Re: Oils and amalgam fillingsOn Mon, 02 Jun 2008 22:59:51 -0400, Steven Bornfeld
<dentaltwinmung@earthlink,net > wrote:
>Newbie@bix.nex wrote:
>> On Mon, 02 Jun 2008 20:55:54 GMT, Mark & Steven Bornfeld
>> <bornfeldmung@dentaltwins,com > wrote:
>>
>>>
>>> Only if you keep in mind that some fluids will destroy the tooth
>>> structure surrounding the fillings--that'll loosen 'em.
>>>
>>> Steve
>>
>>
>> HCl would be my choice.
>
>
> I have seen that--with eating disorders. I'm guessing you have too.
>
>Steve
Actually one of my son-in-laws was duped into taking a sip of "water"
that was in the battery filling room. He said it was HCl but suspect
it was H2SO4- . Luckily he did not swallow.
Nevertheless the enamel was chalky and highly friable. We
made some custom fluoride trays for him and provided 0.4% SnF gel.
The enamel remineralized and to this day there are no sequelae.
Eight years and counting.
Yep, have treated the anorexia/bulimia patient.
Here's my take...
Clinically, prominent acidic erosion of the lingual surfaces
of the anterior region is very common. That finding in conjunction
with other recognizable symptoms, may the first clue to the
dental practitioner of this disorder.
Occlusal surface acidic erosion is likely to be indicative of longer
term sequelae of the pathologic process and palatal cusp erosion
since enamel is thicker in the upper molars, may be considered by
some as pathognomonic.
In extreme cases mandibular lingual cusp erosion will also be present.
Due to *protection* by the tongue during 'purging' the lower molars
are somewhat 'preserved' for a longer period of time, but are not
immune to acidic damage.
We can help mediate the damage to the teeth, but the underlying
factors causing the behavior must be addressed.
Treatment of the psychological nature is well beyond the scope
of dental practice. However we must at least inform the patient
of our clinical findings and the diagnosis that is suggested.
Informing a patient of our findings, and especially in the presence
of a family member or caretaker can sometimes be enough to
effect seeking treatment for the underlying causes of this disorder.