Tooth wear is a common finding in oral examinations. Pathological tooth wear (PTW) is the amount of wear that exceeds the normal phenomena of ageing or the normal threshold value of wear. The objective of this study was to determine the associated factors of PTW among 16-year-old secondary school children.
This case-control study involved 576 participants randomly selected from eight government secondary schools. The Smith and Knight Tooth Wear Index and WHO criteria were used for charting of tooth wear and dental caries respectively. Data were analyzed using a simplified Microsoft Excel program developed based on the index, to quantify PTW. Controls were subjects with no PTW indicated by zero scores on all tooth surfaces. Cases were subjects with PTW having at least one surface scoring 1 for tooth wear. Consequently, responses were obtained from self-administered questionnaire containing socio-demographic profile of the family, general questions, oral hygiene and food and drinks practices and other associated variables for tooth wear, which was previously developed based on expert opinions.
About 40% and 57% were males were in controls and cases respectively. On performing multivariable analysis, sex, monthly household income, carbonated drinks, duration of intake of orange juices, caries experience and swimming were significantly associated with PTW.
In conclusion the factors associated with PTW were no different from those encountered in Western societies. Realizing that some significant variables were modifiable, oral health promotion should emphasize on this information. The erosive potential of some foods and drinks require further investigation.
This conventional literature review discusses whether pathological tooth wear is age dependant. It briefly reviews the components of tooth wear and the prevalence of tooth wear in children, adolescents and adults. The emphasis on terminology relating to tooth wear varies. In some countries, the role of erosion is considered the most important, whereas others consider the process to be a combination of erosion, attrition and abrasion often with one being more dominant. The importance of tooth wear or erosion indices in the assessment and the evidence for progression within subject and within lesions is described. The data from the few studies reporting pathological levels of wear reported in children and adults are discussed, in particular its relationship with age. There is little evidence to support the concept that pathological levels of erosion or wear are age dependant. There is, however, some evidence to suggest that normal levels of erosion or wear are age dependant.
Erosion; Tooth wear; Tooth wear index; Attrition; Abrasion
Aim. To evaluate tooth surface loss (TSL) severity and associated risk factors in a representative sample of Saudi adults. Materials and Methods. Four hundred TSL patients (200 females and 200 males) participated in this study. Each patient completed a comprehensive questionnaire interview (using a modified Tooth wear Assessment Questionnaire) and then examined for the severity of TSL (using ordinal scale). Results. Seventy-five percent of participants demonstrated attrition, 90% had erosion, 15% had abrasion, and 95% had more than one type of TSL. The most common risk factors were consumption of acidic food/drinks (78%), parafunctional habits (70%), and unilateral chewing (50%). 77% of participants demonstrated grade 2 TSL. Males demonstrated greater TSL severity (P ≤ 0.05). Age, systemic disease, number of remaining teeth, acidic food/drinks, bruxism/parafunction, biting objects, facial pain/tenderness, sour taste, exposure to dust, unilateral chewing, using dental abrasives, and brushing frequency/technique had significant relationship with TSL severity (P ≤ 0.05). Conclusions. TSL has a multifactorial aetiology. Parafunction, gastrointestinal problems, and diet were the most common aetiological factors reflecting changes to stressful modern life-styles, eating/drinking habits, and behaviours. Gender didn't influence the aetiology of TSL; however males demonstrated more TSL severity. Patients' age had significant correlation to TSL severity.
Prader-Willi syndrome (PWS) is a rare complex multsystemic genetic disorder characterized by severe neonatal hypotonia, endocrine disturbances, hyperphagia and obesity, mild mental retardation, learning disabilities, facial dysmorphology and oral abnormalities. The purpose of the present study was to explore the prevalence of tooth wear and possible risk factors in individuals with Prader-Willi syndrome.
Forty-nine individuals (6-40 years) with PWS and an age- and sex-matched control group were included. Tooth wear was evaluated from dental casts and intraoral photographs and rated by four examiners using the Visual Erosion Dental Examination (VEDE) scoring system and the individual tooth wear index IA. In accordance with the VEDE scoring system, tooth wear was also evaluated clinically. Whole saliva was collected.
Mean VEDE score was 1.70 ± 1.44 in the PWS group and 0.46 ± 0.36 in the control group (p < 0.001). Median IA was 7.50 (2.60-30.70) in the PWS group and 2.60 (0.90-4.70) among controls (p < 0.001). In the PWS group tooth wear correlated significantly with age (VEDE; r = 0.79, p < 0.001, IA; r = 0.82, p < 0.001) and saliva secretion (VEDE; r = 0.46, p = 0.001, IA; r = 0.43, p = 0.002). Tooth grinding was also associated with tooth wear in the PWS group, as indicated by the mean VEDE 2.67 ± 1.62 in grinders and 1.14 ± 0.97 in non-grinders (p = 0.001) and median IA values 25.70 (5.48-68.55) in grinders and 5.70 (1.60-9.10) in non-grinders (p = 0.003). Multivariate linear regression analysis was performed with tooth wear as the dependent variable and PWS (yes/no), age, tooth grinding and saliva secretion as independent variables. PWS (yes/no), age and tooth grinding retained a significant association with tooth wear, VEDE (p < 0.001) and log IA (p < 0.001). The only factor significantly associated with tooth wear in the control group was age.
Our study provides evidence that tooth wear, in terms of both erosion and attrition, is a severe problem in Prader-Willi syndrome. There is therefore considerable need for prosthodontic rehabilitation in young adults with PWS.
Prader-Willi syndrome; Tooth wear; Tooth grinding; Saliva secretion; Rehabilitation
Tooth wear—attrition, erosion and abrasion—is perceived internationally as an ever-increasing problem. Clinical and epidemiological studies, however, are difficult to interpret and compare due to differences in terminology and the large number of indices that have been developed for diagnosing, grading and monitoring dental hard tissue loss. These indices have been designed to identify increasing severity and are usually numerical. Some record lesions on an aetiological basis (e.g. erosion indices), others record lesions irrespective of aetiology (tooth wear indices); none have universal acceptance, complicating the evaluation of the true increase in prevalence reported. This article considers the ideal requirements for an erosion index. It reviews the literature to consider how current indices have evolved and discusses if these indices meet the clinical and research needs of the dental profession.
Tooth wear; Tooth wear indices
Anthropologists have for many years considered human tooth wear a normal physiological phenomenon where teeth, although worn, remain functional throughout life. Wear was considered pathological only if pulpal exposure or premature tooth loss occurred. In addition, adaptive changes to the stomatognathic system in response to wear have been reported including continual eruption, the widening of the masticatory cycle, remodelling of the temporomandibular joint and the shortening of the dental arches from tooth migration. Comparative studies of many different species have also documented these physiological processes supporting the idea of perpetual change over time. In particular, differential wear between enamel and dentine was considered a physiological process relating to the evolution of the form and function of teeth. Although evidence of attrition and abrasion has been known to exist among hunter-gatherer populations for many thousands of years, the prevalence of erosion in such early populations seems insignificant. In particular, non-carious cervical lesions to date have not been observed within these populations and therefore should be viewed as ‘modern-day’ pathology. Extrapolating this anthropological perspective to the clinical setting has merits, particularly in the prevention of pre-mature unnecessary treatment.
Tooth wear; Attrition; Abrasion; Erosion; Adaptation
In various people of the Western world, gastro-oesophageal reflux (GOR) has been reported to be a common problem. Various studies have also assessed the relationship between GOR and dental erosion. The authors are not aware of such studies in Nigerians. It is therefore the aims of the present study to estimate the prevalence of GOR; to estimate the prevalence of dental erosion in patients with GORD; to document the oral findings in patients diagnosed with GORD and to compare these findings with previous studies elsewhere.
A total of 225 subjects comprising of 100 volunteers and 125 patients diagnosed with GORD were involved in this study. History of gastric juice regurgitation and heartburn were recorded. Oral examination to quantify loss of tooth structure was done using the tooth wear index (TWI) designed by Smith and Knight (1984).
Twenty patients with GORD presented with dental erosion in the maxillary anterior teeth with TWI scores ranging from 1–3. The prevalence of erosion was found to be statistically significant between GORD patients (16%) and control (5%) (p < 0.05), but not significant between endoscopic diagnostic groups (p > 0.05).
The present study supports the consideration of dental erosion as the extra-oesophageal manifestation of GORD. However the association between GORD and burning mouth sensation needs more investigation.
Tooth erosion is a growing dental problem; however, the role of diet in the aetiology of tooth erosion is unclear. A cross-sectional study was conducted to determine the association between tooth erosion occurrence and the consumption of acidic foods and drinks among undergraduate university students.
A total of 150 undergraduate students (33 males and 117 females) aged 19 to 24 years at Universiti Kebangsaan Malaysia participated in this study. The Basic Erosive Wear Examination was used to assess the occurrence of tooth erosion. Information regarding dental hygiene practices, usual dietary habits, and consumption of acidic foods and drinks was obtained through a structured questionnaire.
In all, 68% of subjects had tooth erosion. Subjects who reported having received information about healthy eating were less likely to have tooth erosion (χ2 [1, N = 150] = 7.328, P = 0.007). The frequencies of milk (OR = 0.29, 95% CI = 0.13–0.67) and tea/coffee (adjusted OR = 0.42, 95% CI = 0.19–0.95) consumption were negatively associated with tooth erosion. Dental hygiene practice, the frequency and amount of acidic food and drink intake, and body mass index classification were not significantly associated with the risk of tooth erosion (P > 0.05).
A high prevalence of tooth erosion was observed among this group of students. Preventive measures, such as dietary advice and increased consumption of milk at a younger age, may reduce the occurrence of tooth erosion among this age group.
beverages; cross-sectional study; food habits; public health; tooth erosion; young adult
Association between some socio-demographic attributes and tooth wear among adult male population in a rural community of Igbo-ora, Southwestern Nigeria was investigated in this cross-sectional study.
Cross-sectional study among 200 consenting adult males in Igbo-ora was carried out using a 10-item semi-structured questionnaire to obtain data on socio-demographics. Oral examination to establish the presence of tooth wear lesions was carried out by two examiners. Frequencies and percentages of relevant variables were generated. Multivariate analysis was used to test associations between categorical variables at P<0.05.
The mean age of participants was 35.6±11.7 years. One hundred and six (53.0%) subjects had one form of tooth wear lesion. Sixty eight (34.0%) of the subjects had attrition only and 96 (48.0%) had multiple tooth wear lesions. There was an association between age group, marital status, level of education and tooth wear (p<0.05). However, the association between occupation and tooth wear was not statistically significant (p>0.05). After adjusting for marital status, occupation and level of education, the association between age group and tooth wear was still significant. Though marital status was found to be associated with tooth wear, this association was not significant after adjusting for age, occupation and level of education. The association between some of the socio-demographic factors studied and the types of tooth wear was statistically significant (p<0.05).
Age group was the only independent predictor of tooth wear.
Socio-demographic; Rural Community; Tooth Wear; Nigerian
Some studies have shown that casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and acidulated phosphate fluoride (APF) gel can protect teeth against erosion. The aim of this study was to assess whether CPP-ACP and fluoride could reduce enamel wear rates under erosive conditions simulating abrasion and acidic diet regimen.
Materials and Methods:
Enamel specimens consisted of 3 experimental groups (receiving CPP-ACP, APF or both) and a control group. Specimens were subjected to 5,000 wear cycles at a load of 30 N and a pH of 3 in a tooth wear machine. The amount of wear was determined by stereomicroscope. Data were analyzed using one-way analysis of variance and Tukey post hoc tests (α = 0.05).
Mean wear rate (mean±SD) was 194.6±49.2 micrometers in CPP-ACP group, 197.6±39.5 in APF group, 134.6±44.7 in combination group and 266.2± 22.7 in the control group. Statistical analysis indicated significantly higher wear rate in the control group than the experimental groups and also in the CPP-ACP and APF group than the combination group (P<0.05).
We concluded that although either CPP-ACP or APF can protect enamel against wear, their combination provides significant enamel wear reduction. These findings would lead to new strategies for the clinical management of tooth wear.
Casein phosphopeptide-amorphous calcium phosphate; enamel; fluoride; wear
Chronic regurgitation of gastric acids in patients with gastroesophageal reflux disease may cause dental erosion, which can lead in combination with attrition or bruxism to extensive loss of coronal tooth tissue.
This clinical report describes treatment of severe tooth wear of a gastroesophageal reflux disease patient who is 54-year-old Turkish male patient. After his medical treatment, severe tooth wear, bruxism and decreased vertical dimensions were determined. The vertical dimension was re-established and maxillary and mandibular anterior and posterior teeth were prepared for metal-ceramic restorations. Metal-ceramic fixed partial dentures were fabricated as full mouth restorations for both maxillary and mandibular arches because of splinting all teeth. And then maxillary stabilization splint was fabricated for his bruxism history.
Significant loss of coronal tooth structure must taken into consideration. Gastroesophageal reflux disease by itself or in combination with attrition, abrasion or bruxism may be responsible for the loss. An extensive diagnostic evaluation is essential for the medical and dental effects of the problem.
To estimate the prevalence of tooth wear and to investigate factors associated with tooth wear in patients from general practices in the Northwest United States.
Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients (n = 1530) visiting general dentists from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) (n = 80). Prevalence ratios (PRs) of moderate to severe occlusal and incisal tooth wear by patient characteristics were estimated using cluster-adjusted multiple binomial regression for adults (18+ years) and children/adolescents (3–17 years).
For adults, the mean number of teeth with wear facets was 5.4 [95% confidence interval (CI) = 4.6–6.2] and 51% of the adults had four or more teeth with wear. Participants 45–64 and 65+ years old were 1.3 (95% CI = 1.1–1.6) and 1.4 (95% CI = 1.1–1.8) times as likely to have 4+ teeth with moderate to severe wear facets as participants 18–44 years old. Adult males had a 20% (PR = 1.2; 95% CI = 1.1–1.4) higher prevalence of wear than adult females. Adults who were using, or had ever used occlusal splints had higher prevalence of tooth wear compared to those who never used such appliances (PR = 1.3; 95% CI = 1.0–1.5). Adults with any periodontal bone loss also had a 20% higher prevalence of wear than adults without periodontal disease (PR = 1.2; 95% CI = 1.0–1.4). For children/adolescents, the mean number of teeth with moderate to severe wear facets was 1.6 (95% CI = 0.9–2.6) and 31% of the children had one or more teeth with wear facets. The adjusted prevalence ratio of tooth wear (1+ teeth with wear facets) for boys was 1.6 times as high (95% CI = 1.1–2.4) as compared with girls. The prevalence of wear for children 12+ years old was 50% (PR = 0.5; 95% CI = 0.3–0.8) lower than that of children <12 years old. Angle’s class II was associated with higher tooth wear prevalence (PR = 1.8; 95% CI = 1.3–2.6) than class I. Children with posterior or anterior open bite had lower prevalence of wear than their counterparts (PR = 0.6; 95% CI = 0.3–1.0). No associations were observed between tooth wear and orthodontic treatment, missing teeth, and race/ethnicity.
Tooth wear is a prevalent condition in this population. Among adults, higher prevalences of tooth wear were observed among those who were older, males, had used occlusal splints and had periodontal disease. Among children, higher prevalences were associated with younger age, male gender, class II malocclusion and the absence of open bite. Submitted on behalf of the Northwest PRECEDENT network, with support from NIDCR grants DE016750 and DE016752.
dental practice-based research; malocclusion; Northwest PRECEDENT; tooth attrition
Prosthetic-restorative approach for the restoration of tooth wear. Case report
This article presents a case report of combined prosthetic-adhesive rehabilitation in a patient with a generalized tooth wear.
A combined treatment adhesive - prosthetic was proposed to a male patient of 65 years old having a clinically significant tooth wear, with dentine exposure and with a reduction in clinical crown height. The erosive/abrasive worn dentition have been reconstructed with direct resin composite restorations on the posterior teeth and with zirconia crown on the anterior teeth.
Direct composite restorations have a number of distinct advantages. These restorations have proved durable and aesthetic, protect tooth structure and posterior occlusal contact is predictably re-established.
A combinations of direct and indirect restorations, based on the new vertical dimension of occlusion (VDO), can help to reestablish anatomy and function.
VDO; tooth wear; resin restoration; full-mouth rehabilitation
The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.
The role of tooth wear as a proximate cause of senescence in ruminants has recently been highlighted. There are two competing hypotheses to explain variation in tooth height and wear; the diet-quality hypothesis predicting increased wear in low-quality habitats, and the life-history hypothesis predicting molar height to be related to expected longevity. We compared tooth height and wear from roe deer of known age from two contrasting populations of roe deer (Capreolus capreolus) in France: Trois Fontaines (TF) with good habitat and shorter animal life expectancy and Chizé (CH) with poor habitat and longer animal life expectancy. There was no population difference in tooth wear, leading to rejection of the diet-quality hypothesis. However, despite their smaller body size, initial molar height for animals from CH was larger than for animals from TF. This provides the first evidence that variation in longevity between populations can lead to differences in molar height within a species.
longevity; Capreolus capreolus; intraspecific variation; molar; selective browser
Studies examining human and nonhuman primates have supported the hypothesis that the recent increase in the occurrence of misalignment of teeth and/or incorrect relation of dental arches, named dental malocclusion, is mainly attributed to the availability of a more processed diet and the reduced need for powerful masticatory action. For the first time on live human populations, genetic and tooth wear influences on occlusal variation were examined in a split indigenous population. The Arara-Iriri people are descendants of a single couple expelled from a larger village. In the resultant village, expansion occurred through the mating of close relatives, resulting in marked genetic cohesion with substantial genetic differences.
Dental malocclusion, tooth wear and inbreeding coefficient were evaluated. The sample examined was composed of 176 individuals from both villages. Prevalence Ratio and descriptive differences in the outcomes frequency for each developmental stage of the dentition were considered. Statistical differences between the villages were examined using the chi-square test or Fisher's exact statistic. Tooth wear and the inbreeding coefficient (F) between the villages was tested with Mann-Whitney statistics. All the statistics were performed using two-tailed distribution at p≤0.05. The coefficient inbreeding (F) confirmed the frequent incestuous unions among the Arara-Iriri indigenous group. Despite the tooth wear similarities, we found a striking difference in occlusal patterns between the two Arara villages. In the original village, dental malocclusion was present in about one third of the population; whilst in the resultant village, the occurrence was almost doubled. Furthermore, the morphological characteristics of malocclusion were strongly different between the groups.
Our findings downplay the widespread influence of tooth wear, a direct evidence of what an individual ate in the past, on occlusal variation of living human populations. They also suggest that genetics plays the most important role on dental malocclusion etiology.
The aim of this study was to identify the prevalence of dental caries, periodontal diseases and tooth wear in bariatric patients, and relate the oral health conditions to saliva flow.
Fifty-two patients who had undergone bariatric surgery (Roux-en-Y gastric bypass) and 50 severely obese patients indicated for bariatric surgery were submitted to clinical examinations with regard to dental caries (DMFT index), periodontal condition (CPI index), dental wear (DWI index – Dental wear index) and saliva flow. The data were statistically analyzed by the Student’s-t, Mann-Whitney, Spearman Correlation and Chi-square (χ2) tests at 5% significance level.
The DMFT index was 16.11±5.19 in the surgical group and 16.06±6.29 in the control group (P>.05). The mean CPI was 3.05±0.84 for the operated group and 2.66±1.25 for the obese patients with no significant difference between them (P>.05). There was statistically significant difference between the groups for the presence of periodontal pockets (P=.021). All the patients presented some degree of tooth wear, however, with no significant difference between the two groups (P=.82). The mean saliva flow values of the surgical group and control group were 0.64±0.46 mL/min and 0.66±0.49 mL/min, respectively. There was no significant difference in saliva flow and all oral conditions analyzed (P>.05).
The prevalence of oral diseases was similar in severely obese patients who were candidates for bariatric surgery and in patients who had been submitted to bariatric surgery. Nevertheless, there was higher prevalence of periodontal pockets in the operated group.
Oral health; tooth erosion; periodontal diseases; dental caries; xerostomia; obesity; bariatric surgery
Some of the efforts that have been made to document tooth wear are reviewed here with an emphasis on nonhuman mammals, literature with which dentists may not be very familiar. We project a change in research strategy from the description of wear at various scales of measurement towards investigation of the mechanical mechanisms that actually create the texture of a worn surface. These studies should reveal exactly how tooth tissue is lost and what aspects of the structure of dental tissues affect this. The most important aspects of the interaction between the tooth surface and wear particles would appear to be particle size, particle shape, their mechanical properties with respect to those of tooth tissues, and the influence of saliva.
Although modularity affords various options to the orthopedic surgeon, these benefits come at a price. The unintended bearing surface between the back surface of the tibial insert and the metallic tray results in micromotion leading to polyethylene wear debris. The objective of this study was to examine the backside wear of tibial inserts from three modern total knee designs with very different locking mechanisms: Insall-Burstein II® (IB II®), Optetrak®, and Advance®. A random sample of 71 inserts were obtained from our institution’s retrieval collection and examined to assess the extent of wear, depth of wear, and wear damage modes. Patient records were also obtained to determine patient age, body mass index, length of implantation, and reason for revision. Modes of wear damage (abrasion, burnishing, scratching, delamination, third body debris, surface deformation, and pitting) were then scored in each zone from 0 to 3 (0 = 0%, 1 = 0–10%, 2 = 10–50%, and 3 = >50%). The depth of wear was subjectively identified as removal of manufacturing identification markings stamped onto the inferior surface of the polyethylene. Both Advance® and IB II® polyethylene inserts showed significantly higher scores for backside wear than the Optetrak® inserts. All IB II® and Advance® implants showed evidence of backside wear, whereas 17% (5 out of 30) of the retrieved Optetrak® implants had no observable wear. There were no significant differences when comparing the depth of wear score between designs. The locking mechanism greatly affects the propensity for wear and should be considered when choosing a knee implant system.
polyethylene; wear; knee; backside; back surface; locking mechanism
To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by Dental Practice-Based Research Network (DPBRN) dentists, and associated tooth, patient and dentist characteristics.
Data were collected on placement of 1,301 restorations due to NCTD by 178 DPBRN dentists. Information included: (1) main clinical occurrence or reason, other than dental caries, for restoring previously un-restored permanent tooth surfaces, (2) characteristics of patients who received treatment, (3) dentists’ and dental practices’ characteristics, (4) tooth and surfaces restored, and (5) restorative materials employed.
Restorations were most often placed to treat abrasion, abfraction, and erosion (AAE) lesions (46%) and tooth fracture (31%). Patients older than 40 years received restorations mainly due to AAE (p<0.0001). Premolar and anterior teeth were mostly restored due to AAE; molar teeth were mostly restored due to tooth fracture (p<0.0001). Directly placed resin-based composite (RBC) was largely used to restore AAE and tooth fracture (p<0.0001).
AAE and tooth fracture are the main reasons for restoring non-carious tooth surfaces among DPBRN practices. Premolar and anterior teeth of patients older than 40 years are most likely to receive restorations due to AAE; molars are most likely to receive restorations due to tooth fracture. Both types of NCTD are most often restored with RBC.
non-carious tooth defects; abrasion; abfraction; erosion; tooth fracture; resin-based composite; DPBRN
This study aimed to investigate dentists' general experience, knowledge about diagnosis, and treatment of dental erosive wear in young adults. A questionnaire was sent to 1262 Norwegian public dental health-employed dentists. The response rate was 60%. Results indicated that most dentists recorded erosive wear, half of them used a specific scoring system, and half registered lesions at the tooth surface level. Lesions were reported most often on palatal surfaces of upper anterior teeth (79% of dentists), on occlusal surfaces of lower 1st molars (74%), and on upper 1st molars (32%). Half the dentists used clinical photographs for documentation and 60% made study models. While 40% reported more erosive lesions in males, 36% reported no gender differences. High intake of carbonated beverages and acidic juices were reported as the most common cause by 97% and 72% of the dentists, respectively. Only 21% of dentists recorded the patient's dietary history, and 73% never measured saliva secretion. The majority (78%) of the dentists treated patients with erosive wear themselves. In general, the survey suggests that the dentists are relatively up to date regarding the clinical recording, diagnosis, and treatment of dental erosive wear. However, dietary and salivary analyses were not given priority, and early, preventive treatment was lacking.
Reflectance and transillumination imaging show demineralization with high contrast in the near-IR. The objective of this study is to use lesion size and contrast acquired in reflectance and transillumination near-infrared imaging modes to estimate the severity of natural occlusal caries lesions. Previous studies have shown that near-infrared (NIR) light can be used to effectively image artificial carious lesions. However, its efficacy on natural lesions requires further exploration. Fifty extracted teeth with varying amounts of occlusal decay were examined using a NIR imaging system operating at 1310-nm. Image analysis software was used to calculate contrast values between sound and carious tooth structure. After imaging, teeth were histologically sampled at 1-mm intervals in order to determine lesion depth. Lesion contrast in transillumination mode significantly increased with lesion depth (p<0.001), while lesion contrast in reflectance mode did not increase. The lesion area demonstrated a significant increase with lesion severity in both imaging modes. These results suggest that lesion contrast and area can be used to estimate lesion severity in NIR images.
Near-IR imaging; occlusal surfaces; dental caries; transillumination; reflectance imaging
The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is essential in order to assess the extent of this clinical phenomenon, both on an individual level and in the population, and for the adequate provision of preventive and therapeutic measures. Well-established erosion indices have been used in most of these studies, although in many cases modifications have been made to suit the different research aims. This use of different indices is one reason why it still cannot be claimed that there is enough current knowledge on this clinical phenomenon. This article summarises the proceedings of a workshop to discuss the topic of dental erosion indices. The result of the workshop is the proposal for a new scoring system (Basic Erosive Wear Examination, BEWE) designed for use both within the research field and for dental clinicians, with the aims of standardising assessment of erosion for international comparisons, raising awareness and providing guidelines for treatment of erosive tooth wear in dental practice.
Erosive tooth wear; Index; Epidemiology; Diagnosis; Prevalence
We measured the molar size from a single population of wild baboons from Amboseli (Kenya), both females (n = 57) and males (n = 50). All the females were of known age; the males represented a mix of known-age individuals (n = 31) and individuals with ages estimated to within 2 years (n = 19). The results showed a significant reduction in the mesiodistal length of teeth in both sexes as a function of age. Overall patterns of age-related change in tooth size did not change whether we included or excluded the individuals of estimated age, but patterns of statistical significance changed as a result of changed sample sizes. Our results demonstrate that tooth length is directly related to age due to interproximal wearing caused by M2 and M3 compression loads. Dental studies in primates, including both fossil and extant species, are mostly based on specimens obtained from osteological collections of varying origins, for which the age at death of each individual in the sample is not known. Researchers should take into account the phenomenon of interproximal attrition leading to reduced tooth size when measuring tooth length for ondontometric purposes.
Molar size; Interproximal wearing; Aging; Papio cynocephalus; Amboseli; Kenya
Little is known on the prevalence of tooth decay among pregnant women. Better knowledge of tooth decay risk indicators during pregnancy could help to develop follow-up protocols for women at risk, along with better prevention strategies. The aim of this study was to assess the frequency of tooth decay and the number of decayed teeth per woman in a large sample of pregnant women in France, and to study associated risk indicators.
A secondary cross-sectional analysis of data from a French multicentre case-control study was performed. The sample was composed of 1094 at-term women of six maternity units. A dental examination was carried out within 2 to 4 days post-partum. Socio-demographic and behavioural characteristics were obtained through a standardised interview with the women. Medical characteristics were obtained from the women’s medical records. Risk indicators associated with tooth decay were identified using a negative binomial hurdle model.
51.6% of the women had tooth decay. The mean number of decayed teeth among women having at least one was 3.1 (s.d. = 2.8). Having tooth decay was statistically associated with lower age (aOR = 1.58, 95%CI [1.03,2.45]), lower educational level (aOR = 1.53, 95%CI [1.06,2.23]) and dental plaque (aOR = 1.75, 95%CI [1.27,2.41]). The number of decayed teeth was associated with the same risk indicators and with non-French nationality and inadequate prenatal care.
The frequency of tooth decay and the number of decayed teeth among pregnant women were high. Oral health promotion programmes must continue to inform women and care providers about the importance of dental care before, during and after pregnancy. Future research should also assess the effectiveness of public policies related to oral health in target populations of pregnant women facing challenging social or economic situations.