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Enamel is the hardest substance in the human body, but the repeated exposure to the hydrochloric acid in regurgitated gastric contents over an extended period of time can lead to a unique pattern of enamel erosion called perimylolysis. Perimy- lolysis features the loss of enamel on the lingual, occlusal, and incisal surfaces of the teeth. As opposed to attrition, which is the loss of enamel from repetitive tooth-to-tooth contact or abrasion via an external source (e.g., excessive or overly forceful tooth brushing), the gradual dissolution of the enamel matrix in patients with bulimia leaves a glossy, smooth surface, most commonly on the lingual surfaces of the maxillary anterior teeth [63]. Any lost enamel cannot be regenerated. The underly- ing matrix of dentin is then exposed; it will wear faster than enamel and is more prone to caries. While enamel is devoid of any neural element, dentin contains dentinal tubules whose odontoblastic processes can perceive thermal stimuli as a source of pain. This can cause patients to neglect oral hygiene and increase the risk of caries and periodontal disease. The irreversible loss of enamel will also cause a change in the occlu- sion, decreasing the vertical dimension of occlusion. The loss of tooth structure requires that more complicated and expen- sive restorative options, such as crowns, be utilized. The loss of enamel support around composite or amalgam restorations can lead to their weakening and ultimate loss. The amount of time necessary for the enamel to be eroded in such fashion can range from six months to two years [64].
CONCLUSION Dental treatment of the pediatric patient can be a rewarding experience. Dental schools vary in the amount of pedodontic clinical training undergraduate students receive, and each clinician’s expertise and comfort level with pediatric patients will vary, especially the treatment of those who are very young or those with complex dental problems. Professional ethics require the clinician to assess if he or she has the clinical and interpersonal skills required for these patients. Referral to a pedodontist or a general practitioner with excellent skills in the treatment of pediatric and adolescent patients should be considered if it is in the best interest of the patient. Each child and adolescent is unique in their personality, medical history, and psychologic needs and well-being. Recognizing and respecting these qualities is the foundation upon which a relationship of mutual trust and respect is built.
WORKS CITED https://qr2.mobi/dental-treatment-pedia
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