ÇOCUKLARDA DENTAL EROZYON VE KORUYUCU UYGULAMALAR

Dental erozyon, bakteriyel bir ilişki olmaksızın, asitler tarafından gerçekleştirilen kimyasal olaylar nedeniyle ortaya çıkan, diş sert dokularının geri dönüşümsüz ve ilerleyici yıkımıdır. Ağız ortamında asidik pH’ın oluşmasına neden olan içsel ve dışsal asit kaynakları dental erozyon oluşumunda rol oynar. Diyetle alınan asidik yapıdaki içecekler, yiyecekler ve kullanılan ilaçlar dışsal asit kaynaklarını oluştururken, gastro-özofageal reflü ve kusma içsel asit kaynak- larının ağız boşluğuna ulaşmasına neden olmaktadır. Ayrıca içeceklerin biberon kullanılarak tüketilmesi, karbonatlı içeceklerin teneke kutulardan ve ağızda köpürtülerek içilmesi ve asitli gıda tüketimini takiben dişlerin abraziv özellikli diş macunlarıyla aşırı kuvvet uygulanarak fırçalanması gibi davranışlar da dental erozyon riskini arttırmaktadır. Süt dişlerinde erozyonun en yaygın olduğu alanlar, molarların okluzal yüzleri, üst kesicilerin palatinal ve insizal yüzeyleridir. Dental erozyon sonucu olarak dentin tutulumu, süt dişlerinde daimi dişlere göre daha ince olan mine yapısı ve morfolojik farklılıklar nedeniyle daha hızlı olmaktadır. Dental erozyondan korunmada, hastalar ve ebeveynler öncelikle, eroziv potansiyeli yüksek olan yiyecek ve içecek maddeleri hakkında bilgilendirilmelidir. Asidik yiyecek ve içeceklerin tüketimi azatılmalı ve sadece yemek saatleri ile sınırlandırılmalıdır. Dental erozyon riski olan hastalara yumuşak kıllı diş fırçaları, düşük abraziviteye ve yüksek florür oranına sahip diş macunlarının kullanımı önerilmelidir. Erozyonun tedavisinde, süt dişlenme döneminde, eğer çocuk herhangi bir semptoma sahip değilse restoratif tedavi endike değildir. Dişlerde hassasiyet söz konusu ise, erozyon görülen küçük alanlar rezin materyaller ile örtülebilir. Dental erozyona sahip tüm hastalar, etyolojik faktörleri, hastalığın şiddeti ve ilerleme paternine bağlı olarak düzenli aralıklarla kontrol edilmelidir.

Anahtar Kelimeler:

Dental erozyon, Asitli içecekler, Remineralizasyon

DENTAL EROSION IN CHILDIREN AND PREVENTIVE PRACTICES

Dental erosion is irreversible and progressive destruction of dental hard tissues without bacterial relationship. Internal and external acid sources that causes the formation of acidic pH in the oral environment, plays a role in the formation of dental erosion. While dietary acidic drinks and foods and drugs used are creating external acid sources, gastrooesophageal reflux and vomiting causes of internal acid source reach the oral cavity. In addition , bavarage intake with baby bottle, drinking can of carbonated beverages by foaming at the mouth and following acidic food consumption brushing teeth with an abrasive featured toothpaste and excessive force, increase the risk of dental erosion formation. The most common erosion areas are occlusal surface of the molars and palatal and incisal surfaces of the incisors. Dentin involvement of erosion in primary teeth is faster than permanent teeth, due to morphological differences and thinner enamel structure. In the prevention of dental erosion, firstly, patients and parents should be informed about food and beverages which has high erosive potential. Consumption of acidic foods and beverages should be limited and only at meal time. Patients who has dental erosion risk, should be recommended use of low abrazive toothpaste with high fluoride content and a soft-bristled toothbrush. In primary dentition, restorative treatment of erosion lesions is not indicated if the child does not have any symptoms. In the case of tooth sensitivity, small areas of erosion observed can be covered with resin materials. Depending on the etiologic factors, severity and progressive pattern of disease, all patients with dental erosion should be checked regularly

Keywords:

Dental erosion, Acidic baverages, Remineralization,

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