Features of pathological mechanisms of tooth damage in workers of chemical industries

INTRODUCTION. Under conditions of increasing exposure to chemical factors that predispose individuals to the development of pathology, the processes of hard-tooth-tissue destruction undergo modification not only in terms of their kinetics but also through the direct incorporation of exogenous chemical agents. These circumstances inevitably affect the macro- and microelement composition of enamel, as well as dentin and cementum in cases of disease progression. Obtaining reliable information on elemental composition is crucial for choosing appropriate treatment strategies and substantiating preventive measures.

AIM. To perform X-ray fluorescence analysis of teeth from employees of chemical enterprises, assessing qualitative and quantitative changes in elemental composition associated with pathological processes.

MATERIALS AND METHODS. The dental status of 100 workers and engineering personnel involved in the production of biologically active substances, paint-and-coating materials, and metal products, all of whom had direct contact with inorganic and organic reagents, was assessed. The control group included teeth from 50 individuals working at the same enterprises but not exposed to occupational hazards. The chemical composition of tooth hard-tissue samples was determined using an M4 TORNADO (Bruker) X-ray fluorescence spectrometer. The MultiPoint mode was used. The software provides the content of each element relative to the total amount of detected elements, considering the entire spectrum as 100%. A relatively constant Ca/P ratio served as an additional reference point for discussing deviations from normal values.

RESULTS. The identified diseases in the affected zones were accompanied by atypical accumulations of trace elements detected via XRF spectra. In several employees of a metallurgical plant, high titanium content – up to 1.14 wt% of total elemental content – was found in areas of dental erosion. Titanium levels in adjacent intact enamel were significantly reduced, although trace amounts were still present. In patients with long-term employment at a paint, coating, and anti-corrosion materials enterprise, potassium content in deep carious lesions reached 12.64%, and most individuals also showed substantial levels of zinc, barium, iron, sulfur, chlorine, manganese, and copper. Among workers of an agrobiological enterprise without hot workshops or industrial dust – due to multistage air purification and sterilization – caries prevailed. In employees of a chemical-pharmaceutical production facility, no cases of caries were detected; only non-inflammatory conditions such as increased tooth wear and wedge-shaped defects were diagnosed.

CONCLUSIONS. XRF analysis demonstrated that enamel demineralization processes in workers of chemical industries are accompanied by qualitative and quantitative changes in trace-element profiles within pathological zones. Environmental exposure results in the isomorphic and isoinic incorporation of elements into apatite structures of hard tooth tissues and disrupts the natural kinetics of mineralization and demineralization. The intensity of trace-element accumulation in tooth tissues is directly related to the degree of industrial air purification. Treatment and prevention of dental disorders in these workers must account for industry-specific occupational factors.

1. Patano A., Malcangi G., De Santis M., Morolla R., Settanni V., Piras F. et al. Conservative Treatment of Dental Non-Carious Cervical Lesions: A Scoping Review. Biomedicines. 2023;11(6):1530. https://doi.org/10.3390/biomedicines11061530

2. Mitronin A.V., Fulova A.M., Osipova A.V., Ivankova Yu.A., Prokopov A.A. XRF analysis of tooth enamel under conditions of experimental erosion in vitro. Endodontics Today. 2025;23(3):480–486. https://doi.org/10.36377/ET-0121

3. Muslov S.A., Arutyunov S.D. Physical properties of tooth tissues. Moscow: Prakticheskaya meditsina; 2021. 176 p. (In Russ.)

4. Mitronin A.V., Prokopov A.A., Darsigova Z.T., Alikhanian A.S., Gokzhaev M.B., Dashkova O.P. X-ray fluorescence analysis of dental hard tissues in the early stages of erosive lesions. Cathedra. Dental Education. 2020;71:22–27. (In Russ.)

5. Fulova A.M., Ostanina D.A., Mitronin A.V. Analysis of risk factors for the development of dental erosion (systematic review). Cathedra. Dental Education. 2024;(89):16–19. (In Russ.)

6. Zaidullin I.I., Karimova L.K., Larionova T.K., Gimranova G.G., Masyagutova L.M. Impact of production and non-production risk factors on the formation of dental pathology among chemical industry workers. Yakut Medical Journal. 2024;(4):68–71. (In Russ.) https://doi.org/10.25789/YMJ.2024.88.16

7. Fulova A.M., Ryazantseva P.A., Ostanina D.A., Mitronin A.V., Baitokova A.D. Analysis of dental morbidity of employees of a chemical enterprise. Endodontics Today. 2024;22(4):436–441. (In Russ.) https://doi.org/10.36377/ET-0060

8. Arutyunov S.D., Nagoeva A.A., Prokopov A.A. Elemental composition of dental tissue and its dynamics in buffer solutions. Dentist. 2009;(3):25–33. (In Russ.)

9. Malara P., Fischer A., Malara B. Selected toxic and essential heavy metals in impacted teeth and the surrounding mandibular bones of people exposed to heavy metals in the environment. J Occup Med Toxicol. 2016;11:56. https://doi.org/10.1186/s12995-016-0146-1

10. Gulyaeva O.A., Bakirov A.B., Chemikosova T.S., Aver’janov S.V., Arsenina O.I., Karimova L.K. Dependence of dental status from the level of endogenous intoxication in chemical industry workers based on the oral fluid composition study. Stomatology. 2019;98(6):18–21. (In Russ.) https://doi.org/10.17116/stomat20199806118

11. Mukhsinova L.A. Clinical-Laboratory Examination of Dental Diseases in Chemical Industry Workers. American Journal of Pediatric Medicine and Health Sciences. 2024;2(4):33–38. Available at: https://grnjournal.us/index.php/AJPMHS/article/view/4169 (accessed: 27.10.2025).

12. Zaydullin I.I., Karimova L.K., Kaptsov V.A., Karimov D.O., Muldasheva N.A. Dental status as an indicator of the intensity of exposure to chemical pollution of the air in the working area. Hygiene and Sanitation. 2024;103(11):1292–1297. (In Russ.) https://doi.org/10.47470/0016-9900-2024-103-11-1292-1297

13. Kim K.T., Eo M.Y., Nguyen T.T.H., Kim S.M. General review of titanium toxicity. Int J Implant Dent. 2019;5(1):10. https://doi.org/10.1186/s40729-019-0162-x

14. Mitronin A., Darsigova Z., Alikhanian A., Prokopov A., Dashkova O. X-ray fluorescence analysis of the normal teeth enamel and in case of erosion. Endodontics Today. 2017;15(3):7–13. (In Russ.) Available at: https://www.endodont.ru/jour/article/view/76 (accessed: 27.10.2025).

15. Widanarko B., Modjo R. Occupational risk factors for acute fatigue symptoms among Indonesian beverage industry workers. Journal of International Dental and Medical Research. 2017;10(3):1052–1054.

16. Alruthea M.S. Intrinsic dental erosion: Review of dental management. Journal of International Dental and Medical Research. 2020;13(2):738–744.

17. Adiba S.H., Effendy R., Zubaidah N. Fluoride varnish effect on dental erosion immersed with carbonated beverages. Journal of International Dental and Medical Research. 2018;11(1):299–302.

18. Leontiev V.K. Tooth enamel as a biocybernetic system. Moscow: GEOTAR-Media; 2016. 72 p. (In Russ.)