A Survey on the Prevalence and Risk Indicators of Dental Erosion among 13-15 Year Old Adolescents in Yangsan, Korea

노태환,이금랑,김지연,김신 大韓小兒齒科學會 2016 大韓小兒齒科學會誌 Vol.43 No.3

최근 세계적으로 치아침식증에 대한 관심이 급증하고 인식의 변화가 나타나 많은 연구보고가 있었다. 우리나라 국민건강영양조사에 따르면 청소년기로 갈수록 1일 탄산음료 섭취량이 늘고 있는 추세이며, 이는 청소년들이 치아침식증에 취약할 수있음을 시사한다. 하지만 우리나라에서는 이에 대한 인식이 아직 미진하고, 치과계에서도 연구적, 임상적 관심이 그리 높지않은 실정이다. 본 연구는 양산시 청소년들의 영구치에 나타난 치아침식증의 유병율을 조사하고 설문지를 통하여 그 위험요인을 분석할 목적으로 시도되었다. 양산시에 거주하는 13-15세 중학생 1,371명을 대상으로 단일 검사자가 영구치의 치아침식증 상태를 조사하였다. 치아침식증의 평가기준으로는 Visual Erosion Dental Examination system을 사용하였다. 또한 설문지를 통하여 이들의 식이습관 및 구강위생상태와 치아침식증 간 유의성을 비교ㆍ분석하였다. 치아침식증은 676명(49.3%)에서 관찰되었고, 남성(46.4%)에 비해 여성(53.0%)이 더 높은 유병율을 보였다(p < 0.05). 상악(39.3%)에 비해 하악(43.0%)에서 더 높았으나(p < 0.05), 좌ㆍ우측 간에는 차이가 없었다. 구치에 비해 전치의 유병율 및 치아 당 평균점수가 높았다. 가당 및 무가당우유는 치아침식증에 영향을 미치는 반면(p < 0.05), 다른 음료, 식이섭취방법, 구강위생, 그리고 BMI의 영향은 미미했다(p > 0.05). 본 연구에서 나타난 유병율은 20~30% 내외인 다른 보고들에 비해 높았으며, 남성이 호발한다는 기존의 보고들과 달리여성에서 유병율이 더 높았다. It is a trend that carbonated drink intake among adolescents is increasing, which makes young people more vulnerable to dental erosion. However, in Korea, public knowledge about dental erosion is very insufficient. The aim of this study was to investigate the prevalence of dental erosion and to assess its risk indicators among 13- 15 years old students in Yangsan, Korea. A total of 1,371 adolescents were examined by one calibrated clinician. Dental erosion was assessed by using the Visual Erosion Dental Examination system. Correlation between their dietary habit, oral hygiene and dental erosion was assessed. The data showed that 676 (49.3%) adolescents had dental erosion. The prevalence of dental erosion was significantly higher in females than in males. The prevalence of tooth erosion in mandible is higher than in maxilla. Dental erosion was generalized to develop mostly on anterior teeth, especially lateral incisor, however, the severity score was highest in canines. Following questionnaire analysis, dental erosion was significantly associated with milk and flavored milk. No other associations were detected. The prevalence of dental erosion in this study is higher than those of previous reports. On the contrary to previously reported studies, the prevalence of dental erosion in females is higher than in males.

산취급사업장근로자에서 산의 원천별 치아부식증의 분포 및 연관 요인에 관한 조사연구

박승민 ( Seung-min Park ),신명섭 ( Myung-seop Shin ),공미선 ( Mi-sun Kong ),김현덕 ( Hyun-duck Kim ) 대한구강보건학회 2016 大韓口腔保健學會誌 Vol.40 No.4

Objectives: No evidence has been found on various types of dental erosion, except for occupational dental erosion. This study aimed to evaluate the distribution of four types of dental erosion (occupational, dietary, systemic, and gastric) and its associated factors among workers in factories that use acids. Methods: Of 89,034 workers from 4,625 factories that use acids, 716 workers from 38 factories were selected for this cross-sectional epidemiological study by using three-stage stratified cluster sampling. Evaluation for dental erosion was performed by a trained dentist by using Kim`s criteria, and a saliva sample was collected directly from each participant. Data on acid sources and associated factors were collected by using questionnaires. By using a complex sample analysis, the T test and Rao-Scott chisquare test were applied to analyze the distribution of four acid factors and to evaluate the associated factors. Results: The prevalence of overall dental erosion was 37.7% for occupational dental erosion, 23.1% for dietary dental erosion, 3.1% for systemic dental erosion, and 3.2% for gastric dental erosion. The prevalence of severe dental erosion was 10.5% for occupational dental erosion, 7.1% for dietary dental erosion, 1.8% for systemic dental erosion, and 1.7% for gastric dental erosion. The factors associated with dental erosion were age, sex, acid exposure, dental cervical abrasion, and dental attrition. Conclusions: Our data showed that the prevalence of dental erosion was high, moderate, and low in occupational, dietary, and gastric and systemic dental erosions, respectively, among workers exposed to acids. The related factors differed according to the types of dental erosion. Our data suggested that different types of promotion programs for dental erosion should be considered according to acid source.

소아 예방치과

김진범 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.2

Dental caries is the first disease to cause the pathological extraction of teeth in children. The complete prevention of dental caries is not achieved by toothbrushing alone. The use of fluoride and pit and fissure sealant is regarded as key tools to prevent dental caries. Fluoride-containing tablets or multi-vitamins and community water fluoridation can be used as systemic application techniques. Professional fluoride application, fluoride iontophoresis on teeth, fluoride mouth rinsing and fluoride- containing toothpaste can be used as local application techniques. Pit and fissure sealant is mainly used to prevent dental caries on occlusal surfaces of premolars and molars. Sweeteners not to occur dental caries has been developed to substitute sucrose. Dental erosion increases according to the high consumption of acidic soft drink or beverages. The appropriate use of fluoride and pit and fissure sealant are recommended to prevent dental caries effectively and the education is required to reduce the consumption of acidic soft drinks or beverages to decrease dental erosion.

시판 매실음료에 칼슘첨가시 치아부식증 억제 효과

김지은 ( Ji-eun Kim ),윤인경 ( In-gyeong Yun ),정성숙 ( Seong-soog Jeong ),정기호 ( Ki-ho Chung ),최충호 ( Choong-ho Choi ) 대한예방치과·구강보건학회 2019 大韓口腔保健學會誌 Vol.43 No.3

Objectives: We examined the effect of commercial plum beverages on dental erosion and whether the addition of calcium to these beverages would inhibit dental erosion. Methods: We analyzed three groups as follows: Maesil 1 group (Chorok Maesil), Maesil 2 group (Sunkist plum), both of which were selected from commercially-available plum beverages, and Calcium-added maesil group (addition of 3% calcium to Chorok Maesil). For negative and positive control groups, Jeju Samdasoo and Coca Cola were selected, respectively. The characteristics of the experimental beverages were analyzed, and the specimens were immersed in the experimental beverage. The degree of erosion was measured by Vickers hardness number (VHN) and scanning electron microscope images. Results: Positive control group had the lowest pH (2.50±0.03), followed by Maesil 2 (pH 2.59±0.01), Maesil 1 (pH 2.81±0.02), calcium-added maesil (pH 4.19±0.01), and negative control group (pH 7.57±0.06). Significant differences were found in surface microhardness between positive control, Maesil 1, Maesil 2 and calcium-added maesil group before immersion and at 30 minutes after immersion (P<0.05), and change in VHN (positive control group, ―80.94±20.63; Maesil 1 group, ―69.33±24.88; and Maesil 2 group, ―78.49±18.60 in comparison with negative control group, ―6.57±26.73). There was no significant difference (P<0.05) in change in VHN between calcium-added maesil (―13.02±17.33) and negative control group. Conclusions: Plum beverages can potentially induce dental erosion due to their low pH. However, adding calcium to these beverages can reduce the risk of dental erosion. Therefore, the risk of dental erosion must be considered during consumption of plum beverages, and the addition of calcium into plum beverages may be considered as a way to prevent dental erosion.

유산균발효유 섭취 시 칼슘과 불소 사용에 따른 치아부식증 예방효과

김경희,신애리 한국콘텐츠학회 2022 한국콘텐츠학회논문지 Vol.22 No.9

The purpose of this study was to determine the incidence of dental erosion according to the type of lactic acid bacteria fermented oil and to identify a method for preventing dental erosion. For the lactic acid bacteria fermented milk, liquid fermented milk, condense-stirred type fermented milk, and condense-drink type fermented milk were used, and bovine tooth specimens used in the experiment were used. As a method to prevent dental erosion, the method of adding calcium to the lactic acid bacteria fermented milk, the method of applying high and low concentrations of fluoride to the teeth before exposure to the lactic acid bacteria fermented milk, and the method of applying these two methods together were measured to measure the preventive effect of dental erosion. As a result of immersing the specimen in the experimental beverage, the surface hardness of liquid fermented milk decreased the most. When comparing the difference in surface hardness before and after prophylaxis care, the Ca 2% group and the NaF 0.05%+Ca 0.5% group showed no significant difference from the negative control group, confirming that it is an effective method for preventing dental erosion. However, considering the change in taste and the stability of ingredients, a method of adding calcium at a low concentration rather than adding a high concentration of calcium is proposed. Therefore, it is recommended to use low-concentration calcium and low-concentration fluoride together to recognize the possibility of dental erosion when ingesting lactic acid bacteria and to prevent dental erosion caused by it. 본 연구는 유산균발효유의 타입에 따른 치아부식증의 발생정도를 확인하고, 치아부식증을 예방하는 방법을 확인하고자 하였다. 유산균발효유는 액상발효유, 스터드타입 농후발효유, 드링크타입 농후발효유를 사용했고, 실험에 사용된 치아시편은 우치를 사용했다. 치아부식증을 예방하는 방법으로 유산균발효유에 칼슘을 첨가하는 방법, 유산균발효유 노출 전 치아에 고농도와 저농도의 불소를 도포하는 방법과 이 두 가지 방법을 함께 적용하여 치아부식증의 예방효과를 측정했다. 시편을 실험음료를 침지한 결과 액상발효유의 표면경도가 가장 많이 감소했다. 예방처리 전과 후의 표면경도 차이를 비교했을 때 Ca 2%군과 NaF 0.05%+Ca 0.5%군은 음성대조군과 유의한 차이를 보이지 않아 치아부식증을 예방하는 효과적인 방법임을 확인했다. 하지만 맛의 변화 및 성분의 안정성 등을 고려할 때 고농도의 칼슘을 첨가하는 것 보다 저농도의 칼슘을 첨가하는 방법을 제안한다. 본 연구는 칼슘섭취와 불소도포를 단독으로 또는 동시에 적용함에 따른 차이를 확인하는 의미가 있는 연구이지만 타액 등 구강환경에 의한 작용이 배제되었기에 타액을 이용한 순환모델을 적용하는 후속연구가 필요할 것이다. 따라서 유산균발효 섭취 시 치아부식증의 가능성을 인식하고, 그로 인한 치아부식증을 예방하기 위해서는 저농도 칼슘과 저농도 불소를 함께 사용하는 것을 권장한다.

양산시에 거주하는 8~9세 어린이의 치아침식증과 관련된 위험요인 분석

김현정,김신,정태성 大韓小兒齒科學會 2013 大韓小兒齒科學會誌 Vol.40 No.1

치아침식증은 경조직의 비가역적 소실을 야기하는 다인자성 질환이다. 최근 많은 연구자들이 이 질환에 주목하고 있으나, 국내에서는 연구가 부족한 실정이다. 이 연구는 양산시 8~9세 어린이 664명의 치아침식증 유병률을 조사하고, 관련된 위험요인을 성별, 돌보는 사람의 유형, 식이 습관 및 구강 위생 습관, 그리고 치아침식증에 대한 보호자의 지식 정도의 측면에서 분석하였다. 그 결과, 치아침식증은 242명에서 관찰되었다. 탄산음료는 선호도, 섭취 빈도, 섭취 방법에서 치아침식증과 연관성이 있었 고(p < 0.05), 과일주스는 선호도와 섭취 빈도에서 연관성이 있었으나(p < 0.05), 섭취 방법에서는 연관성이 없었다(p > 0.05). 또한 성별, 돌보는 사람의 유형, 구강 위생 습관, 보호자의 지식 정도는 치아침식증과 연관성이 없었다(p > 0.05). 결론적으로 어린이의 치아침식증 예방을 위해서는 이에 대한 교육뿐만 아니라, 행동으로 이어지도록 하는 동기부여가 필요 할 것으로 사료되었다. Dental erosion is a complex disease of multifactorial etiology with high risk of loss of tooth structure, which still has not been appropriate interest. The aim of this study was to assess the prevalence and risk indicators of dental erosion in Korean school children. A cross-sectional survey was performed on 664 children aged 8~9 years. Data concerning gender, types of caregiver, dietary habits, oral hygiene habits and parental knowledge were obtained from a questionnaire, which was answered by the parents of the children. Association between erosion and the factors were statistically analyzed with chi-squared test and independent t-test at a significance level of 0.05. Dental erosion was present in 242 children. In carbonated drinks, dental erosion was significantly associated with preference, frequency of consumption and the ingestion method (p < 0.05). In fruit juices, dental erosion was significantly associated with preference and frequency of consumption (p < 0.05), but no significant associations were found with the ingestion method (p > 0.05). There were no significant associations between dental erosion and gender, type of caregiver, oral hygiene habits and parental knowledge (p > 0.05). In conclusion, it was considered that motivation to be followed by practice is important as well as education for prevention of dental erosion.

구연산과 칼슘이 치아침식증의 발생에 미치는 영향

송인경,이광희,김대업,양영숙 大韓小兒齒科學會 2005 大韓小兒齒科學會誌 Vol.32 No.3

산성 음료의 치아침식증 유발력을 감소시키기 위한 연구의 일환으로, 0.1%, 0.3%, 0.5%, 1.0% 구연산용백의 5분, 15분, 30분, 60분간의 사람 소구치 법랑질의 치아침식증 유발력 및 구연산용액에 첨가되는 칼슘 0.05%, 0.1%, 0.2%에 따른 치아침식증 발생 억제효과를 표면미세경도를 측정하여 연구하였다. 전체적으로 볼 때, 구연산 농도가 높을수륵, 탈회시간이 길수록, 칼슘농도가 낮을수록 탈회후 경도가 하락하였다. 탈회 5분 후 경도는 칼슘 무첨가의 경우에 76~90%이었고 칼슘 첨가에 따른 5분간의 탈회억제량은 2~l5%이었다. 탈회 15분 후 경도는 칼슘 무첨가의 경우에 65~84%이었고 칼슘 첨가에 따른 15분간의 탈회억제량은 3~l7%이었다. 탈회 30분 후 경도는 칼슘 무첨가의 경우에 53~72%이었고 칼슘 첨가에 따른 30분간의 탈회억제랑은 6~22%이었다. 탈회 60분 후 경도는 칼슘 무첨가의 경우에 43~66%이었고 칼슘 첨가에 따른 60분간의 탈회억제량은 7~l9%이었다. 탈회억제량의 분포를 전체적으로 보면, 구연산 농도에서는 1.0%에서 가장 크게 나타났고, 칼슘농도에서는 0.2%에서 가장 크게 나타났으며, 탈회시간에서는 0,1% 구연산용액에서는 탈회시간이 증가함과 더불어 탈회억제량도 함께 커지는 경향을 보였으나, 0.3% 이상의 구연산용액에서는 30분에 가장 크고 60분에 약간 감소하는 경향을 보였다 이상의 결과는 구연산에 의한 치아침식증 발생에 칼슘이 억제효과를 나타낼 수 있음을 시사한다. The purpose of study was to observe the effect of calcium and citric acid on the dental erosion of human premolar enamel. Enamel specimens were demineralized in 0.1%, 0.3%, 0.5%, or 1.0% citric acid solutions with 0.05%, 0.1%, or 0.2% calcium for 5, 15, 30, and 60 minutes, and then the surface microhardness of the enamel was measured. The hardness decreased as the concentration of citric acid and the demineralization time increased. Hardness after 5 minutes was 76~90% in case of no calcium and the inhibition of dental erosion by calcium addition was 2~15%. Hardness after 15 minutes was 65~84% in case of no calcium and the inhibition of dental erosion by calcium addition was 3~17%. Hardness after 30 minutes was 53~72% in case of no calcium and the inhibition of dental erosion by calcium addition was 6~22%. Hardness after 60 minutes was 43~66% in case of no calcium and the inhibition of dental erosion by calcium addition was 7~19%. The inhibition was the highest in 1.0% citric acid and 0.2% calcium. In 0.1% citric acid the inhibition increased as the demineralization time increased, but in 0.3% to 1.0% citric acid the inhibition was most high at 30 minutes and decreased a little at 60 minutes. These results suggest that calcium has a inhibitory effect on the citric acid induced dental erosion.

칼슘함유량에 따른 유산균 발효유의 치아부식증 예방에 대한 연구

김경희,김다은,김애옥,신애리,정성숙,최충호 한국치위생학회 2017 한국치위생학회지 Vol.17 No.6

Objectives: The present study aimed to evaluate the preventive effects of exposure to liquid fermented milk containing various concentrations of added calcium on dental erosion, and to investigate the optimal concentration of calcium effective in reducing dental erosion. Methods: The present study consisted of a total of 6 experimental groups: a mineral water group, a fermented milk with no added calcium (0%) group, and four fermented milk with various concentrations of added calcium (0.1%, 0.5%, 1%, and 2%) groups. Twelve specimens were immersed for 1, 3, 5 and 10 minutes in each experimental drink and the change in surface microhardness was measured. Additionally, the surface was observed using a scanning electron microscope. Results: The difference in surface microhardness before and after 10 minutes of immersion in the experimental drink was the highest in the Ca 0% group, followed by the Ca 0.1%, 0.5%, 1%, 2% group and the mineral water group, in that order. The groups with a calcium concentration of more than 0.5% showed statistically significant differences in surface microhardness compared to the Ca 0% group. In addition, when the surface morphology of enamel was observed under a scanning electron microscope, the results showed that the highest level of surface damage was observed in the Ca 0% group, followed by the Ca 0.1%, 0.5%, 1%, 2% group, in that order. Conclusions: The present study confirms that a higher calcium concentration in fermented milk is associated with a higher possibility of preventing dental erosion. The addition of 0.5% calcium, which is a relatively low concentration, did not completely prevent dental erosion, but significantly inhibited dental erosion compared to fermented milk without any added calcium. Therefore, it is suggested that consumers should be educated and provided with guidance to consider the calcium content when choosing fermented milk.

시판 탄산수에 의한 우치 법랑질 침식과 침착 효과

임도선 ( Do Seon Lim ),반유희 ( Yu Hee Ban ),민영은 ( Young Eyn Min ),박진주 ( Jin Joo Park ),유예진 ( Ye Jin Yu ),인소라 ( So Ra In ),주현지 ( Hyun Ji Ju ),정선영 ( Sun Young Jung ),황영선 ( Young Sun Hwang ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.4

Due to the attractive benefits with regard to bone health, digestion, and hydration, carbonated water consumption have rapidly grown over the past few years. However, the acidic drink has latent potential for enamel erosion. The most experimental studies about the enamel erosion have focused on the carbonated beverages with sugar and artificial sweeteners. Here, we determined the enamel erosion potential by commercially available carbonated waters with bovine teeth. The erosion was verified by pH value, calcium concentration, and scanning electron microscope. Then plaque accumulation by bacterial adhesion was determined on the enamel erosion surface to measure roughness. In the present study, we observed that the increased calcium content after being immersed in carbonated waters result from the overall enamel erosion. There were no significant differences between general carbonated waters and mineral waters for erosive capacity. Therefore, commercially available carbonated waters are potentially erosive. In addition, oral bacteria strongly adhered to the erosive enamel surfaces thereby facilitating the development of dental plaque. Thus, it is urgently necessary to provide food safety information on the carbonated water as acidic drink to prevent the enamel erosion.

시판 석류음료가 치아 법랑질 표면에 미치는 영향

정가영 ( Ka-young Jung ),김지은 ( Ji-eun Kim ),최충호 ( Choong-ho Choi ) 대한예방치과·구강보건학회 2021 大韓口腔保健學會誌 Vol.45 No.4

Objectives: This study examines the pH and titratable acidity of pomegranate drinks sold in Korea to identify the risk of dental erosion, and to provide basic data for oral health when consuming such drinks. Methods: The experiment included 5 groups: As experimental drinks, Sunkist pomegranate (Group A), Beauty liked pomegranate (Group B), Pomegranate juice 100 (Group C) were selected, and Jeju Samdasoo and Coca-Cola were selected for negative and positive controls. The components of the experimental beverage were analyzed, and the degree of erosion was measured using the Vickers hardness number (VHN) and by scanning electron microscope images. Results: When comparing the surface microhardness before and 30 minutes after beverage immersion, there was a significant difference in the positive control group, Group A, Group B, and Group C (P< 0.05), while there was no significant difference in the negative control group (P >0.05). The difference in surface microhardness (ΔVHN) was found in Group C (-117.33±17.41), Group A (-112.90±15.19), the positive control group (-103.80±13.23), Group B (-90.82±24.60), and the negative control group (-13.44±14.60), in that order. The positive control group, Group A, Group B, and Group C showed a significant difference from the negative control group (P<0.05), and Group B showed a significant difference from Group A, and Group C (P< 0.05), whereas Group A, Group B, and Group C did not differ significantly from the positive control group (P >0.05). Conclusions: This study found that the low pH and high titratable acidity of commercially available pomegranate drinks can potentially cause dental erosion. Therefore, it is imperative to provide dietary guidance so that consumers can recognize the possibility of dental erosion when consuming pomegranate drinks and manage their oral health.