This Hallowe’en many health conscious parents will try to limit their children’s sweet and chocolate intake, which is all to the good in terms of reducing the risk of tooth decay. What is perhaps less well known amongst the general public is that modern diets also have an impact on tooth wear.
A parent, for example, might think swapping a chocolate bar for a low calorie fizzy drink or a fruit smoothie is a great result, but do that too often and it is we dentists who have to break the upsetting result – that their child is suffering tooth erosion beyond that which we would expect for their age.
The latest Child Dental Health Survey year reinforces the concern being felt amongst the dental profession, revealing that 4% of the population’s 15 year olds are affected by significant tooth surface loss. While 4% may seem a small proportion, in reality it equates to nearly 30,000 adolescents in the UK.
As the Survey states: ‘Although active treatment at this age  is uncommon, this is a progressive condition and where several teeth are affected would be a real concern as it would indicate very early damage and a considerable risk and potential burden for the future.’
Speaking on this issue, Professor Andrew Eder, Clinical Director of the London Tooth Wear Centre®, commented ‘The key to successful prevention in the area of erosive tooth wear would seem to lie in raising patient awareness in the form of education about the impact of acidic foods and drinks.
‘For example, would your health-conscious patients know that items such as fruit juices, smoothies, sports beverages and fizzy drinks − including sugar-free − as well as foods otherwise considered to be healthy like citrus fruits, yoghurt and honey consumed over a long period may result in irreversible damage requiring extensive and expensive restorative treatment in later life?’
Patients may need to be confronted with the ugly truth, in that erosion can result in:
• Tooth sensitivity
• Discolouration, including yellowing and loss of shine (where some of the outer enamel layer has been lost)
• Sharp or chipped anterior teeth
• Occlusal surfaces wearing flat and taking on a shiny, pitted appearance
• Altered occlusion as vertical height changes
• Restorations standing proud of the teeth
• Abfraction lesions developing cervically
• V-shaped notches or shallower cupping present cervically?’
To help prevent further erosion, helpful advice to be communicated to parents and their children includes:
• Drinking still water or low fat milk between meals
• Limiting fruit juice to once per day, preferably with meals, and avoid fizzy drinks
• Rinsing the mouth with water for 15 to 30 seconds after consuming acidic foods or drinks
• Chewing sugar free gum or eating a piece of cheese after consuming acidic food or drink
• Waiting at least an hour to brush teeth after consuming any acidic foods or drinks
• Using a toothpaste that contains at least 1400ppm fluoride and a non-abrasive toothbrush
• Using a fluoridated mouthwash every day at a different time to tooth brushing, as well as before or after acidic foods and drinks, to help limit the erosive potential.
The London Tooth Wear Centre® offers an evidence-based and comprehensive approach to managing tooth wear. To request advice, make a referral or for further information on the work of the London Tooth Wear Centre®, please visit www.toothwear.co.uk, email firstname.lastname@example.org or call 020 7486 7180.
Professor Andrew Eder is a Specialist in Restorative Dentistry and Prosthodontics and Clinical Director of the London Tooth Wear Centre®, a specialist referral practice in central London. He is also Professor/Honorary Consultant at the UCL Eastman Dental Institute and Pro-Vice-Provost and Director of Life Learning at UCL.
The London Tooth Wear Centre® offers an evidence-based and comprehensive approach to managing abrasion, attrition and erosion, utilising the latest clinical techniques and an holistic approach in a professional and friendly environment.