

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

1. The initial stage, when damage affects the surface 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 almost completely destroyed the enamel and began to affect the dentin.

In addition, the phases of the disease can be determined. It:

• Active, in which the clinic manifests itself quickly and brightly. The rapid development of erosion covers most of the dentition, causes unpleasant sensations in the patient and changes the color of the enamel in a fairly short period.
• 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 is tooth enamel erosion manifested?

Symptoms of the disease look different, or they 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 the course of erosion.

1. At the initial stages, there is only a slight darkening of the enamel shade, a loss of gloss in some places. Changes can be noticed only when the surface is completely dried or when iodine drops are 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 consuming hot and cold drinks and food.
3. And only at the last stage do the symptoms of the disease manifest themselves quite clearly. The shade of the teeth changes, tangible pain appears even during hygienic processing.

Diagnostic steps

During the examination, the doctor should conduct a differential diagnosis, which will help to make an accurate diagnosis. After all, the erosion of enamel 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. The following procedures are carried out:

• 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 the dental, it is necessary to carry out diagnostics by a gastroenterologist and an endocrinologist, who can establish malfunctions of the thyroid or other endocrine glands.

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

Treatment methods

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

• The most important is to carry out remineralizing therapy in the form of applications with fluoride and calcium on the affected parts of the tissue. Such a course can last 2-3 weeks, after which the surface is covered with fluoridated varnish.
• For a similar purpose of restoring the mineral composition of the tooth, calcium electrophoresis is performed.
• If the units are severely damaged and hard tissue correction is necessary, the doctor may recommend the installation of veneers, the application of a light-cured composite, or prosthetics with crowns.
• A fortifying course is carried out, in which drugs with a high content of fluoride and calcium are prescribed, as well as multivitamin complexes.
• To correct darkening or appearance of age spots, surfaces are polished with special pastes, whitening procedures, as well as varnishes or gels with fluoride.

The duration, complexity and characteristics of treatment will depend on the degree of damage to the enamel by erosive processes. In some cases, the doctor may decide to have 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: the dentist talks about tooth enamel.

Preventive measures

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

• Avoid foods and drinks that contain a particularly high concentration of various acids. If it is difficult to do this, then at least try to consume such a drink through a straw, without holding it in your mouth for a long period.
• Stop eating hot foods, as high temperatures can have a negative effect faster than too low temperatures.
• You can use sugar-free chewing gum or a piece of hard cheese to neutralize the acidity in your mouth.
• After taking acidic 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.
• do with a soft brush, without working too hard on the surface.
• If for any purpose you use pastes with abrasive particles, then after two to three weeks replace it with a regular one and take a significant break.
• Do not get carried away folk remedies for teeth whitening.
• Use periodically high fluoride and calcium pastes for cleaning.
• A regular visit to the dentist will help to identify the defect at the very initial stage and treat it with the least consequences.

Additional questions

ICD-10 code

In the International Classification, enamel erosion is under the code K03.2 and belongs to other diseases of hard dental tissues.