Sivasithamparam K, Young W G, Jirattanasopa V, Priest J, Khan F, Harbrow D, Daley T J
School of Dentistry, The University of Queensland, St Lucia.
Aust Dent J. 2002 Dec;47(4):298-303. doi: 10.1111/j.1834-7819.2002.tb00541.x.
Asthma medication places patients at risk of dental erosion by reducing salivary protection against extrinsic or intrinsic acids. But patterns of lesions in asthmatics may differ from patterns in non-asthmatics, because gastro-oesophageal reflux (GOR) is found in 60 per cent of asthmatics.
The lesions in 44 asthma cases were compared to those of age and sex match controls with no history of asthma or medications drawn from the dental records of 423 patients referred concerning excessive tooth wear. The subjects were 70 males age range 15 to 55 years and 18 females age range 18 to 45. Anamnestic clinical data were compared between the two groups. Models of all 88 subjects were examined by light microscopy, and wear patterns were recorded on permanent central incisor, canine, premolar and first molar teeth.
Clinical differences were a higher incidence of tooth hypersensitivity, xerostomia, salivary gland abnormalities, gastric complaints, and self induced vomiting in the cases. No differences were found between the cases and controls on citrus fruit and acid soft drink consumption. More occlusal erosion sites were found in cases, whereas more attrition sites were found in the controls. There were no significant differences in palatal erosion on maxillary anterior teeth found between cases and controls. Lingual erosion of the mandibular incisors, found only in GOR patients, was not observed.
A higher incidence of erosion was found in asthmatics. Gastro-oesophageal reflux symptoms were not associated with the sign of lingual mandibular incisor erosion. The clinical significance is that asthmatics are at risk of dental erosion from extrinsic acid, but GOR does not appear to contribute in a site-specific manner.
哮喘药物通过减少唾液对外部或内部酸的保护作用,使患者面临牙齿侵蚀的风险。但哮喘患者的病损模式可能与非哮喘患者不同,因为60%的哮喘患者存在胃食管反流(GOR)。
将44例哮喘患者的病损与423例因牙齿过度磨损前来就诊的患者牙科记录中年龄和性别匹配、无哮喘病史或用药史的对照者的病损进行比较。受试者为70名年龄在15至55岁之间的男性和18名年龄在18至45岁之间的女性。比较两组的既往临床数据。对所有88名受试者的模型进行光学显微镜检查,并记录恒中切牙、尖牙、前磨牙和第一磨牙的磨损模式。
临床差异在于病例组牙齿过敏、口干、唾液腺异常、胃部不适和自我催吐的发生率较高。病例组和对照组在柑橘类水果和酸性软饮料的摄入量上没有差异。病例组发现更多的咬合面侵蚀部位,而对照组发现更多的磨耗部位。病例组和对照组在上颌前牙腭侧侵蚀方面没有显著差异。仅在胃食管反流患者中发现的下颌切牙舌侧侵蚀未被观察到。
哮喘患者中侵蚀的发生率较高。胃食管反流症状与下颌切牙舌侧侵蚀的体征无关。临床意义在于,哮喘患者有因外部酸导致牙齿侵蚀的风险,但胃食管反流似乎并未以特定部位的方式起作用。