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Rius-Bonet O, Roca-Obis P, Zamora-Olave C, Willaert E, Martinez-Gomis J. Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase. J Oral Rehabil 2024; 51:861-869. [PMID: 38186266 DOI: 10.1111/joor.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/19/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition. OBJECTIVE This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population. METHODS We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models. RESULTS Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values. CONCLUSIONS The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.
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Affiliation(s)
- Ona Rius-Bonet
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Paula Roca-Obis
- Department of Oral Medicine, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Zamora-Olave
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Eva Willaert
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Jordi Martinez-Gomis
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
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Margaritis V, Alaraudanjoki V, Laitala ML, Anttonen V, Bors A, Szekely M, Alifragki P, Jász M, Berze I, Hermann P, Harding M. Multicenter study to develop and validate a risk assessment tool as part of composite scoring system for erosive tooth wear. Clin Oral Investig 2020; 25:2745-2756. [PMID: 32964309 DOI: 10.1007/s00784-020-03589-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 09/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES (i) To develop, validate, and apply in practice a new risk assessment tool for erosive tooth wear (ETW) including a risk factors questionnaire and a saliva secretion evaluation, which combined with a clinical index, can be part of an ETW composite scoring system; (ii) to assess ETW lesions and current and past erosive challenges in younger age groups. METHODS The Tooth Surface Loss/Erosion Working Group of the European Association of Dental Public Health consisted of an international panel of experts designed the survey component of the new tool (Erosive Wear Assessment of Risk-EWAR) and confirmed its construct and content validity. After receiving ethical approvals and informed consents, the EWAR tool (questionnaire + saliva secretion evaluation) was applied in a multicenter cross-sectional study with 207 participants aged 15-21 years old from four countries (Finland, Greece, Romania, the USA). BEWE score was used for the clinical assessment of ETW. RESULTS A total of 58.5% of participants had ETW. 10.9% and 20.3% of participants had low secretion of stimulated (< 1 ml/min) and unstimulated saliva (< 0.25 ml/min), respectively. The following factors were bivariately significantly associated with ETW: energy drink consumption, low secretion of stimulated saliva, juices consumption, erosive drink consumption for quenching thirst between meals, erosive drink kept in the mouth, feeling pain/icing after consuming something acidic or cold, and co-existence of other type of tooth wear. In regression analysis, only energy drink consumption (OR = 3.5, 95% CI: 1.39, 8.9), low secretion of stimulated saliva (OR = 36.3, 95% CI: 4.71, 78.94), and feeling pain/icing (OR = 8.8, 95% CI: 1.92, 40.04) remained significant. CONCLUSIONS The examiners of the study reported that the EWAR tool appeared to be an affordable and easy-to-use instrument. Some challenges occurred during the saliva collection process. Inferential analysis revealed that the risk factors/indicators of low stimulated salivary flow, energy drink consumption, and pain/icing with ETW were considered the most important in ETW occurrence. CLINICAL RELEVANCE EWAR tool combined with the BEWE clinical index can be used for ETW risk assessment for epidemiological studies and chairside use.
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Affiliation(s)
- Vasileios Margaritis
- School of Health Sciences, Walden University, 100 Washington Av. South. Suite 1210, Minneapolis, MN, 55401, USA.
| | | | - Marja-Liisa Laitala
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Andreea Bors
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania
| | - Melinda Szekely
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania
| | - Panagiota Alifragki
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Máté Jász
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Ildikó Berze
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Mairead Harding
- Oral Health Services Research Centre, Cork University Dental School and Hospital, University College Cork, Cork, Ireland
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Tulek A, Vieira AR, Weber ML, Bezamat M, Deeley K, Stenhagen KR, Sehic A, Sovik JB, Mulic A. Aquaporins' Influence on Different Dental Erosive Wear Phenotypes in Humans. Caries Res 2020; 54:165-175. [PMID: 32045909 DOI: 10.1159/000505965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 01/16/2020] [Indexed: 11/19/2022] Open
Abstract
Dental erosive wear is a multifactorial condition of high prevalence. Nowadays, there is an emphasis on discovering individual genetic predisposition for the development of this condition. Aquaporins (AQPs) are water channel proteins expressed in salivary glands, as well as during tooth development. They are involved in salivary secretion and composition and linked to physiological protection of the oral cavity. The aim of this study was to explore the relationship between different dental erosive wear phenotypes, AQP genes, and selected environmental factors. Data from 705 dental patients were used to investigate the association between dental erosive wear phenotypes and AQPs' single-nucleotide variants. Phenotypes were further analyzed considering diet and oral hygiene data, using logistic regression analysis, as implemented in PLINK, with the assumption that dental erosive wear is a complex gene-environment model. Associations were found between severe erosive tooth wear and rs2878771 (AQP2) for the genotypic (p = 0.02) and dominant (p = 0.03) models, and rs3736309 (AQP5) for the allelic model (p = 0.02). Logistic regression analyses, after implementing the Bonferroni correction, showed that several significant associations were present when covariates were included, suggesting that a strong environmental component is present. Our results show that dental erosive wear establishes under a gene-environmental complex model.
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Affiliation(s)
- Amela Tulek
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway,
| | - Alexandre Rezende Vieira
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Megan L Weber
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mariana Bezamat
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathleen Deeley
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Amer Sehic
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Jenny Bogstad Sovik
- Department of Cariology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Aida Mulic
- Nordic Institute of Dental Materials, Oslo, Norway
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[Dental erosion in a sample of Valencian children. Prevalence and evaluation of eating habits]. NUTR HOSP 2020; 37:895-901. [PMID: 32960641 DOI: 10.20960/nh.03095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: dental erosion is the pathological, chronic, localized and painless loss of dental tissues, produced by the chemical action of acids, where the action of microorganisms is not involved. In recent years, a significant increase in the prevalence of this pathology has been observed, especially in children and adolescents. Objectives: to determine the prevalence of dental erosion in temporary dentition using the Basic Erosive Wear Examination Index (BEWE) in children between 5 and 12 years of age, and to determine the eating habits that may favor the development of these lesions. Methods: a cross-sectional study was carried out on a sample of 391 children. A survey was conducted where eating habits were analyzed and a clinical examination of the temporary teeth was performed using the BEWE index. Results: the prevalence of dental erosion in the studied sample was 19.7 %, with mild lesions being most common. Conclusions: in all, 30.62 % of the studied population had a low risk of dental erosion, and risk was seen to increase with consumption of acidic beverages (soft drinks, isotonic drinks and fruit juices) and acidic fruits such as oranges, grapes and apples.
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Coupal I, Sołtysiak A. Dental erosion in archaeological human remains: A critical review of literature and proposal of a differential diagnosis protocol. Arch Oral Biol 2017; 84:50-57. [DOI: 10.1016/j.archoralbio.2017.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 01/19/2023]
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Schlichting LH, Resende TH, Reis KR, Magne P. Simplified treatment of severe dental erosion with ultrathin CAD-CAM composite occlusal veneers and anterior bilaminar veneers. J Prosthet Dent 2016; 116:474-482. [DOI: 10.1016/j.prosdent.2016.02.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 10/21/2022]
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Tomczyk J, Zalewska M. Mechanical and chemical dental wear in historical population from the Syrian lower Euphrates valley. Arch Oral Biol 2016; 62:49-57. [DOI: 10.1016/j.archoralbio.2015.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 11/26/2022]
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Murakami C, Tello G, Abanto J, Oliveira LB, Bonini GC, Bönecker M. Trends in the prevalence of erosive tooth wear in Brazilian preschool children. Int J Paediatr Dent 2016; 26:60-5. [PMID: 25726857 DOI: 10.1111/ipd.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To report trends in the prevalence of ETW in Brazilian preschool children. METHODS Three cross-sectional surveys were carried out on boys and girls aged 3-4 years living in Diadema, in the years 2008, 2010 and 2012 following the same criteria and methodology. A total of 2801 children were systematically examined during a National Day of Children's vaccination. Examiners were trained and calibrated to diagnose ETW using a modified version of the O'Brien index. RESULTS The prevalence of ETW was 51.6% (95% CI 48.4-55.0) in 2008, 53.9% (95% CI 50.7-57.0) in 2010 and 51.3% (95% CI 47.8-54.7) in 2012. There was no significant association between prevalence of ETW from 2008 to 2012 (χ(2) for trend: P = 0.92). There was no significant association in the severity of ETW during this study's period. Most lesions were confined to enamel in all three studies. CONCLUSIONS A high prevalence of ETW was found in this sample of preschool children in 2008, 2010 and 2012. No trends of increase or decrease in the prevalence and severity of ETW during this study's period.
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Affiliation(s)
- Christiana Murakami
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gustavo Tello
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Jenny Abanto
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Gabriela Cunha Bonini
- Department of Pediatric Dentistry, São Leopoldo Mandic, School, Campinas, SP, Brazil
| | - Marcelo Bönecker
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
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Abstract
Tooth wear has an increasing prevalence in the UK population. The aetiology is commonly multifactorial, and the aetiopathology is through a combination of erosion, attrition, abrasion and abfraction. Erosion is associated with intrinsic or extrinsic acids, and therefore subjects with reflux disease and eating disorders are at increased risk. Fruit juice, fruits and carbonated drink consumption, frequency of consumption and specific habits are also risk factors. Attrition is more prevalent in bruxists. Other habits need to be considered when defining the risk of tooth wear. Abrasion is usually associated with toothbrushing and toothpastes, especially in an already acidic environment. Patients with extensive lesions that affect dentin may be at higher risk, as well as those presenting with unstained lesions. Monitoring of the progress of tooth wear is recommended to identify those with active tooth wear. Indices for tooth wear are a helpful aid.
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Søvik JB, Vieira AR, Tveit AB, Mulic A. Enamel formation genes associated with dental erosive wear. Caries Res 2015; 49:236-42. [PMID: 25791822 DOI: 10.1159/000369565] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 10/31/2014] [Indexed: 11/19/2022] Open
Abstract
Dental erosive wear is a multifactorial condition that is greatly affected by environmental factors. So far, no study has investigated how dental erosive wear is influenced by variations in enamel formation genes. The aim of the present study was to investigate polymorphisms in genes involved in enamel formation and their influence on enamel susceptibility to dental erosion. DNA samples were collected from 795 Norwegian adolescents aged 16-18 years. Five single-nucleotide polymorphism markers were genotyped in selected candidate genes (ameloblastin, amelogenin, enamelin, tuftelin 1 and tuftelin interacting protein 11), reported to influence enamel formation. Allele and genotype frequencies were compared within two patient groups with dental erosions; all participants with dental erosion and only those with severe dental erosion (erosion extending into dentine). Overrepresentation of the G allele of the enamelin marker was seen in the erosion group compared to the unaffected group (p = 0.047). When erosion severity was considered, statistical significant difference in allele frequency was observed for amelogenin, with the C allele suggesting a protective role (p = 0.02). A suggestive overrepresentation of the TT genotype of the amelogenin marker was also seen in cases with severe erosion (p = 0.049) when compared to cases with no dentine erosion. Amelogenin was also associated with severe erosion in the recessive model; the TT genotype was significantly more frequent in the affected group than in the unaffected group (p = 0.01). The present study suggests that polymorphisms in enamel formation genes are statistically associated with an individual's susceptibility to dental erosive wear.
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Affiliation(s)
- Jenny B Søvik
- Department of Cariology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Isaksson H, Birkhed D, Wendt LK, Alm A, Nilsson M, Koch G. Prevalence of dental erosion and association with lifestyle factors in Swedish 20-year olds. Acta Odontol Scand 2014; 72:448-57. [PMID: 24286494 DOI: 10.3109/00016357.2013.859727] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the prevalence, distribution and severity of dental erosion and its association with lifestyle, oral and general health in young adults. MATERIALS AND METHODS Four hundred and ninety-four individuals, 20-years of age, participated. Dental erosion in molars and maxillary incisors was evaluated. Caries, plaque and gingivitis were registered. Saliva samples were taken and the subjects were interviewed about behavioural and dietary habits and oral and general health. Body mass index (BMI) was calculated. The individuals were sub-divided into two groups according to the presence and absence of dental erosion: within the group with erosion was a sub-group of individuals with extensive erosion. RESULTS Of the individuals 25% had no erosion, 75% had erosion and 18% had extensive erosion. Erosion was found in molars in 74% of the individuals and on buccal and palatal surfaces in maxillary incisors in 4% and 7%, respectively. Cupping was seen in 65% of individuals and severe erosion in molars in 1.6%. Compared to subjects with no erosion, those with extensive erosion had a higher consumption of soft drinks (p = 0.05), caries prevalence (p < 0.01), prevalence of mutans Streptococci (p < 0.01) and BMI (p < 0.05). Furthermore, subjects with erosion had higher caries prevalence (p < 0.01) and BMI (p < 0.01) than those with no erosion. CONCLUSIONS Swedish young adults have a high prevalence of dental erosion, but the level of severe erosion is low. The study disclosed a relationship between dental erosion and behavioural factors, oral health and BMI.
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Affiliation(s)
- Helén Isaksson
- Department of Paediatric Dentistry, The Institute for Postgraduate Dental Education , Jönköping , Sweden
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12
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A prospective survey of secondary care tooth wear referrals: demographics, reasons for concern and referral outcomes. Br Dent J 2014; 216:E9. [PMID: 24603273 DOI: 10.1038/sj.bdj.2014.179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 11/08/2022]
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Dental caries and erosion status of 12-year-old Hong Kong children. BMC Public Health 2014; 14:7. [PMID: 24397565 PMCID: PMC3890525 DOI: 10.1186/1471-2458-14-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 01/05/2014] [Indexed: 11/19/2022] Open
Abstract
Background This study aimed to assess the dental caries and erosion status of 12-year-old Hong Kong children and study the determinants of dental caries and dental erosion of these children. Methods The survey was performed from 2011 to 2012 with ethics approval. Stratified random sampling was adopted to select 12-year-old children in 7 primary schools in Hong Kong. The participating parents were asked to complete a self-administered questionnaire concerning their children’s diet and oral health habits. The children were examined for caries status with WHO criteria by 3 calibrated examiners. Detection of dental erosion followed Basic Erosive Wear Examination (BEWE) criteria. Results A total of 704 children were recruited and 600 (316 boys, 53%) participated in the survey. There were 124 children (21%) with caries experience (DMFT > 0) and their DMFT was 0.34 ± 0.76. About half of their decay was unfilled (DT = 0.16 ± 0.52) The DMFT of girls and boys were 0.45 ± 0.89 and 0.23 ± 0.61, respectively (p = 0.001). Girls also had a higher DT (0.21 ± 0.62 compared with 0.11 ± 0.41, p = 0.013) and FT than boys (0.23 ± 0.63 compared with 0.12 ± 0.44, p = 0.016). Most children (75%) had at least some sign of erosion (BEWE > 0), but no severe erosion (BEWE = 3). Logistic regression showed girls who consumed soft drinks and took vitamin C supplements had higher caries risk. Dental erosion was more severe among the children who had caries experience and consumed fruit juice. Conclusions The 12-year-old Hong Kong children had low caries experience, and almost half of the decay was left untreated. Although severe erosion was not found, many children had early signs of erosion.
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Mulic A, Tveit AB, Skaare AB. Prevalence and severity of dental erosive wear among a group of Norwegian 18-year-olds. Acta Odontol Scand 2013; 71:475-81. [PMID: 22762481 DOI: 10.3109/00016357.2012.696689] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim was to study prevalence, distribution and severity of erosive wear in a group of 18-year-olds. MATERIALS AND METHODS A total of 1456 adolescents were screened for erosive wear as part of their regular visit at the Public Dental Health Service (PDHS) clinics in Oslo. Of 554 (38%) registered with erosive wear, 267 accepted a second examination to record lesion distribution and severity, performed by one previously calibrated clinician. A tested erosive wear system (VEDE) was used. Occlusal surfaces of the first and second molars in both jaws and the labial and palatal surfaces of the upper incisors and canines were selected as index surfaces. RESULTS Of the 267 individuals with erosive wear, 13.5% were without lesions, 54.3% had erosive wear in enamel only, whereas 32.2% had at least one lesion extending into dentine. The upper central incisors (46%) and first lower molars (44%) were the most affected teeth with the highest presence on the palatal surfaces. Cuppings were registered in 62% of the individuals, usually in addition to erosive lesions on other surfaces. Eighty-five per cent of the cuppings were on first molars and 34% on the mesio-buccal cusp. Males had significantly more lesions into dentine compared with females (p = 0.03). There was a significant association between presence of erosive lesions and DMFT (p < 0.01), but no association between lesions and socio-economic or national background. CONCLUSIONS A high proportion of adolescents had erosive wear. Cuppings were a common finding.
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Affiliation(s)
- Aida Mulic
- Department of Cariology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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Opinions on Dental Erosive Lesions, Knowledge of Diagnosis, and Treatment Strategies among Norwegian Dentists: A Questionnaire Survey. Int J Dent 2012; 2012:716396. [PMID: 22927855 PMCID: PMC3426243 DOI: 10.1155/2012/716396] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 05/25/2012] [Accepted: 07/04/2012] [Indexed: 11/28/2022] Open
Abstract
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.
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Saeves R, Espelid I, Storhaug K, Sandvik L, Nordgarden H. Severe tooth wear in Prader-Willi syndrome. A case-control study. BMC Oral Health 2012; 12:12. [PMID: 22639910 PMCID: PMC3437195 DOI: 10.1186/1472-6831-12-12] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 04/18/2012] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Ronnaug Saeves
- TAKO-centre, Lovisenberg Diakonale Hospital, Lovisenberggt 17, 0440 Oslo, Norway
| | - Ivar Espelid
- Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Kari Storhaug
- TAKO-centre, Lovisenberg Diakonale Hospital, Lovisenberggt 17, 0440 Oslo, Norway
| | - Leiv Sandvik
- Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Nordgarden
- TAKO-centre, Lovisenberg Diakonale Hospital, Lovisenberggt 17, 0440 Oslo, Norway
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17
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López-Frías FJ, Castellanos-Cosano L, Martín-González J, Llamas-Carreras JM, Segura-Egea JJ. Clinical measurement of tooth wear: Tooth wear indices. J Clin Exp Dent 2012; 4:e48-53. [PMID: 24558525 PMCID: PMC3908810 DOI: 10.4317/jced.50592] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 10/02/2011] [Indexed: 11/15/2022] Open
Abstract
Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification corresponds to a different process with specific clinical features. Classifications made so far have no accurate prevalence data because the indexes do not necessarily measure a specific etiology, or because the study populations can be diverse in age and characteristics.
Tooth wears (attrition, erosion and abrasion) is perceived internationally as a growing problem. However, the interpretation and comparison of clinical and epidemiological studies, it is increasingly difficult because of differences in terminology and the large number of indicators/indices that have been developed for the diagnosis, classification and monitoring of the loss of dental hard tissue. These indices have been designed to identify increasing severity and are usually numerical, none have universal acceptance, complicating the evaluation of the true increase in prevalence reported. This article considers the ideal requirements for an erosion index. A literature review is conducted with the aim of analyzing the evolution of the indices used today and discuss whether they meet the clinical needs and research in dentistry.
Key words:Tooth wear, tooth wear indices, attrition, erosion, abrasion, abfraction.
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Affiliation(s)
| | | | | | - José M Llamas-Carreras
- Associated Professor, Department of Orthodontics, School of Dentistry, University of Sevilla
| | - Juan J Segura-Egea
- Professor, Department of Endodontics, School of Dentistry, University of Sevilla
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18
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Gambon DL, Brand HS, Boutkabout C, Levie D, Veerman ECI. Patterns in consumption of potentially erosive beverages among adolescent school children in the Netherlands. Int Dent J 2011; 61:247-51. [PMID: 21995371 DOI: 10.1111/j.1875-595x.2011.00067.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIM To determine the frequency of intake and patterns in consumption of potentially erosive beverages in school children in the Netherlands. METHODS A cross-sectional, single centre study was performed among 502 school children in Rotterdam, in age varying between 12 and 19 years. Data on consumption of soft drinks, energy drinks, sports drinks and alcopops were obtained through a self-reported questionnaire. Gender- and age-related differences in consumption were analysed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Associations between variables were investigated with Chi-square tests and Spearman's rank order correlation analysis. RESULTS Boys consumed soft drinks, energy drinks and sports drinks more frequently than girls, and on average also consumed higher amounts of these drinks. No gender-related differences were observed in alcopop consumption. Consumption of all drinks was most frequent at 14- or 15-year of age, with the exception of alcopops which was most frequent by 16-year-old school children. Significant positive associations were observed between the consumption of soft drinks, energy drinks and/or sports drinks. Alcopop consumption was only associated with consumption of energy drinks. CONCLUSION Consumption of soft drinks, energy drinks, sports drinks and alcopops by school children is related to age and gender. The significant positive associations between the consumption of these drinks suggest that a subgroup of school children exists with a high cumulative intake of these potentially erosive drinks.
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Affiliation(s)
- Dien L Gambon
- Bambodino Paediatric Dental Clinic, Meerum Terwogtlaan, PP Rotterdam, The Netherlands.
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19
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Nahás Pires Corrêa MS, Nahás Pires Corrêa F, Nahás Pires Corrêa JP, Murakami C, Mendes FM. Prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. Int J Paediatr Dent 2011; 21:451-8. [PMID: 21793955 DOI: 10.1111/j.1365-263x.2011.01150.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BaCKGROUND. The prevalence of dental erosion seems to be rising in young populations, particularly among individuals of higher socioeconomic status. AIM. To assess the prevalence and associated factors of dental erosion in children and adolescents of a private dental practice. DESIGN. A total of 232 participants, aged 2-20 years, were examined. Dietary habits, oral hygiene, and medical data were collected from dental records. Logistic regression analyses were conducted. RESULTS. Dental erosion prevalence was of 25.43% and was highest on the occlusal surfaces (76%). Associated factors were: frequent consumption of soft drinks (OR = 2.33; 95% CI = 1.01-5.38) and candies (OR = 3.23; 95% CI = 1.25-8.32); and interaction between these two factors (OR = 3.95; 95% CI = 1.60-9.75). On anterior teeth, associated factors were: frequent consumption of fruits (OR = 2.53; 95% CI = 1.09-5.91); and age (OR = 1.07 95% CI = 1.01-1.14). Milk consumption was associated with a lower prevalence of dental erosion (OR = 0.40; 95% CI = 0.17-0.94). CONCLUSIONS. A relatively high prevalence of erosion was found in association with frequent intake of soft drinks, candies, and fruits. The consumption of milk seemed to protect against dental erosion on anterior teeth.
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20
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Rakhmatullina E, Bossen A, Höschele C, Wang X, Beyeler B, Meier C, Lussi A. Application of the specular and diffuse reflection analysis for in vitro diagnostics of dental erosion: correlation with enamel softening, roughness, and calcium release. JOURNAL OF BIOMEDICAL OPTICS 2011; 16:107002. [PMID: 22029364 PMCID: PMC3206927 DOI: 10.1117/1.3631791] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 08/03/2011] [Accepted: 08/08/2011] [Indexed: 05/15/2023]
Abstract
We present assembly and application of an optical reflectometer for the analysis of dental erosion. The erosive procedure involved acid-induced softening and initial substance loss phases, which are considered to be difficult for visual diagnosis in a clinic. Change of the specular reflection signal showed the highest sensitivity for the detection of the early softening phase of erosion among tested methods. The exponential decrease of the specular reflection intensity with erosive duration was compared to the increase of enamel roughness. Surface roughness was measured by optical analysis, and the observed tendency was correlated with scanning electron microscopy images of eroded enamel. A high correlation between specular reflection intensity and measurement of enamel softening (r(2) ≥ -0.86) as well as calcium release (r(2) ≥ -0.86) was found during erosion progression. Measurement of diffuse reflection revealed higher tooth-to-tooth deviation in contrast to the analysis of specular reflection intensity and lower correlation with other applied methods (r(2) = 0.42-0.48). The proposed optical method allows simple and fast surface analysis and could be used for further optimization and construction of the first noncontact and cost-effective diagnostic tool for early erosion assessment in vivo.
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Affiliation(s)
- Ekaterina Rakhmatullina
- University of Bern, Department of Preventive, Restorative and Paediatric Dentistry, Freiburgstrasse 7, Bern, CH-3010, Switzerland.
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21
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Margaritis V, Mamai-Homata E, Koletsi-Kounari H. Novel methods of balancing covariates for the assessment of dental erosion: A contribution to validation of a synthetic scoring system for erosive wear. J Dent 2011; 39:361-7. [DOI: 10.1016/j.jdent.2011.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 02/20/2011] [Accepted: 02/21/2011] [Indexed: 10/18/2022] Open
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Murakami C, Oliveira LB, Sheiham A, Nahás Pires Corrêa MS, Haddad AE, Bönecker M. Risk indicators for erosive tooth wear in Brazilian preschool children. Caries Res 2011; 45:121-9. [PMID: 21430381 DOI: 10.1159/000324807] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 01/30/2011] [Indexed: 10/18/2022] Open
Abstract
The aim of this study was to assess the prevalence and risk indicators for erosive tooth wear (ETW) in Brazilian preschool children. A total of 967 children aged 3-4 years were examined. ETW was assessed using a modified version of the index recommended by O'Brien [London, Her Majesty's Stationary Office, 1994]. The 16 examiners were trained and calibrated. Hierarchical logistic regression was applied to investigate the association between ETW and socio-economic, environmental, nutritional and behavioural factors, as well as factors related to the child's characteristics. ETW was present in 51.6% of children. Most lesions were confined to enamel (93.9%) and involved over two thirds of the tooth surface's area (82%). There were no significant associations between ETW and socio-economic, environmental and nutritional variables. ETW was significantly associated with soft drink intake twice or 3 or more times a day (p = 0.043 and 0.023, respectively), frequent reported gastro-oesophageal reflux (p = 0.005) and age (p = 0.003). In conclusion, there was a high prevalence of ETW in the preschool children examined, and the risk indicators were frequent consumption of soft drinks, reported gastro-oesophageal reflux and age.
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Affiliation(s)
- Christiana Murakami
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, Brazil.
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23
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Margaritis V, Mamai-Homata E, Koletsi-Kounari H, Polychronopoulou A. Evaluation of three different scoring systems for dental erosion: a comparative study in adolescents. J Dent 2010; 39:88-93. [PMID: 21035516 DOI: 10.1016/j.jdent.2010.10.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 08/09/2010] [Accepted: 10/21/2010] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of the study was to evaluate and compare three scoring systems for dental erosion representing different approaches: the recently proposed Basic Erosive Wear Examination (B.E.W.E.), the Simplified Tooth Wear Index (S-T.W.I.), and the Evaluating Index of Dental Erosion (EV.I.D.E.), which are introduced and calibrated in the present study, in order to contribute to the development of a standardised and validated erosion index. METHODS A cross-sectional study was conducted, in which a random and stratified sample of 502 adolescents aged 14-16 years was examined using the aforementioned scoring systems. RESULTS A significant number of Greek adolescents had experienced dental erosion: 58%, 51.6% and 45.2%, according to the B.E.W.E., S-T.W.I. and EV.I.D.E. scores, respectively. Additionally, 22.7-24.3% of the subjects had lesions into dentine (according to the EV.I.D.E. and S-T.W.I. scores respectively), whereas the B.E.W.E. classified all subjects with erosion in the "none" and "low" risk level categories. However, the use of the B.E.W.E. cumulative scores was important for avoiding the overestimation of the prevalence of erosion. The aetiological criteria of the EV.I.D.E. seemed to reduce the false positive cases. CONCLUSIONS The S-T.W.I. appeared to have the lowest content validity, while the B.E.W.E. was a convenient to use index, with sufficient sensitivity and specificity. Nevertheless, the B.E.W.E. cut-off values have to be reconsidered in order to reflect the severity of the erosive lesions. The B.E.W.E. could also be supplemented with a group of sufficient validated aetiological criteria, which are necessary to establish a more accurate differential diagnosis of dental erosion.
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Affiliation(s)
- Vasileios Margaritis
- Department of Preventive and Community Dentistry, Dental School, National and Kapodistrian University of Athens, 2, Thivon Street, 11527 Goudi, Athens, Greece.
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Kuijpers MAR, Kiliaridis S, Renkema A, Bronkhorst EM, Kuijpers-Jagtman AM. Anterior tooth wear and retention type until 5 years after orthodontic treatment. Acta Odontol Scand 2009; 67:176-81. [PMID: 19247853 DOI: 10.1080/00016350902773390] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To study occlusal wear of anterior teeth in orthodontic patients retained with different retainers until 5 years post-treatment, and to investigate whether type of retention influences occlusal wear. MATERIAL AND METHODS Orthodontic patients (n=222), aged 15 years maximally at the start of treatment, were followed until 5 years post-treatment. In the maxilla, a retainer bonded on all six teeth or a removable retainer was used; in the mandible, a lingual retainer was bonded on all anterior teeth or on canines only. Dental casts were analyzed before treatment (T(0)), after treatment (T(1)), and 5 years post-treatment (T(5)). Incisal and canine wear were scored by applying a grading scale. Intercanine width, overjet, and overbite were measured with an electronic caliper. Statistics used were: Paired samples t-test for differences over time; Pearson correlation coefficients for associations between wear and retention type; and backward linear regression for influence of retention type on wear. RESULTS There was an increase in wear during all time periods and for all teeth. From T(0) to T(5) an increase in maxillary intercanine width and maxillary retention had an effect on changes in canine wear. Incisal wear was associated with an increase in upper intercanine width (T(1)-T(5)). For both arches, an increase in maxillary intercanine width during treatment was associated with less progression of canine and incisal wear, but the explained variance was low, 13.4% and 19.3%, respectively. CONCLUSIONS Retention type and, occasionally, an increase in intercanine width influence anterior teeth wear post-treatment. However, the clinical significance and impact of the examined retention methods on occlusal wear are small.
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McGuire J, Szabo A, Jackson S, Bradley TG, Okunseri C. Erosive tooth wear among children in the United States: relationship to race/ethnicity and obesity. Int J Paediatr Dent 2009; 19:91-8. [PMID: 19250393 DOI: 10.1111/j.1365-263x.2008.00952.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The study aims were to estimate the prevalence of erosive tooth wear (ETW) in children and to specifically examine its association with race/ethnicity and obesity in the United States. DESIGN We analysed data from the National Health and Nutrition Examination Survey (NHANES), 2003-2004. ETW was measured using the modified Smith and Knight Tooth Wear Index derived from the 1998 United Kingdom Adult Health Survey. RESULTS This study shows that 45.9% of children aged 13-19 years had evidence of ETW in at least one tooth. The prevalence of ETW was bilaterally symmetrical in all teeth examined and was most prevalent in mandibular [corrected] teeth. Females had significantly lower rates of ETW of any tooth compared to males. African Americans had significantly lower rates of ETW (except in the canines), and Hispanics had similar rates compared to whites. Compared to 'healthy weight' children, those 'at risk for overweight' had lower rates of ETW and the 'overweight' groups had higher rates, but results were not significant. CONCLUSIONS Substantial proportions of children in the US are affected by ETW. Compared to whites, African American children had significantly lower rates of ETW. Although not significant, 'overweight' (obese) children had increased odds of having ETW and those at 'risk for overweight' had lower odds compared to 'healthy weight' children.
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Affiliation(s)
- Jesse McGuire
- Department of Developmental Sciences, Marquette University School of Dentistry, Milwaukee, WI 53201-1881, USA
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Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig 2008; 12 Suppl 1:S65-8. [PMID: 18228057 PMCID: PMC2238785 DOI: 10.1007/s00784-007-0181-5] [Citation(s) in RCA: 278] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 12/18/2007] [Indexed: 10/25/2022]
Abstract
A new scoring system, the Basic Erosive Wear Examination (BEWE), has been designed to provide a simple tool for use in general practice and to allow comparison to other more discriminative indices. The most severely affected surface in each sextant is recorded with a four level score and the cumulative score classified and matched to risk levels which guide the management of the condition. The BEWE allows re-analysis and integration of results from existing studies and, in time, should initiate a consensus within the scientific community and so avoid continued proliferation of indices. Finally, this process should lead to the development of an internationally accepted, standardised and validated index. The BEWE further aims to increase the awareness of tooth erosion amongst clinicians and general dental practitioners and to provide a guide as to its management.
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Affiliation(s)
- D Bartlett
- Department of Prosthodontics, King's College London Dental Institute, Floor 25, Guy's Tower, London Bridge, SE1 9RT, London, UK.
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