The role of saliva in dental erosion and a prosthetic approach to treatment: a case report.
OBJECTIVE
The aim of this report is to describe the relationship of some salivary parameters to dental erosion resulting from excessive citric acid consumption and present a description of a prosthetic approach used to restore the damaged dentition of a patient with severe erosion.


BACKGROUND
The high consumption of dietary sources of acids can lead to erosion or the excessive wear of dental hard tissues. Erosion may be modified by salivary parameters such as flow rate, pH, and buffering capacity. Porcelain-fused-to-metal (PFM) restorations and composite resin veneers can be used successfully to restore impaired esthetics and eliminate tooth hypersensitivity in such cases.


RESULTS
A 37-year-old woman with a history of excessive lemon consumption presented with a complaint of tooth hypersensitivity and the poor appearance of her dentition due to erosion. Stimulated and unstimulated salivary samples of the patient were evaluated for flow rate, pH, and buffering capacity before and after treatment. The pre-treatment values were found to be higher than post-treatment values. Stimulated samples showed an increase of salivary flow rate, pH, and buffering capacity. The measured parameters put forth the defensive potential of saliva against the acidic diet, and the salivary flow rate and buffering capacity decreased after reducing acidic consumption. The excessively eroded teeth were restored using PFM restorations whereas the superficially eroded teeth were restored with composite resins.


CONCLUSIONS
The introduction of acidic foods, beverages, or other agents can exceed the natural buffering capacity of saliva. The result is a lowering of the pH of the oral environment which can lead to erosion of enamel and dentin. Loss of tooth structure due to erosion can compromise the esthetics of the dentition and lead to hypersensitivity of the teeth. Teeth damaged by erosion can be successfully restored by composite resin or porcelain restorations and esthetics and function of dentition can be improved.


CONCLUSIONS
This report is a profound example of how the over consumption of acidic agents affect not only dental tissues but also the chemical balance of the oral environment as well as the oral habitat.
Gazi University Faculty of Dentistry, Ankara, Turkey. bavbekab@yahoo.com
Andac Barkin
AB
Bavbek
Orhan Murat
OM
Dogan
Tamer
T
Yilmaz
Arife
A
Dogan
D000328:Adult; D002021:Buffers; D019343:Citric Acid / Q000009:adverse effects; D002957:Citrus / Q000009:adverse effects; D003188:Composite Resins; D003793:Dental Restoration, Permanent / Q000379:methods*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016876:Metal Ceramic Alloys; D012463:Saliva / Q000737:chemistry / Q000502:physiology*; D012636:Secretory Rate; D013391:Sucking Behavior; D014077:Tooth Erosion / Q000209:etiology* / Q000534:rehabilitation*
D002021:Buffers; D003188:Composite Resins; D016876:Metal Ceramic Alloys; D019343:Citric Acid