Community Dent Oral Epidemiol 2002; 30: 16–23 Copyright C Munksgaard 2002 Printed in Denmark . All rights reserved ISSN 0301-5661 Manal I. Al-Malik, Ruth D. Holt and Raman Bedi Erosion, caries and rampant caries Department of Transcultural Oral Health, Eastman Dental Institute, University College London, University of London, London, UK in preschool children in Jeddah, Saudi Arabia Al-Malik MI, Holt RD, Bedi R. Erosion, caries and rampant caries in preschool children in Jeddah, Saudi Arabia. Community Dent Oral Epidemiol 2002; 30: 16–23. C Munksgaard, 2002 Abstract – Objectives: The objective of this study was to determine the prevalence of dental erosion in preschool children in Jeddah, Saudi Arabia, and to relate this to caries and rampant caries in the same children. Methods: A sample of 987 children (2–5 years) was drawn from 17 kindergartens. Clinical examinations were carried out under standardised conditions by a trained and calibrated examiner (M.Al-M.). Measurement of erosion was confined to primary maxillary incisors and used a scoring system and criteria based on those used in the UK National Survey of Child Dental Health. Caries was diagnosed using BASCD criteria. Ram- pant caries was defined as caries affecting the smooth surfaces of two or more maxillary incisors. Results: Of the 987 children, 309 (31%) had evidence of erosion. Key words: caries; erosion; preschool children; relation between caries and erosion For 186 children this was confined to enamel but for 123 it involved dentine and/ or pulp. Caries were diagnosed in 720 (73%) of the children and rampant caries in Dr Ruth Holt, Eastman Dental Institute, Transcultural Oral Health Department, 336 (34%). The mean dmft for the 987 children was 4.80 (∫4.87). Of the 384 256 Gray’s Inn Road, London, WC1X 8LD, children who had caries but not rampant caries, 141 (37%) had erosion, a signifi- UK cantly higher proportion than the 72 (27%) out of 267 who were clinically caries Tel: π44 20 7915 1138 (text) free (SNDΩ2.61, P0.01). Of the 336 with rampant caries, 96 (29%) also had evi- Fax: π44 20 7915 1233 e-mail: r.holt/eastman.ucl.ac.uk dence of erosion. Conclusions: The level of erosion was similar to that seen in children of an equivalent age in the UK. Caries was a risk factor for erosion in this Submitted 31 May 2000; group of children. accepted 14 February 2001 Dental caries continues to play a dominant role in thinking and practice in child oral health through- out the world but tooth wear and, more partic- ularly, erosion have emerged more recently as a problem affecting children and adolescents. Ero- sion is a direct result of chemical action on the tooth surface and is caused primarily by acids. These may include gastric acid that comes into con- tact with the teeth during regurgitation or, more often, acid contained in the diet (1). The type of acid, the nature of the food or drink which contains it and the pattern of consumption are all believed to be important in determining the effects of the acid. Subjects may also vary in their susceptibility to erosion, and saliva is believed to exert an impor- tant influence on the occurrence and severity of er- osion as well as caries (2). Many foods and drinks 16 that are acidic in nature are also high in non milk extrinsic sugars so that caries and erosion might be expected to occur together in at least a proportion of cases. However, investigations of erosion have been largely confined to European countries, where caries has declined with time. It has been suggest- ed that erosion may be more common amongst those who are less susceptible to caries (1–4) but there appears to have been little investigation of the relationship between the two. There has also been less consideration of erosion in countries and cultures, particularly developing countries, where caries affects a higher proportion of children. Middle Eastern countries have undergone espe- cially rapid development and modernisation with commensurate changes in lifestyle and diet for much of the population. These changes are likely