April 18, 2007
Tooth erosion and decay
I recently saw a young man in my clinic who had not visited a dentist for a substantial period of time.He was persuaded to come to see a dentist because he had bleeding gums and “black stains” on his teeth.
When I did the initial examination,I asked him a couple of questions and discovered that he is a smoker,he is not very diligent in his tooth-brushing(and obviously does not floss) and he drinks a lot of Coca Cola.That,by the way is one of the potent combinations for dental disaster.
I spent a rather long session cleaning his teeth and teaching him how to brush and floss correctly and advising him against his high-sugar and high-acid diet.

This picture was taken 2 weeks later after his swollen and bleeding gums had healed considerably and he had been brushing his teeth much more carefully.The black patches are due to erosion and decay.He also had extensive decay in between all his front teeth.
The erosion is due to his long-term relationship with Coca Cola.Dental erosion is a process whereby the tooth stucture (enamel and sometimes,dentin)is destroyed by the long-term exposure and action of acid on it.This is an external cause ie from his diet.The decay is also a contribution from Mr Coke plus the fact that he was not careful with his tooth brushing.Decay is a process where the tooth structure is destroyed by acid-producing bacteria,Streps Mutans.
The process of dental erosion is irreversible and requires treatment to arrest the situation, and also a drastic change in dietary and oral hygiene habits.Decay is a progressive disease which needs to be dealt with as soon as possible before it progresses to reach the pulp of the teeth.
There was much to be done for this young man.He had taken a tremendous step to improve his oral hygiene and to visit the dentist more regularly.He also promised to cut down on,if not stop all his fizzy and sweet beverages.One of his front teeth is already non vital,due to the decay reaching and destroying the pulp of the tooth.And he would require a root canal treatment for that tooth.
As a first line of treatment,now that he is able to manage his oral hygiene reasonably well,I did some direct composite veneers to his 4 front teeth,after removing all the decay present.

He was rather pleased that he can now smile confidently after such a long time.
Just to mention a bit more on dental erosion,young people especially teenagers and young working adults are most susceptible because of the high consumption of fizzy or soft drinks.The diet version may be lower in sugar content,but the acidic effect is actually much worse.Pure fruit juices which are acidic like citrus juices,are just as bad in its errosive abilities.
There need to be a more acute awareness about this problem.I see an increase in dental erosion and decay amongst the growing affluent society.When I walk along the aisle of the supermarket where drinks are being sold,I see rows and rows of soft drinks,juices of all sorts,not to mention a whole load of sweetened drinks like cultured milk,soya milk and the list goes on.
Apart from your dentist advising you or your child about this problem,parents and care-givers play a crucial role.Watch what your children are drinking and take them for regular dental check up,so that if there is an inherent problem,the situation can be quickly diagnosed and delat with accordingly.





