Dental Erosion Among Children Journal of Dentistry for Children-72:1, 2005 Çaglar et al 5 Dental Erosion Among Children in an Istanbul Public School Esber Çaglar, DDS, PhD Betul Kargul, DDS, PhD Ilknur Tanboga, DDS, PhD Adrian Lussi, DDS, PhD ABSTRACT T he aim of this study was to evaluate the prevalence, clinical manifestations, and etiology of dental erosion among children. A total of 153 healthy, 11-year-old children were sampled from a downtown public school in Istanbul, Turkey comprised of middle-class children. Data were obtained via: (1) clinical examination; (2) questionnaire; and (3) standardized data records. A new dental erosion index for children designed by O’Sullivan (2000) was used. Twenty- eight percent (N=43) of the children exhibited dental erosion. Of children who consumed orange juice, 32% showed erosion, while 40% who consumed carbonated beverages showed erosion. Of children who consumed fruit yogurt, 36% showed erosion. Of children who swam professionally in swimming pools, 60% showed erosion. Multiple regression analysis revealed no relationship between dental erosion and related erosive sources (P>.05). (J Dent Child 2005;72:5-9) KEYWORDS: DENTAL EROSION PREVALENCE, FRUIT YOGURT, ISTANBUL, ORANGE JUICE, SWIMMING Dr. Çaglar is a dentist, Drs. Kargurl and Tanboga are professors, Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey; Dr. Lussi is professor, Department of Operative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Berne, Berne, Switzerland. Correspond with Dr. Çaglar at caglares@yahoo.com JDC CASE REPORT D ental hard tissue loss is caused by a number of fac- tors, including dental caries, trauma, and, increas- ingly, tooth wear—which can occur by abrasion, attrition, and erosion. 1,2 Dental erosion is defined as a loss of dental hard tissue caused by acid and, in contrast to car- ies, without bacterial involvement. Erosion may be caused by intrinsic as well as by extrinsic factors. 3 The intrinsic fac- tors for dental erosion include vomiting, regurgitation, gas- troesophageal reflux, or rumination. 4,5 T he extrinsic factors for dental erosion in childhood are related to acids of di- etary or medicinal origins and also to behavioral factors. T he consumption of soft drinks such as acidic fruit juices, artificially sweetened fruit drinks, and carbonated beverages are the risk factors most significantly related to this dental hard tissue defect. 6-10 Lifestyle and behavior differences must also be considered important in the etiology of dental ero- sion. 11 Epidemiological studies have shown that the preva- lence of dental erosion in children varies widely between 2% and 57%. 12-15 As a candidate for the European Union, Turkey has under- gone especially rapid development, with commensurate changes in lifestyle and diet. T hese changes are likely to cause substantial increases in the sale and consumption of acidic products, which could have an effect on children’s oral health. T his study’s objective was to evaluate the prevalence, clinical manifestations, and etiology of extrinsic dental erosion in a sample of 11-year-old Istanbul schoolchildren. METHODS SAMPLE T he ethical clearance for this study was obtained from the Pediatric Dentistry Department Review Board of Marmara University Dental School, Istanbul, Turkey. T he school was selected because of its established caries-preventive history and because it was representative of middle-class Istanbul children. T he district’s drinking water fluoride level was stated as <0.05 mg/l. 16 A total of 153 healthy 11-year-old schoolchildren (75 boys and 78 girls) were randomly sampled. Written informed con- sent was obtained from the parents. Children were asked to brush their teeth prior to examination for better oral moni- toring. Oral examinations were carried out by 1 examiner in well-lit classrooms using a mirror and probe. Following the clinical examination, children completed an extensive ques- tionnaire with the examiner and their parents (Table 1). CLASSIFICATION T he dental literature provides useful clinical indices for the epidemiological recording of dental erosion. 6,10,14,17,18 T hese indices seemed inadequate for the present study.