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Gastroesophageal reflux disease (GERD) is known as the most prevalent gastrointestinal disorder in the United States, leading to substantial morbidity, although associated mortality is rare. Based on the appearance of esophageal mucosa on upper endoscopy, GERD is divided into erosive esophagitis (ERD) and nonerosive reflux disease (NERD). Heartburn and acid regurgitation are the typical symptoms of the disease, although some patients may present atypical manifestations such as epigastric pain, nausea, asthma, chronic cough, pharyngitis, laryngitis, sleep disturbances, otitis, and sinusitis. Other signs, such as oral mucosal lesions may result from GERD by direct acid or acidic vapor contact in the oral cavity. Oral manifestations such as tooth erosion, periodontitis, gingivitis, palatal erythema, ulceration, glossitis, oral acid burning sensation, halitosis, xerostomia have recently been reported in GERD patients. A considerable percentage of the patients are affected by oral manifestations before the onset of gastrointestinal symptoms, although in most cases the gastrointestinal signs and symptoms dominate the clinical picture. The injured oral mucosa negatively impacts the quality of life, especially functional limitation, physical inability and psychological disabilities, thus leading to social isolation. There is plenty of non-standardized information on the oral mucosal changes in GERD. In this context, we aimed at synthesizing and analyzing the current available evidence on non-dental oral cavity lesions and complaints that are present in patients diagnosed with GERD. [ABSTRACT FROM AUTHOR]

Dental erosion (DE) is a well-accepted multifactorial form of tooth wear involving acids. Due to its irreversible nature, recognizing the early signs is important to develop appropriate preventive strategies. However, its place in dental curricula remains unclear. Consensus has not been established regarding the integration of erosive tooth wear into core cariology curricula in North America. The extent to which DE is taught is questionable since etiology, risk assessment, and management are not all the same as for dental caries. The aim of this study was to survey U.S. and Canadian dental schools regarding their teaching of DE. Email invitations were sent to deans, chairs, and selected faculty members at all 76 U.S. and Canadian dental schools in 2016, asking them to either respond or forward the survey-link provided to the appropriate person in their school. Responses from the same school were combined for analysis. Respondents from 59 schools (77.6% response rate) responded to the survey, and all of them confirmed the inclusion of DE in their curricula. However, only 15.3% of respondents identified correctly all the clinical signs of DE. Although management through behavioral intervention was prioritized, diet analysis was often not a clinical requirement, and 45.8% of respondents did not teach any type of tooth wear index for monitoring. This study concluded that DE has a place in dental curricula, but whether this topic is adequately covered is questionable. There is a need to establish clearer topics and requirements emphasizing the diagnosis and management of DE, potentially in cariology curricula. [ABSTRACT FROM AUTHOR]

The article discusses the significant role of dental nurses in managing the dental care of patients with eating disorders. It provides an overview of the disorder including its prevalence rate, aetiology, and clinical findings. Also included are ways for dental nurses on how to manage the dental care of patients with eating disorders which include updating the medical history of patients, complication preparedness, and health care counselling.

Abstract: Objective: Our objective was to compare the physiochemical properties and erosion potentials between beverages available in the UK and the US. Methods: The physiochemical properties (pH, titratable acidity and fluoride concentration) and erosion potential on enamel surfaces of beverages available in the UK were compared to similar beverages from the US. Enamel windows were exposed to beverages for 25h. Teeth were sectioned through the windows, and lesion depths were defined as the average distance between the original tooth structure and the base of demineralization. Results: The pH was lower in UK apple juice, orange juice, Diet Pepsi® and Sprite Zero® (p <0.05), and higher in UK orange soda and diet orange soda than in similar US beverages (p <0.05). Titratable acidities were higher in UK apple juice, orange juice, orange soda, diet orange soda and Sprite® (p <0.01), and lower in UK Sunny D® than in the US counterpart (p <0.001). Fluoride concentrations were lower in UK apple juice, orange juice, Coke®, and Diet Coke®, Sprite® and Sprite Zero® (p <0.001), and higher in UK orange soda, diet orange soda, Pepsi® and Diet Pepsi® than in their US counterparts (p <0.001). Lesion depths were higher in UK apple juice, orange juice, Diet Coke®, Sprite® and Sprite Zero® than in their US counterparts (p <0.05). Lesion depths were associated with pH (p =0.010) and country of origin (p =0.002). Conclusions: Under similar laboratory conditions, the physiochemical properties and erosion potentials on enamel surfaces differed between some, but not all, beverages available in the UK and the US. [Copyright &y& Elsevier]

Abstract: Acidic beverages are thought to increase the potential for dental erosion. We report pH and titratable acidities (ie, quantity of base required to bring a solution to neutral pH) of beverages popular in the United States and lesion depths in enamel and root surfaces after beverage exposure, and we describe associations among pH, titratable acidity, and both enamel and root erosive lesion depths. The pH of 100% juices, regular sodas, diet sodas, and sports drinks upon opening and the titratable acidity both upon opening and after 60 minutes of stirring were measured. Enamel and root surfaces of healthy permanent molars and premolars were exposed to individual beverages (4 enamel and 4 root surfaces per beverage) for 25 hours, and erosion was measured. Statistical analyses included 2-sample t tests, analyses of variance with post hoc Tukey studentized range test; and Spearman rank correlation coefficients. All beverages were acidic; the titratable acidity of energy drinks was greater than that of regular and diet sodas that were greater than that of 100% juices and sports drinks (P < .05). Enamel lesion depths after beverage exposures were greatest for Gatorade, followed by those for Red Bull and Coke that were greater than those for Diet Coke and 100% apple juice (P < .05). Root lesion depths were greatest for Gatorade, followed by Red Bull, Coke, 100% apple juice, and Diet Coke (P < .05). Lesion depths were not associated with pH or titratable acidity. Beverages popular in the United States can produce dental erosion. [Copyright &y& Elsevier]

Purpose: To discuss the composition and rationale for the use of sports drinks along with recent studies investigating the relationship between sports drinks and dental erosion. Methods: A review of the literature of sports drinks and dental erosion was done. Results: For most athletes and individuals engaged in physical activity, the use of sports drinks does not provide a benefit over water. Furthermore, although there is much in vitro evidence that acidic drinks such as wine, fruit juices and carbonated soft drinks have erosive potential and there are relationships between consumption of these drinks and erosion, only one study has reported an association between sports drinks and dental erosion. Other factors such as drinking habit and salivary production may be more important determinants of dental erosion. [ABSTRACT FROM AUTHOR]

Acidic soft drinks, including sports drinks, have been implicated in dental erosion with limited supporting data in scarce erosion studies worldwide. The purpose of this study was to determine the prevalence of dental erosion in a sample of athletes at a large Midwestern state university in the USA, and to evaluate whether regular consumption of sports drinks was associated with dental erosion. A cross-sectional, observational study was done using a convenience sample of 304 athletes, selected irrespective of sports drinks usage. The Lussi Index was used in a blinded clinical examination to grade the frequency and severity of erosion of all tooth surfaces excluding third molars and incisal surfaces of anterior teeth. A self-administered questionnaire was used to gather details on sports drink usage, lifestyle, health problems, dietary and oral health habits. Intraoral color slides were taken of all teeth with erosion. Sports drinks usage was found in 91.8% athletes and the total prevalence of erosion was 36.5%. Nonparametric tests and stepwise regression analysis using history variables showed no association between dental erosion and the use of sports drinks, quantity and frequency of consumption, years of usage and nonsport usage of sports drinks. The most significant predictor of erosion was found to be not belonging to the African race (p < 0.0001). The results of this study reveal no relationship between consumption of sports drinks and dental erosion. [ABSTRACT FROM AUTHOR]

The article reports that a panel from the National Reseach Council (NRC) has urged the government to lower the maximum contaminant level goal (MLCG) for fluoride in the U.S. According to the NRC, the current MLCG for fluoride does not protect children from suffering severe enamel fluorosis and should be lowered. the panel's 576-page report, concludes that severe enamel fluorosis, a permanent pitting of tooth enamel caused by early exposure to elevated fluoride levels, is an adverse health effect that can occur at drinking water fluoride levels at or near the current MCLG.

Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians' management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians' adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician., (© 2021 S. Karger AG, Basel.)