Dietary factors associated with dental erosion: a meta-analysis

Evaluation of the Surface Roughness and Microleakage of Dental Composites Exposed to Different Beverages

AIM

The purpose of this study was to determine the effect of different solutions cola soft drink (CSD) and coffee on roughness and microleakage of composite resin restorations.

MATERIALS AND METHODS

Sixty bovine incisors were prepared and restored using Filtek Z350 XT (3M/ESPE) nanoparticulate resin. The samples were divided into three groups (n = 20): A (control)-Immersion in artificial saliva (14 days); B: Immersion in coffee (14 days), for 15 minutes (3x/day) and C: Immersion in CSD for 14 days (3x/day). Then the samples were analyzed for microleakage (dye penetration) and surface roughness (atomic force microscope). The one-way analysis of variance (ANOVA) was applied to assess the surface roughness and microleakage. The Tukey's test was set at 0.05.

RESULTS

Group A (roughness-GAR) presented significantly the lowest average surface roughness. Group C (microleakage-GCM) showed significantly the highest average microleakage.

CONCLUSION

It was concluded that CSD and coffee change the surface roughness and increase the microleakage of restorations.

CLINICAL SIGNIFICANCE

Nowadays there is a high consumption of artificially sweetened soft drinks, sports drinks, high-energy beverages and coffee products by people that cause problems in composite resin restorations.

Energy Drink Consumption: Beneficial and Adverse Health Effects

Consumption of energy drinks has been increasing dramatically in the last two decades, particularly amongst adolescents and young adults. Energy drinks are aggressively marketed with the claim that these products give an energy boost to improve physical and cognitive performance. However, studies supporting these claims are limited. In fact, several adverse health effects have been related to energy drink; this has raised the question of whether these beverages are safe. This review was carried out to identify and discuss the published articles that examined the beneficial and adverse health effects related to energy drink. It is concluded that although energy drink may have beneficial effects on physical performance, these products also have possible detrimental health consequences. Marketing of energy drinks should be limited or forbidden until independent research confirms their safety, particularly among adolescents.

Influence of various acidic beverages on tooth erosion. Evaluation by a new method

MATERIAL & METHODS

We have analyzed the loss of enamel and dentine after exposure to different non-alcoholic drinks with a simple new method using bovine teeth. 100 enamel and 100 dentine specimens from freshly extracted bovine incisors were randomly attributed to 10 groups (n=10 for enamel and dentine each). Prior to the start of the experiment all specimens were weighed using a precision balance. The mean initial masses (SD) were 35.8 mg (7.2) for enamel and 24.7 mg (7.0) for dentine. No statistically significant differences were found between groups for initial masses (p>0.05, ANOVA with Bonferroni post hoc test). Thereafter, all specimens of one group were simultaneously placed in 200 ml of the following fluids: Coca-Cola, Coca-Cola light, Sprite, apple juice, Red Bull, orange juice, Bonaqua Fruits (Mango-Acai), tap water, chlorinated swimming pool water, and lemon juice. Fluids were continuously ventilated at 37° C for 7 days. Thereafter the specimens were weighed again and the mean mass loss was calculated.

RESULTS

The values were (enamel/dentine): Coca-Cola 7.5 mg/6.6 mg; Coca-Cola light 5.2 mg/3.5 mg, Sprite 26.1 mg/17.7 mg, apple juice 27.1 mg/15.2 mg, Red Bull 16.6 mg/17.0 mg, orange juice 24.3 mg/20.2 mg, Bonaqua Fruits (Mango-Acai) 17.8 mg/16.2 mg, tap water -0.2 mg/-0.3 mg, swimming pool water -0.3 mg/-0.2 mg, and lemon juice 32.0 mg/28.3 mg. From all drinks, Cola and Cola light showed the least erosivity (p<0.001, ANOVA with Bonferroni post hoc test) whereas lemon juice showed statistically significant higher erosivity than all other drinks except Sprite and apple juice (p<0.01, ANOVA with Bonferroni post hoc test).

CONCLUSIONS

In conclusion, erosivity of common non-alcoholic drinks varies widely. For example, Sprite, apple juice, and orange juice are about five times more erosive than Coca-Cola light. The findings from the present study should be taken into account in choosing a diet that provides satisfactory nutrition while minimizing tooth erosion.

Erosive Tooth Wear among 12-Year-Old Schoolchildren: A Population-Based Cross-Sectional Study in Montevideo, Uruguay

The aim of this study was to assess the prevalence, extent, severity, intraoral distribution and risk indicators for erosive tooth wear (ETW) among 12-year-old schoolchildren from Montevideo, Uruguay. A population-based, cross-sectional survey was conducted using a representative sample of 1,136 12-year-old schoolchildren attending public and private schools. Parents answered questions on socioeconomic status and general health. Schoolchildren answered questions on dietary and oral hygiene habits. Two calibrated examiners recorded ETW on permanent teeth according to the Basic Erosive Wear Examination (BEWE) score system. Logistic regression models were performed to assess the association between the predictor variables and the prevalence of ETW (overall and severe ETW). Odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated. The prevalence of ETW was 52.9%, being mild erosion (BEWE = 1) in the vast majority of cases (48.5%). Severe erosion (BEWE ≥2) was detected in 4.4% of schoolchildren. The overall prevalence of ETW differed significantly between categories of gender and socioeconomic status, but only between gender in the severe ETW analysis. The overall extent of ETW was significantly different between categories of gender, socioeconomic status, and swish before swallow. The extent of severe ETW differed between categories of swish before swallow and brushing frequency. In the logistic regression analysis, no association was found between the studied variables and the overall prevalence of ETW. Males were more likely to have severe ETW than females (OR = 3.22, 95% CI = 1.50-6.89). ETW may be considered a public health problem among 12-year-old-Uruguayan schoolchildren.

Energy drinks: Getting wings but at what health cost?

Energy drink consumption represents a global public health problem, especially among adolescents and young adults. The consumption of energy drinks has seen a substantial increase during the past few decades, especially in the Western and Asian countries. Although manufacturers of energy drinks claim that these beverages are beneficial in that they can boost energy, physical performance, and improve cognitive performance, there is insufficient scientific evidence to support these claims. The known and unknown pharmacology of the constituents of energy drinks, supplemented with reports of toxicity, raise concern for the potentially severe adverse events linked with energy drink use. Limited numbers of reviews have been published on this important subject..The aim of this review was to identify the major ingredients in energy drinks and to delineate the adverse effects related to their consumption.

Methods: Electronic databases of PubMed, Clinical Key, and Google and Cochrane library were extensively searched for energy drink articles. More than hundred articles were reviewed, scrutinized and critically appraised and the most relevant forty articles were used

Conclusion: Energy drinks & its ingredients are potentially dangerous to many aspects of health. Measures should be taken to improve awareness among adolescents and their parents regarding the potential hazards of energy drinks. Furthermore, the sale of energy drinks on college and university campuses and to adolescents below 16 years should be prohibited.

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents

OBJECTIVE

The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents.

MATERIALS AND METHODS

A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression.

RESULTS

Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer.

CONCLUSION

High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.

Paroxysmal paralytic attacks secondary to excessive cola consumption

We report a rare case of cola-induced hypokalemia presenting as recurrent attacks of lower extremity weakness and falls. Excessive consumption of cola-based drinks has been associated with dental enamel erosion, obesity, and diabetes. There are very few published cases depicting the correlation between cola drinks and hypokalemic manifestations. In our patient an extensive workup was performed, and common causes were ruled out before making the diagnosis of cola-induced hypokalemia. Improvement in the patient's symptoms and electrolyte levels after reducing the consumption of cola-based drinks further confirmed our diagnosis. This case also emphasizes the importance of obtaining a detailed history and consideration of broad differential diagnoses in identifying uncommon but reversible etiologies.

Effects of diode laser therapy and stannous fluoride on dentin resistance under different erosive acid attacks

OBJECTIVE

This in vitro study aimed to evaluate the effect of a low intensity diode laser (λ=808 nm; 60 J/cm2) associated with stannous fluoride on the inhibition of dentin erosion by assessing percentage of superficial hardness loss (%SHL) and calcium release into the acid solution.

MATERIALS AND METHODS

Human root dentin slabs were assigned to eight groups (n=10), according to treatments (control, stannous fluoride, diode laser therapy, and the combination of stannous fluoride and laser therapy), and acid challenge (hydrochloridric or citric acid). All slabs were subjected to a previous 2 h acquired pellicle formation; laser and fluoride treatments were performed according to the groups. Subsequently, the slabs were exposed to erosive challenge (0.01 M hydrochloridric acid or citric acid 1% for 60 sec). Additionally, calcium released into the acid solution during erosive challenge was analyzed by photometric test. Data were analyzed by ANOVA followed by Tukey's test (p<0.05).

RESULTS

Mean values (±SD) for %SHL of treated groups did not present statistically significant differences, regardless of the erosive challenge. However, in relation to released calcium concentration, groups treated with laser presented statistically significant lower calcium loss under hydrochloridric acid challenge (p<0.001). To groups under citric acid attack, only the combination of treatments (p=0.037) was able to show a protective effect on dentin.

CONCLUSIONS

Under the conditions of this study, 808 nm diode laser with or without stannous fluoride could effectively reduce dentin surface loss under both acid exposures. Only calcium concentration analysis was sensitive enough to measure the effects under the tested conditions.

Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study

Dental erosion is a pathological condition resulting from the irreversible dissolution of the mineralized portion of the teeth, being recognized in modern society as an important cause of loss of tooth structure. The aim of this study was to assess the prevalence and its association with diet in Brazilian adolescents of Campina Grande, PB, Brazil. A population-based study was conducted on a stratified sample of 675 adolescents aged from 15 to 19 of both sexes using the index proposed by O'Sullivan. Dental examinations were performed by two calibrated dentists (kappa = 0.82). The significance level adopted was 5%. The prevalence of dental erosion was 21%, and the upper central incisors and lateral incisors were the most affected elements, with 50.5% and 40.2%, respectively. The buccal surface showed greater impairment (51.4%) and 67.8% of teeth with dental erosion had more than half of the surface of affected area. Most damage was on the enamel (93.5%). There were no statistically significant differences between the occurrence of dental erosion and gender, age, socioeconomic status, self-reported ethnicity, and diet. There was high prevalence of dental erosion in its early stages among adolescents and there were no significant differences in the frequency of the consumption of foods and beverages and the presence of dental erosion.

Dental caries in Arab League countries: a systematic review and meta-analysis

OBJECTIVE

The aim of this review was to determine prevalence of dental caries in primary and permanent teeth in the 2-20-year-old population of the Arab league.

METHODS

A literature search was performed on Pubmed, Summon and Google Scholar using the key words 'Dental caries', 'dmft' and 'DMFT'. A total of 293 articles were found, of which 35 passed our inclusion criteria and were included in analysis. Tables were made separately for primary and permanent teeth; the age group for primary teeth was 2-12 years and for permanent teeth 6-20 years.

RESULTS

A meta-analysis was run by using data extracted from the studies included. Heterogeneity was tested by forest plot and chi-square test, and considerable heterogeneity was found. Mean decayed, missing and filled teeth (dmft) was 4.341 (95% CI 3.714, 4.969) and in permanent teeth (DMFT) was 2.469 (95% CI 2.019, 2.919) from a random effect model. Publication bias diagnostics suggested missing of four studies of primary teeth caries data and eight studies of permanent teeth caries data to obtain symmetry in the funnel plot.

CONCLUSION

The incidence of caries in primary teeth was found to be high compared with caries in permanent teeth in the Arab League. This study does not provide a comprehensive picture of caries prevalence in the Arab League because in many of these countries only a few studies were performed. Therefore, these data cannot provide a complete picture of the prevalence of caries in those countries. Additional studies are needed to better evaluate the prevalence of caries in children and young adults in Arab League countries.