Dental erosion is becoming more and more precocious

While the consumption of sodas, fruit juices and other refreshing drinks continues to increase, dental surgeons are worried. In fact, more and more young adults, and even children, have characteristic tooth lesions.

Acid drinks, leading responsible

Already criticized for their content of sugars, caffeine and other substances not always identified, these drinks are particularly acidic. Consumed regularly during the day, they attack the teeth which lose enamel and become more sensitive. 1. Professor Pierre Colon 2, a dental practitioner teaching conservative odontology and endodontics, sounds the alarm.

The consumption mode also counts

As life expectancy grows longer, we are also more likely to retain our teeth until old age. Dental surgeons are now used to spotting and treating wear and tear. "Dental erosion is not only more frequent but, especially, it occurs in patients who are still young, sometimes even children," explains Pr Colon Since the early 2000s, many works have been published in international journals, most of which concern children and young adolescents because at their age, erosion is necessarily linked to the way of life.
Is it possible to reverse the trend?

One of the last studies, published in 2010 and carried out by 2251 Icelandic children, showed that at 12 years of age, 16% had at least one tooth involved and at 31 years they were 31%. And the predominantly affected teeth vary according to the countries, the age of the children and the evaluation methods used, but the finding is the same: erosion, more and more commonly observed on milk teeth, continues on Teeth at a worrying speed 1.

Unlike caries, which extend deeply, lesions of wear first touch the surface of the teeth. Professor Colon explains: "These lesions begin with a thinning of the enamel, which eventually brings out the yellowish dentin, which in turn is hollow. In the children examined, the erosion concerns the incisors, which lose their profile slightly And the triturating face 4 of the first lower molars which is also flattened.This wear is typical, situated along the path of the ingested drinks. "

The correlation has indeed been established several times: children with damaged teeth are also the biggest consumers of acidic foods and drinks.1 This is also true in adulthood. In 2011, an English study 5 estimated that the risk of dental erosion is multiplied by 6.5 for 18-30 year-olds drinking alcoholic beverages.

If the wear on the teeth of today's children remains relatively small, given their age, what shape will it take in 10 or 30 years if their habits do not change? "When the erosion reaches the dentine, which is softer than the enamel, the lesions progress even more rapidly," continues the specialist. "There is then the appearance of dental hypersensitivity and sometimes an important aesthetic and functional repercussion." < Code>

Now, apart from flat water and milk, all drinks are acidic. "Teeth begin to demineralize when they are at pH 6 below 5.5," says Professor Colon. "Sodas, energy and energy drinks, iced teas, fruit juices, flavored waters, wines, beers. Have a pH of between 2.5 (such as lemon juice) and 4.5, whether or not the acidity is perceptible at the taste level ". Note that sugar, contained in most of these drinks, amplifies the problem since it is transformed into acids by bacteria responsible for caries.

In the United States, consumption of non-alcoholic refreshing drinks is estimated at 60 liters per person per year.7 The figure may seem reasonable compared to the average consumption of Europeans (94l) or Americans (180l) .8 However, It hides large disparities and sales are constantly increasing (+ 32% from 1994 to 2004, + 224% for light versions) 7.

Professor Colon points out, however, that it is not abnormal for the teeth to be in contact with acidic beverages or foodstuffs: "It is a question of proportion: the acidity of the product, its capacity to be more Or less rapidly neutralized by saliva and, above all, the mode of consumption, also count. "

Today, however, exposure to fruit juices, sodas, compotes and other acid products sometimes begins at an early age thanks to the mini-sizes or bottles of grenadine, cola always ready to quench the thirst during the day. When they grow up, these children continue to claim sugary drinks at the expense of water and dairy products. Adolescents, they sipped their glass of soda, throughout the day, reviewing their exams or watching TV ... Some do not hesitate to keep a bottle at hand for the night.

"People who tend to have dry mouth, professionals exposed to heat (building workers, bakers ...) and sportsmen are also big consumers of this type of drinks, but their acidity is even more deleterious In this context since the saliva, which could neutralize it, is not present in sufficient quantity ", notes Professor Colon. As for the adepts of the regimes, often women, they use and sometimes abuse drinks without sugars and acid seasonings (vinegars, lemon, mustard ...) without being aware of their repercussions on the teeth. >
In the face of long-term risks, many studies conclude that there is a need for further research into erosion factors and ways of preventing erosion by, for example, adding protective elements to acidic foods and beverages. The research undertaken for this purpose, however, began more than 20 years ago without any change at the moment.

Meanwhile, parents and savvy consumers themselves can take some precautions to limit the damage. The first is of course to limit its consumption of sodas, fruit juices and other refreshing drinks by replacing them with milk or flat water (the soda water is often slightly acidic).

In order to better neutralize their acidity, Prof Colon advises also to consume them at the time of the meals: "The salivary secretion is maximum and one can finish the meal with a protective food, typically a dairy product Drink with a straw in order to limit the contact With teeth, rinsing your mouth with water, chewing gum without sugars and, above all, washing your teeth after each meal, can also slow or stop erosion if not too advanced. Otherwise, it is essential to restore damaged teeth to protect them from further attacks and reduce hypersensitivity.

1 - Taji S, Seow WK. A literature review of dental erosion in children. Aust Dent J. 2010 Dec, 55 (4): 358-67. 2 - Interview conducted in July 2012 with Pierre Colon, Professor of Universities (Paris Diderot University), hospital practitioner in conservative odontology and endodontics in the dental odontology department of the Rothschild Hospital (AP-HP, Paris). ), Researcher in materials chemistry in the Biomaterials and biological interfaces laboratory of the Multimaterials and Interfaces Laboratory UMR CNRS 5615 (Lyon 1). 3 - Arnadottir IB, Holbrook WP, Eggertsson H et al. Prevalence of dental erosion in children: a national survey. Community Dent Oral Epidemiol. 2010 Dec, 38 (6): 521-6. 4 - The embossed face on which the food is crushed 5 - Bartlett DW, Fares J, Shirodaria S et al. The association of tooth wear, diet and dietary habits in adults aged 18-30 years old. J Dent. 2011 Dec, 39 (12): 811-6. Online summary 6 - The pH is expressed on a logarithmic scale from 0 to 14. This means that a drink of pH 6 is ten times more acidic than a drink of pH 7, such as pure water 7 - Pellae M. Evolution of food consumption and behavior in the United States. Dossier Food and dental erosion. Med. Nutr. Flight. 8 - Brochure of the National Syndicate of Refreshments (SNBR)

The French Union for Oral Health (UFSBD) for its Nutrition and Oral Health Guides for dental surgeons but in which the general public can find accessible information and advice adapted to each age. As well as its departmental branch in the Vosges for its advice of prevention.