In August 2022 I fell off my roof at home and ruined a perfectly good body. You would have thought that many months of paralysis from the waist down would be a time for deep inner reflection and a chance to emerge reborn as a wonderful human being. Sadly, that was not the case. I got better and I am still a cynical, miserable bastard.
Here is a less than glowing review of a recent article in the International Endodontic Journal:
Potential predisposing features of external cervical resorption: An observational study
Shanon Patel, Francesc Abella, Kreena Patel, AbdulAziz Bakhsh, Paul Lambrechts, Nassr Al-Nuaimi
https://doi.org/10.1111/iej.14166
When a patient presents with external cervical resorption (ECR), I explain to them that gums eating away teeth is not that peculiar.
Between the ages of seven and 13 the gums eat away your teeth as you shed your deciduous dentition. They are supposed to stop, but sometimes something triggers them and off they go again.
The idea of some sort of gum regression to early years excited one strange (Californian) patient of mine who presented with multiple ECRs. He was convinced that at the age of 62 he was experiencing shades of Benjamin Button and these were proof he was getting younger.
The next question will always be about why it has happened, and I will authoritatively tell them that we don’t know. That is why it is most often referred to as idiopathic external cervical resorption. Idiopathic meaning designating (or of) a disease whose cause is unknown or uncertain. (Collins English Dictionary).
Prof Shanon Patel has attempted to find the cause, or predisposing factors to ECR by asking 194 patients with ECR lesions a number of questions, including sex, age, ethnic background, trauma, orthodontics, cat ownership …. (not an exhaustive list).
Cat ownership was a new one on me. I keep learning things here. I have never asked an ECR patient if he/she has a cat and then blamed it on Tiddles. You might as well ask if they drink milk, and you are bound to come up with a meaningful correlation.
As I have said here before, I don’t much like articles where I can read the title and easily guess the outcome. Sure enough, there is a reason why it’s called idiopathic Shanon.
The article, though, is considered so groundbreaking that it is given open access by the IEJ.
The conclusion reads: ‘The main potential predisposing factors associated with the ECR presence were a history of orthodontic treatment (25.6%), traumatic dental injury (20.9%), cats (15.8%) and parafunctional habits (10.2%). A significant portion of patients had no identifiable predisposing factor. The information may be helpful in diagnosing early stage ECR.’
Helpful in diagnosing early stage ECR? Really? I will have to start checking my cat-owning patients more carefully.
Written by Dr Richard Kahan
