Comparison of factors potentially related to the occurrence of dental erosion in high- and low-erosion groups

Effective approach for improving a gummy smile : Upward movement of the maxillary occlusal plane using midpalatal miniscrews and a modified transpalatal arch

PURPOSE

Correction of a gummy smile by orthodontic treatment alone has recently become feasible with the use of miniscrews. However, the optimal treatment mechanics remain unclear. Here we cephalometrically evaluated jaw and tooth displacement in cases where a gummy smile was improved using a level anchorage system (LAS).

METHODS

Sixteen patients underwent orthodontic treatment using an LAS consisting of a modified transpalatal arch and midpalatal miniscrews. Cephalometric pretreatment and posttreatment measurements were compared using the paired t‑test to determine significant skeletal and dental changes. The Mann-Whitney U test was used for nonparametric data. Spearman's rank correlation coefficient was used to evaluate correlations between different variables and the vertical change in prosthion position which was used to indicate the amount of gingival exposure.

RESULTS

The changes noted after treatment were intrusion of the maxillary first molars (P < 0.001) combined with only minor extrusion of the mandibular first molars. Suppressed extrusion of the mandibular first molars was significantly correlated with greater upward movement of the prosthion (r = 0.676, P < 0.01). Upward movement of the prosthion was also significantly correlated with intrusion of the maxillary and mandibular incisors, anterior upward movement of the maxillary occlusal plane, and an increase of the SNP angle.

CONCLUSIONS

Treatment involving the combined use of miniscrews and a modified transpalatal arch resulted in intrusion of the maxillary first molars and maxillary incisors and consequently elevated the maxillary occlusal plane. The results of this study suggest that intruding the maxillary occlusal plane and minimizing mandibular molar extrusion were effective to induce autorotation of the mandible and to improve a gummy smile.

Detection of Erosive Changes on Smooth Surfaces with and without Orthodontic Brackets Using an Intraoral Scanner-An In Vitro Study

BACKGROUND

Consumption of acidic beverages favours development of erosions. Modern diagnostic methods are required to detect erosions at an early stage. This study aimed to evaluate the suitability of an intraoral scanner (IOS) for detection of erosive changes on smooth surfaces adjacent to orthodontic brackets.

METHODS

Orthodontic metal brackets were attached to the buccal surfaces of 58 extracted permanent human teeth. Teeth were randomly divided into groups: A = 6% citric acid, B = Coca-Cola, C = Redbull, D = Powerade, E = Control, no acid exposure. Teeth were exposed to acid in three erosion cycles, followed by rinsing and brushing. Scans of teeth were performed at baseline and after each erosion cycle and enamel loss was measured. Quantitative light-induced fluorescence (QLF) measurements were performed as reference standard.

RESULTS

Significant substance loss was measured in all acid groups after the second and third erosion cycle (p < 0.0001). Correlation between scans and QLF were significant (p = 0.001).

CONCLUSIONS

With IOS, it was possible to detect and quantify enamel erosion at smooth surfaces with and without orthodontic brackets after a short exposure time. Considering the limitations of in vitro results, the use of IOS can be a promising digital tool to detect and monitor erosive enamel changes during fixed orthodontic treatment.

Determining the performance of a temperature sensor embedded into a mouthguard

Objective

This study aimed to determine the steady-state errors of oral-based temperature sensors, that are embedded in mouthguards, using a robust assessment process.

Materials and methods

Four electronic boards with temperature sensors were encapsulated in mouthguards made from ethylene-vinyl acetate (EVA). The error and time to reach steady-state temperature were determined using a thermostatic water bath during three different conditions (34, 38.5 and 43 °C). Subsequently, a case study of one volunteer wearing the instrumented mouthguard is presented.

Results

The water bath tests showed that a mean absolute error of 0.2 °C was reached after a maximum of 690 s across all test conditions. The case study yielded an absolute error was 0.2 °C after 1110 s.

Conclusion

These results show that an instrumented mouthguard with temperature sensing capabilities can yield a consistent steady-state error that is close to the clinical requirements across a range of temperatures. However, the time it takes to reach steady-state temperature needs to be considered for these systems to correctly interpret the outcomes.

Soft drinks and dental erosion during pediatric age: a clinical investigation

BACKGROUND

Dental erosion is an irreversible condition of loss of teeth hard tissues caused by intrinsic or extrinsic acids attack, without bacterial involvement. Common soft drinks have an acid pH and they release hydrogen ions and act as chelating agents, dissolving teeth mineral component. The aim of the study was to investigate the correlation between the consumption of soft drinks in children and the degree of dental erosion.

METHODS

A questionnaire of 15 multiple choice questions was addressed to the parents of the 231 children needing different dental treatments. Responses were compared with the level of dental erosion of their child, that was clinically investigated using the Basic Erosive Wear Examination (BEWE) index.

RESULTS

About 26.8% of subjects fall into a high-risk category of dental erosion while 24.2% in a low risk level. Socioeconomic status and oral hygiene habits are able to affect the degree of dental erosion. Toothpastes containing fluoride have not proved effective in preventing this phenomenon and no significant correlations were found between the type of toothbrush used and its frequency of use.

CONCLUSIONS

It is necessary to apply preventive measures such as information on the processes and causes of erosion, instruction about right home oral hygiene maneuvers and the possible use of specific products, to avoid the development of problems related to severe dental wear.

Prevalence and risk factors of erosive tooth wear among young adults in the Singapore military

OBJECTIVES

Erosive tooth wear (ETW) is defined as the irreversible chemo-mechanical loss of dental hard tissues without plaque or bacteria and has been a growing phenomenon in the general population worldwide. The aim of this study was to determine the prevalence of ETW and the associated risk factors among young military personnel in Singapore.

MATERIALS AND METHODS

This cross-sectional study consisted of a questionnaire and clinical examination of military personnel between 18 and 25 years. The questionnaire collected information on demographics, medical and dental history, lifestyle and dietary habits. Tooth wear was clinically evaluated using the Basic Erosive Wear Examination (BEWE) index. The participants were profiled into four risk categories (none, low, moderate, severe) based on the sum score. Multivariable logistic regression analysis was performed to determine the risk factors associated with the presence of ETW.

RESULTS

Out of 1296 participants evaluated, 21.8% of them had ETW. The anterior sextants were more affected by erosion than posterior sextants for both arches. The risk factors significantly associated with ETW were GERD (OR = 2.83, p = 0.041), presence of self-reported TMD symptoms (OR = 2.51, p < 0.001), acidic food (OR = 2.03, p < 0.001) and drinks (OR = 3.07, p < 0.001), high caries risk (OR = 4.59, p < 0.001) and toothbrush stiffness (OR = 4.67, p < 0.001).

CONCLUSION

ETW is prevalent among the young military population, with over half of the population at a risk of ETW. Gastric reflux disease, TMD, acidic diet, dental caries susceptibility and the use of stiff toothbrushes were identified as significant risk factors.

CLINICAL RELEVANCE

A large proportion of young military personnel exhibited mild to moderate risk of ETW. Dental professionals can identify risk-susceptible individuals at a young age and educated them with preventive measures and dietary interventions to prevent the progression of the condition.

Cross Sectional Study on the Association between Dental Caries and Life Habits in School Age Italian Children

Dental caries is still a major public health issue and influences the overall health of children. The risk factors for caries include biological, socio-behavioral, and environmental factors. Our aim is to assess the association between dental caries and the life habits of children and their parents. A cross-sectional study was conducted in Rome (Italy) among primary school children aged 5 to 11. Parents completed the anamnestic questionnaire, and a dental clinical examination was performed on 333 children. Caries prevalence was 38.7% overall, 47% in males and 31.9% in females. The association between bottle night-time feeding and caries was statistically significant (43.2%; p = 0.013). Usage of a honeyed pacifier was also significantly associated with the presence of caries (72.7%; p = 0.027). Finally, higher caries prevalence was found among male children (47% vs. 31.9%; p = 0.005). The present study shows that the percentage of caries is still high in the paediatric population, and caries prevalence is associated with life habits. Our results highlight the importance of oral health education programs at primary school that involve teachers and parents to contribute to improving lifestyles.

Relationship between erosive tooth wear and possible etiological factors among dental students

OBJECTIVES

The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students.

MATERIALS AND METHODS

A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables.

RESULTS

Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001).

CONCLUSIONS

Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times.

CLINICAL RELEVANCE

The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.

Methodology to Quantify and Screen the Demineralization of Teeth by Immersing Them in Acidic Drinks (Orange Juice, Coca-Cola™, and Grape Juice): Evaluation by ICP OES

Oral health problems may occur as a result of the ingestion of acid drinks. The objective of this in vitro study was to quantify and screen the concentration of potassium (K), phosphorus (P), calcium (Ca), magnesium (Mg), manganese (Mn), zinc (Zn), iron (Fe), copper (Cu), barium (Ba), lead (Pb), arsenic (As), cadmium (Cd), aluminum (Al), cobalt (Co), chromium (Cr), molybdenum (Mo), sodium (Na), nickel (Ni), selenium (Se), and vanadium (V) released from bovine incisors during an erosive challenge at different times of exposure when immersed in Coca-Cola™, orange juice, and grape juice. A total of 240 samples of bovine incisor teeth were used for the erosive challenge and allocated in groups. Digestion of drinks was performed using microwave-assisted digestion. The content in acidic drinks was monitored before and after the erosive challenge at exposure times of 1, 5, and 60 min using inductively coupled plasma optical emission spectrometry (ICP OES). The drinks’ pH varied slightly during the erosive challenge but remained below the critical value of pH 5 to cause tooth demineralization. The concentrations of elements released from the bovine incisors during the in vitro erosive challenge depend on exposure times when immersed in acidic beverages. For some elements such as Ca, Mn, Zn, Fe, Cu, Ba, Pb, As, and Cd, quantified in acidic drinks, grape juice had greater erosive potential than Coca-Cola™ and orange juice. Quantification and monitoring of chemical elements in bovine teeth can be performed considering a longer erosive time and other types of acidic drinks. Further analysis using human teeth is still not available and must be conducted. The demineralization of teeth not only occurs in acidic beverages; physical and chemical factors play other roles and should be investigated.

Dental erosive wear in primary teeth among five-year-olds - Bergen, Norway

OBJECTIVE

To estimate the prevalence of dental erosive wear among five-year-olds in Bergen, Norway, and to investigate associations between background factors and the condition.

METHODS

A total of 387 children received a dental examination in five Public Dental Service clinics in Bergen, Norway. The parents responded to items about the children's dental hygiene and drinking habits, type of beverage container, diet, and other habits, and about their own age, educational level and country of origin. We explored background variables for possible associations with the outcome status as worst affected by erosive wear (19.4%, n = 75). Chi-squared statistics and logistic regression (Odds Ratios (OR): 95% Confidence Intervals (CI), served as statistical tools).

RESULTS

Approximately 80% showed erosive wear (by SEPRS and by adopted diagnostic instrument (78.5% vs 79.8%)). The condition affected maxillary anterior teeth in 13.9% (n = 54), and cuppings in molars in 79.3% (n = 307) of cases. Grinding teeth during the day and/or night (OR: 1.87, CI: 1.07-3.25) and male sex (OR: 1.76, CI: 1.05-2.96) significantly related to outcome status as worst affected by erosive wear, respectively.

CONCLUSION

Dental erosive wear was widespread. Grinding teeth and male sex associated with outcome status as worst affected by erosive wear.

Consumption of acidic drinks, knowledge and concern about dental erosive wear in Norwegian high school students

OBJECTIVES

The objectives of the present study were to assess the consumption of acidic beverages, knowledge and concern about preventing dental erosive wear, and to examine potential associations between these variables, in a sample of high school students.

MATERIALS AND METHODS

A survey measuring acidic beverage consumption, knowledge and concern about erosive tooth wear was conducted at 13 high schools in Rogaland county, Norway.

RESULTS

Of the 850 students who completed the questionnaire, 26% reported that they drink acidic beverages every day. There were significant gender differences for the consumption of acidic drinks. The survey also demonstrated that a high proportion of students lacks basic knowledge of what erosive tooth wear is, and that this lack of knowledge is associated with a more frequent intake of acidic beverages. However, students who responded that they are concerned about preventing dental erosive wear reported that they drink soft drinks and energy drinks less frequently than students who are not concerned about this.

CONCLUSIONS

Results from this study support assumptions about a lack of knowledge about dental erosive wear in youth, and that this lack of knowledge is associated with a more frequent intake of acidic drinks.

A time based objective evaluation of the erosive effects of various beverages on enamel and cementum of deciduous and permanent teeth

Background

Erosion of the teeth is a chronic irreversible process leading to loss of surface enamel and even the dentin, in turn causing sensitivity and pain. Increased consumption of carbonated beverages remains a major cause for dental erosion. However, many of the so called safe beverages that are consumed may also have sufficiently low pH to cause dental erosion. One of the parameters to measure the dental erosion is estimation of hardness and surface roughness. Thus, this study aims to evaluate the difference in hardness and surface roughness of enamel and cementum using three beverages namely (carbonated drink, lime soda, lime juice) in deciduous and permanent teeth.

Material and Methods

Ten permanent and three deciduous teeth samples each were kept in lime juice, lime soda, carbonated beverage and tap water. The VHN using Vickers hardness tester and Ra value using surface profilometer were assessed at baseline, 1 day and 10 days.

Results

At the end of 10 days the decrease in hardness of enamel of permanent teeth was maximum for teeth immersed in carbonated beverage followed by lime soda and lime juice. However, in the deciduous teeth it was observed that the VHN drop was maximum at 1 day in relation to teeth immersed in carbonated beverage followed by lime juice and lime soda. The hardness of cementum decreased significantly at the end of ten days both in deciduous as well as permanent teeth.

Conclusions

The present study shows that many of the most commonly used beverages like lime juice and lime soda have a sufficiently low pH to cause erosion of the enamel surface as well as that of cementum of both deciduous and permanent teeth. Though protective mechanisms do exist in the oral cavity to neutralize the acids present in these beverages, continuous usage of these beverages leads to irreversible damage to the tooth structure.

Key words:Dental erosion, hardness, surface roughness, permanent teeth, deciduous teeth.

Dietary assessment and counseling for dental erosion

BACKGROUND AND OVERVIEW

Dental erosion occurs after exposure to intrinsic or extrinsic acids. Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. Extrinsic dietary acids from foods or beverages also can cause erosion, particularly when exposure is prolonged by holding or swishing behaviors.

CONCLUSIONS

Clinicians should screen patients exhibiting dental erosion for anorexia nervosa, bulimia nervosa, rumination syndrome, and gastroesophageal reflux disease. Clinicians should screen patients without a medical explanation for their erosion for exposure to acidic foods and beverages, particularly for habits that prolong exposure.

PRACTICAL IMPLICATIONS

Identification of intrinsic and extrinsic acid exposures and recommendations to minimize exposures are important to prevent erosion and maintain oral health.

Prevalence of non-carious cervical lesions among the general population of the Republic of Srpska, Bosnia and Herzegovina

INTRODUCTION

As non-carious cervical lesions (NCCLs) may compromise aesthetics and function, knowledge of their aetiological covariables enhances management of clinical complaints and success of restorative treatments.

AIMS

The primary aim of this study was to assess the presence of NCCLs among the general population of the Republic of Srpska, Bosnia and Herzegovina and the potential association with patient-related risk factors.

METHODS

A prevalence study of NCCLs included 738 respondents from eight towns/municipalities. Two dental practitioners examined all respondents. NCCLs were diagnosed according to the Smith and Knight tooth wear index, measured using a Williams periodontal probe. Data regarding risk factors were obtained through a structured questionnaire. Multivariate logistic regression was used to analyse the association of risk factors and the occurrence of NCCLs.

RESULTS

Non-carious cervical lesions were diagnosed in 384 (52%) respondents. Multivariate regression analysis showed that several variables were independently associated with the risk of developing NCCLs, including frequent consumption of acid food (P = 0.001), frequent consumption of acid drinks (P = 0.001), retaining drink in the mouth (P = 0.001), alcohol consumption (P = 0.030), bruxism (P = 0.018) and gastro-oesophageal reflux (P = 0.023). First mandibular premolars were the most affected teeth (left: 46.0%; right: 44.0%), followed by the second right maxillary premolars (37.3%), second left maxillary premolars (33.6%) and finally by the first right maxillary premolars (34.0%).

CONCLUSION

The results of the current study suggest that NCCLs occur frequently and have a multifactorial aetiology. The lowest prevalence was recorded among individuals younger than 20 years of age. As the majority of risk factors are modifiable, regular dental care could lead to the early detection of NCCLs.

Oral findings in children and adolescents with Prader-Willi syndrome

OBJECTIVE

To assess the significance of changes in the saliva in the etiology of gingivitis and tooth wear in children and adolescents with Prader-Willi syndrome (PWS).

MATERIALS AND METHODS

The study included 80 (2.8-18 years old; 39 girls and 41 boys): 40 in PWS group (mean age 8.0 ± 4.24 years) and 40 in control group (mean age 7.9 ± 4.12 years). General condition, oral para-functional habits, tooth wear (modified TWI), oral hygiene and gingival status (Plaque Index (PLI) and Gingival Index (GI)), localization of gingivitis, and salivary characteristics were assessed. The chi-square test, the Mann-Whitney U test, Spearman's rank correlation, and odds ratio based on logistic regression in a statistical analysis were applied.

RESULTS

Chances of gingivitis were increased by low PLI (odds ratio (OR) = 32.53), low resting salivary flow (OR = 3.96), increased viscosity of saliva (OR = 3.54), and mouth breathing (OR = 8.17). For gingivitis in anterior regions, low PLI (OR = 107.67), low resting (OR = 5.73) and stimulated (OR = 1.86) salivary flow, increased viscosity of saliva (OR = 5.87), mouth breathing (OR = 10.00), and low stimulated salivary flow (OR = 3.18) were observed. Tooth wear rates were increased by teeth grinding (OR = 16.20), mouth breathing (OR = 4.33), increased viscosity of saliva (OR = 11.67) and low resting (OR = 6.07), and stimulated (OR = 4.22) salivary flow.

CONCLUSIONS

In PWS, reduced salivary secretion, increased viscosity, of saliva and mouth breathing increase the risk of plaque-induced gingivitis and tooth wear.

CLINICAL RELEVANCE

The prevention and treatment of tooth wear and gingivitis in PWS patients is necessary not only to treat bruxism and mouth breathing but also to limit the influence of negative changes of saliva.

Dental erosion, prevalence and risk factors among a group of adolescents in Stockholm County

Aims

To investigate the prevalence and risk factors of dental erosion (DE) among a group of adolescents in Stockholm County.

Materials and methods

This cross sectional cohort study was conducted at three clinics of the Public Dental Service in Stockholm County. Fifteen and 17 year old adolescents (1335) who scheduled their regular dental health examination were asked to participate. After drop-outs a sample of 1071 individuals, 547 males and 524 females were enrolled in the study. Presence of erosive wear was diagnosed (yes/no) on marker teeth by trained dentists/dental hygienists and photographs were taken. The adolescents answered a questionnaire regarding oral symptoms, dietary and behavioural factors. Two calibrated specialist dentists performed evaluation of the photographs for severity of DE using a modified version of the Simplified Erosion Partial Recording System (SEPRS).

Results

DE was clinically diagnosed in 28.3% of 15 years old and 34.3% of 17 years old. Severe erosive wear (grade 3 and 4 according to SEPRS) was found in 18.3% of the adolescents based upon the intra-oral photographs. DE was more prevalent and severe among males than females. Clinically diagnosed erosive lesions correlated significantly with soft drink consumption (p < 0.001), the use of juice or sport drinks as a thirst quencher after exercise (p = 0.006) and tooth hypersensitivity when eating and drinking (p = 0.012). Furthermore, self-assessed gastric reflux was a factor strongly associated with DE (p < 0.001).

Conclusion

The study indicated that DE was common among adolescents in Stockholm County and associated with both internal and external risk factors.

Dissolution of Enamel on Exposure to Various Commercial Beverages Available in India

AIM

The study was aimed to estimate the pH of the commonly available soft drinks in the Indian market and to assess the detrimental effects of the juices and beverages on the tooth surface by measuring the weight loss of the tooth sample.

MATERIALS AND METHODS

The study was done with eight different types of commercially available carbonated drink and fruit juices available in the Indian market among which six were carbonated drinks and two were juices. Carbonated drinks experimented were Coca-Cola, Pepsi, Fanta, Mirinda, 7Up and Sprite, and two fruit juices were Tropicana orange juice and real orange juice. Ten different bottles from each category were obtained, and the pH was estimated. Each of the beverages was divided into batch of 10 containers containing the tooth sample. Weight of all samples was measured at 24, 48, 72, 96, and 120 hours with subsequently changing each solution at an interval of 24 hours.

RESULTS

The mean pH of the beverages was found ranging from 2.13 ± 0.02 in Pepsi to 3.41 ± 0.02 in Tropicana on opening. The mean pH of water was found to be 6.98 ± 0.01. Among carbonated drinks, the mean weight loss after 24 hours was highest in Coca-Cola and least in 7Up. Tropicana fruit juice had a higher tooth loss than real orange juices. When compared with water, the tooth loss was significantly higher in Coca-Cola after all specified time (hours).

CONCLUSION

The pH of both carbonated drinks and fruit juices was below the critical pH. The weight loss was also seen after every 24 hours in all the carbonated drinks and beverages. The study showed that these commercial beverages are harmful to the tooth structures, and hence, the health professionals play a major role in educating the population about its effects and advising them to use these products precisely.

CLINICAL SIGNIFICANCE

The change in lifestyle has increased the demand of soft drinks and artificial juice in Indian market. The use of these carbonated drinks and fruit juices causes damage to the tooth structure in all ages, especially in young mass. Our study provides an idea about the deleterious effects of these commercial drinks on dental hard tissues.

Preliminary Assessment of Risk Factors for Tooth Wear

Background: Epidemiological studies have reported an increasing prevalence of tooth wear, and general dental practitioners see a greater number of patients seeking treatment with worn dentition. Improper oral hygiene, unhealthy habits, occupational hazards, and potentially erosive processed foods seem to play a major role in the non-carious loss of dental hard tissue. The aim of this study is to assess the factors and cofactors that may play a major role in the genesis of dental attrition, dental abrasion, and, especially, dental erosion.

Material and methods: Seventy-nine consecutive patients, aged between 17 and 78 years, have enrolled in our study, completing a questionnaire regarding chronic illnesses, eating habits, and dental hygiene, followed by a dental clinical examination.

Results: The male-female ratio was 1.4:1, with a mean age of 35.6 years. Forty-four (55.7%) patients presented objective signs of tooth wear. Regarding oral hygiene habits, the use of a hard toothbrush is linked to increased tooth wear, while brushing in a circular motion seems to be the least abrasive. We found a considerable prevalence of bruxism (19%), which led to severe generalized attrition in almost half of such patients. The most popular drinks with erosive potential were coffee (58.2%), soft drinks (57%), and tea (24.1%), and extrinsic erosion was more frequent in patients younger than 30 years. Understandably, physiological tooth wear was more common in older patients. The questionnaire revealed that over 60% of patients have inaccurate knowledge of tooth wear.

Conclusions: Tooth wear is partially a progressive physiological process. Unfortunately, we see it increasing in younger patients due to pathological influencing factors. These include improper tooth brushing technique and materials, bruxism, dental prosthesis, dietary habits. Primordial and primary prevention is the key to reducing morbidity, health education being an essential part of it.

Dental erosion in groups of Yemeni children and adolescents and the modification of an erosion partial recording system

BACKGROUND

The prevalence of dental erosion is rising especially among children and adolescents and its grading needs further investigation.

AIMS

To determine the prevalence and severity of dental erosion in groups of Yemeni children and adolescents, and to clinically compare an erosion partial recording system (EPRS) with a proposed modified-simplified version (EPRS-M).

DESIGN

Of 6163 individuals aged 5-6, 13-14 and 18-19 years, 911 were randomly selected, of which 668 participated in the study. Dental erosion was graded using EPRS. EPRS-M was proposed, and its sensitivity and specificity was calculated in relation to EPRS.

RESULTS

Prevalence of erosion extending into dentine on at least one tooth was 6.8% among 5- to 6-year-olds, 3.0% among 13- to 14-year-olds and 14.6% among 18- to 19-year olds. The highest prevalence was 19.2% among girls aged 18-19 years which was significantly higher than boys (10.4%) in the same age group (P = 0.044). Sensitivity and specificity for EPRS-M in relation to EPRS were 85.7% and 100% for primary teeth, and 84.1% and 100% for permanent teeth.

CONCLUSIONS

Dental erosion was common among children and older teenagers and highest among older girls but less common among younger teenagers. The tested accuracy of EPRS-M qualifies it to be used as an initial quick detection tool in future dental erosion research.

Diurnal variation of intraoral pH and temperature

Objective/Aims

The aim of this study was to measure continuously the intraoral pH and temperature of healthy individuals to investigate their diurnal variations.

Materials and Methods

Seventeen participants (mean age, 31±9 years) wore a custom-made intraoral appliance fitted with a pH probe and thermocouple for two sets of 24 h, while carrying out normal daily activities including sleep. The continuous changes in intraoral pH and temperature were captured using a sensor placed on the palatal aspect of the upper central incisors. The collected data were categorised into different status (awake and sleep) and periods (morning, afternoon, evening and night). Both quantitative and qualitative analyses were conducted.

Results

The intraoral pH change was found to show a distinctive daily rhythm, showing a 12-h interval between maximum (7.73) and minimum (6.6) pH values. The maximum and minimum values were found to repeat after 24 h. The mean pH over 48 h (two sets of 24 h) was found to be 7.27 (±0.74). There was significant difference found in pH when subjects were awake and asleep and different periods during the day (P<0.001). The mean intraoral temperature was 33.99 °C (±4.9), with less distinctive daily rhythm compared with pH. There was a significant difference found in temperature depending on the time of the day, except between morning and afternoon (P=0.78).

Conclusion

Our results showed that there is a distinctive daily, circadian-like pattern in intraoral pH variation over a 24-h period, which has been considered as one of the risk factors in sleep-related dental diseases.

Efficacy of Stannous Ions on Enamel Demineralization under Normal and Hyposalivatory Conditions: A Controlled Randomized in situ Pilot Trial

The study aim was to investigate the effect of antierosive agents on enamel under normal and hyposalivatory conditions. This double-blind crossover in situ pilot study evaluated 4 toothpastes: placebo (0 ppm F), sodium fluoride (NaF, 1,450 ppm), stannous/sodium fluoride (SnF/NaF, 1,450 ppm F-, 1,090 ppm Sn2+), and sodium fluoride, stannous chloride and chitosan (NaF/Sn/Ch, 1,450 ppm F-, 3,500 ppm Sn2+, 0.5% Ch). Twenty participants were assigned to 2 groups (n = 10 each): normal and low salivary flow. Participants wore palatal appliances holding 4 bovine enamel specimens previously eroded in vitro (D1) for 20 min prior to an in situ phase after which they were eroded again (D2). Surface microhardness was determined at baseline (BL), after D1, in situ phase and D2 to assess hardness loss (%SMH), residual hardness loss (%RHL) and erosion resistance (%RER). Additional specimens were evaluated by scanning electron microscopy after the in situ phase. ANOVA and a factorial analysis for between-subject effects were performed. Sn-based toothpastes showed the best effects (p < 0.05). Under normal flow, SnF/NaF showed higher efficacy, with a significant difference compared to NaF/Sn/Ch, NaF, and placebo (p < 0.05). Under low flow, SnF/NaF and NaF/Sn/Ch were comparable (p > 0.05); NaF and placebo were statistically similar. Comparing salivary conditions, there were significant differences for SnF/NaF for %SMH after the in situ phase (%SMHtotal)), %RHL and for all toothpastes in case of %RER. Factorial analysis revealed interactions between toothpaste and saliva flow for %SMHtotal and %RHL. Salivary flow can influence the efficacy of the antierosive toothpastes; however, Sn2+ preparations show even under low salivary flow conditions the highest efficacy in the prevention of enamel erosion.

The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

Objective:

The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors.

Materials and Methods:

A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria.

Results:

In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05).

Conclusions:

The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion.

A 4 year prospective longitudinal study of progression of dental erosion associated to lifestyle in 13-14 year-old Swedish adolescents

OBJECTIVES

To evaluate the progression of dental erosion in 13-14 year-olds after 4 years, and its association with lifestyle and oral health.

METHODS

227 randomly selected 13-14 year-olds from a Public Dental Clinic, Örebro, Sweden, were investigated. A clinical examination was performed which included dental caries/gingival/plaque status, as well as grading of dental erosion at the tooth surface and participant levels in "marker teeth", including buccal/palatal surfaces of 6 maxillary anterior teeth (13-23), and occlusal surfaces of first molars. An interview and a questionnaire regarding drinking habits and other lifestyle factors were completed. All investigations were repeated at follow-up. The participants were divided into high and low progression erosion groups and logistic regression statistics were applied.

RESULTS

175 individuals participated at follow-up. Progression occurred in 35% of the 2566 tooth surfaces. 32% of the surfaces had deteriorated by one severity grade (n=51 individuals) and 3% by two grades (n=2 individuals). Boys showed more severe erosion than girls at the follow-up. Among the variables predicting greater progression, a lower severity of erosive wear at baseline had the highest OR (13.3), followed in descending order by a "retaining" drinking technique, more frequent intake of drinks between meals, low GBI and lesser sour milk intake, with reference to the baseline recording. Using these five variables, sensitivity and specificity were 87% and 67% respectively, for predicting progression of erosion.

CONCLUSIONS

Progression of erosive lesions in Swedish adolescents aged 13-14 years followed up to age 17-18 years was common and related to certain lifestyle factors.

CLINICAL SIGNIFICANCE

In permanent teeth, dental erosion may develop early in life and its progression is common. Dental health workers should be made aware of this fact and regular screenings for erosion and recording of associated lifestyle factors should be performed.

Intraoral pH and temperature during sleep with and without mouth breathing

To measure and compare the intraoral pH and temperature of individuals during sleep with and without mouth breathing. Ten healthy participants [mean age = 25·8 (± 4·3)] wore a custom-made appliance fitted with a pH probe and thermocouple for two sets of 48 h. Continuous pH and temperature measurements were taken from the palatal aspect of the upper central incisors. To simulate mouth breathing during sleep, participants wore a nose clip for two nights of the four, with the first group (n = 5) wearing the nose clip during the first night and the rest (n = 5) wearing the nose clip during the second night of sleep to balance any potential bias from the wearing sequence. Both qualitative and quantitative analyses were conducted. The mean intraoral pH during daytime was 7·3 (± 0·4) and during sleep was 7·0 (± 0·5). The mean intraoral pH during sleep with mouth breathing was 6·6 (± 0·5), which was statistically significant compared with the normal sleep condition (P < 0·01). The intraoral pH decreased slowly over the hours of sleep in all participants. When sleeping with forced mouth breathing, intraoral pH showed a greater fall over a longer period of time. The mean intraoral temperature was 33·1 °C (± 5·2) during daytime and 33·3 °C (± 6·1) during sleep, with no statistical significance between sleep with and without mouth breathing (P > 0·05). The results suggest that mouth breathing during sleep is related to a decrease in intraoral pH compared with normal breathing during sleep, and this has been proposed as a causal factor for dental erosion and caries.

Interaction of Polyelectrolytes with Salivary Pellicles on Hydroxyapatite Surfaces under Erosive Acidic Conditions

The modification of acidic beverage formulations with food-approved, nonhazardous substances with antierosive properties has been identified as a key strategy for counteracting the prevalence of dental erosion, i.e., the acid-induced dissolution of hydroxyapatite (HA, the main mineral component of tooth surfaces). While many of such substances have been reported, very little is known on how they interact with teeth and inhibit their acid-induced dissolution. With the aim of filling this gap in knowledge, we have studied under acidic conditions the interaction between two polyelectrolytes of differing ionic character, carboxymethyl cellulose (CMC) and chitosan, and saliva-coated hydroxyapatite, i.e., a model for the outer surface of teeth. These studies were performed by means of ellipsometry, quartz crystal microbalance with dissipation monitoring, and atomic force microscopy. We also studied, by means of pH variations, how dissolution of saliva-coated HA is affected by including these polyelectrolytes in the erosive solutions. Our results confirm that salivary films protect HA from acid-induced dissolution, but only for a limited time. If the acid is modified with CMC, this polyelectrolyte incorporates into the salivary films prolonging in time their protective function. Eventually, the CMC-modified salivary films are removed from the HA surfaces. From this moment, HA is continuously coated with CMC, but this offers only a weak protection against erosion. When the acid is modified with the cationic chitosan, the polyelectrolyte adsorbs on top of the salivary films. Chitosan-modified salivary films are also eventually replaced by bare chitosan films. In this case both coatings offer a similar protection against HA dissolution, which is nevertheless notably higher than that offered by CMC.

Informing a realistic laboratory erosion-testing regime--observations

OBJECTIVES

To measure aspects of fizzy drink consumption in a social environment to inform the development of a laboratory testing regime.

METHODS

This was an observational study in which participants were invited to attend one of four pizza and soft drink parties. All such foods and drinks were served in an air conditioned room at a temperature of 24°C. All drinks were at a temperature of 4°C and each participant was asked to spit out, into graduated cups, their first and second sips. Both the temperature and volume of these were measured. Upon completion of the party the volume of drinks consumed was determined. Video footage of the experiment was recorded for subsequent analysis to determine sip count and the elapsed time period between first and last sip. These values were compared to the analogous measured value of expectorated volume in order to assess the usefulness of video observation in the context of this work.

RESULTS

The mean expectorated beverage temperature was 14.9±2.0°C. The mean time spent drinking was 44.2±17.4 minutes with a mean consumption rate of 13.3±6.0 ml/min. Only the sip volume and sip count per can values were significantly different between sexes (P<0.05) with females displaying lower values for volume and a higher sip count. There was close agreement between the sip volume values observed and calculated using video observation derived parameters.

CONCLUSIONS

Several human drinking behaviour values were reported in this study and these will be of value in the development of more realistic laboratory erosion-testing regimes. It is concluded, within the limitations of this work, that (1) there are differences in the drinking behaviour of males and females with respect to sip volume and count, (2) the intraoral rise in temperature of a 4°C beverage is lower than that used in previous laboratory simulations and (3) the values derived from video observation agree with those measured directly validating this technique for use in further studies.

CLINICAL SIGNIFICANCE

The work provides valuable quantitative data on which to base simulated laboratory erosion work. Perhaps the most significant finding is that sipped beverages attain a temperature of only 14.9°C.

Scanning Electron Microscope Characterization of Erosive Enamel in Human Teeth

This study aimed to examine the surface characteristics of erosive enamel in extracted human teeth by scanning electron microscopy. Morphologic changes in naturally eroded enamel depend on the stages of dental erosion. In its early stages, the enamel surfaces show a honeycomb appearance due to the dissolution of enamel rod ends. In its advanced stages, the erosive process involves the underlying dentin and the eroded dentin shows exposed dentinal tubules and the dentinal matrix may be exposed due to the dissolution of the peri- and intertubular dentin. Evidence of remineralization is seen at the early stage of natural dental erosion.

Clinical enamel surface changes following an intra-oral acidic challenge

OBJECTIVES

Investigation of early enamel erosion using replica impressions to compare changes in enamel surface topography in vivo prior to and over a 24 h period following acid challenge.

METHOD

A single treatment, blinded, enamel replica clinical study was undertaken in 20 healthy subjects. Replica tooth impressions were taken at baseline, following acid challenge and 2, 4, 7 and 24 h post challenge. Subjects consumed 500 ml of acidic soft drink over 30 min. Scanning electron microscopy of surface tomography was characterised with a descriptive 5 point scale by four judges. Duplicate impressions were taken to assess reproducibility.

RESULTS

18 subjects had scorable sequences. Descriptive analyses showed erosive changes following acid consumption and reparative changes in the subsequent 24 h period. Comparing baseline replica to the 24 h replica, there were no significant differences (p=0.26) in tooth surface characteristics. Comparing the replica taken immediately following acidic challenge with the subsequent replicas at 2, 4, 7 and 24 h, showed clear reduction of erosive effects on the enamel surface at 2 h (p=0.02) and a highly significant reduction at 4, 7 and 24 h (p<0.001).

CONCLUSION

This methodology demonstrated the ability to follow the progression and recovery of early erosive enamel lesions over 24 h being accurate and reproducible. This study suggests enamel repair commences within 2 h following a substantial acidic challenge and is completed 4-24 h later. After 24 h, the tooth surface appeared visibly indistinguishable from the original tooth surface, suggestive of a recovery process occurring.

CLINICAL SIGNIFICANCE

Healthy erosive lifestyles often culminate in tooth wear. The time taken for enamel remineralisation following acidic challenge is unknown however, this study suggests the repair process is relatively slow following a substantial acidic challenge, and at least 4-24 h should elapse prior to further acidic consumption to allow for recovery.

Enamel formation genes associated with dental erosive wear

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.

Sour sweets and acidic beverage consumption are risk indicators for dental erosion

This study aimed to investigate the association between dental erosive wear and potential background, behavioural and dietary risk indicators and to assess whether there is a dose-response relationship between the level of acidic beverage consumption and dental erosive wear among adolescents. Of 846 adolescents (aged 16-18 years) scheduled for dental recall examinations, 795 (94%) accepted to participate. All participants completed a self-administered questionnaire regarding their background (gender and age), tooth-brushing frequency and dietary habits (the amount and frequency of acidic food and beverage consumption as well as the chosen method and manner of consuming acidic drinks). The association between the presence of erosive lesions and the possible risk indicators was assessed by logistic regression analyses. Of all participants examined, 37% had ≥3 surfaces with dental erosions and were considered to be affected individuals. In the present study, multivariate logistic analyses revealed a significant association between the dental erosive wear and high consumption of sour sweets and sports drinks. The tooth-brushing frequency was not significantly associated with dental erosive wear. Additionally, to the best of our knowledge, the results are the first to indicate a dose-response relationship between the daily consumption of acidic drinks and dental erosive wear.

Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials

In this in vitro study, the effects of a Cola drink, and fresh fruit juice (citrus) on the surface roughness on flowable composite and resin-modified glass ionomer cement (RMGIC) each was evaluated and compared. Using a brass mold 70 pellets each of flowable composite (Filtek™ Flow) and RMGIC tricure restorative material were prepared according to the manufacturer's instructions. Two groups (groups I and II) were formed containing 30 pellets of each material. Remaining 10 pellets of each restorative material did form the control group [water (group III)]. Experimental group pellets were again divided into three subgroups (mild, moderate and severe) containing 10 pellets each and were kept in plastic containers with 30 ml Cola drink (group I) and fresh fruit juice (group II) respectively. Immersion regime was followed according to M aupome G et al. Baseline and final surface roughness (Ra) value for each pellet was evaluated using a profilometer. Statistical analysis was done with Wilcoxon's signed rank test and analysis of variance (ANOVA) followed by Mann-Whitney test. Results showed that the erosive effect of both Cola drink and fresh fruit juice caused significant surface roughness on both flowable composite and RMGIC restorative materials in the mild, moderate and severe immersion regimes. How to cite this article: Maganur P, Satish V, Prabhakar AR, Namineni S. Effect of Soft Drinks and Fresh Fruit Juice on Surface Roughness of Commonly used Restorative Materials. Int J Clin Pediatr Dent 2015;8(1):1-5.

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents

OBJECTIVE

The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents.

MATERIALS AND METHODS

A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression.

RESULTS

Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer.

CONCLUSION

High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.

Tooth wear and the role of salivary measures in general practice patients

OBJECTIVES

The goal of this study was to investigate the association between tooth wear and salivary measures in a random sample of patients from practices of dentist members of a practice-based research network.

MATERIALS AND METHODS

Patients completed a questionnaire on oral self-care, health, dietary habits, medications, and socio-demographic variables. Six salivary characteristics (consistency, resting salivary flow, resting salivary pH, stimulated salivary flow, stimulated salivary pH, and buffering capacity) were measured, and a dental examination included categorizing patients according to the dentist's judgment of the degree of tooth wear (i.e., none/minimal, some, or severe/extreme). Bivariate and multinomial logistic regression models were used to relate salivary characteristics and other factors to the outcome of tooth wear.

RESULTS

Data are reported from 1,323 patients (age range 16-97 years) from 61 practices. Patient age, gender, number of teeth, and perception of dry mouth were associated with tooth wear, but salivary and dietary factors were either weakly or not related.

CONCLUSIONS

The findings of this cross-sectional assessment suggest that using these salivary tests and dietary assessments in real-life clinical settings is unlikely to be useful in assessing tooth wear risk. Suggestions are offered about risk assessment for tooth wear.

CLINICAL RELEVANCE

Assessing a dental patient's risk of tooth wear using salivary measures and dietary assessments as described is not recommended for general dental practice until stronger evidence exists indicating its utility.

In Vitro assessment of dentin erosion after immersion in acidic beverages: surface profile analysis and energy-dispersive X-ray fluorescence spectrometry study

The aim of this study was to investigate the effects of some acidic drinks on dentin erosion, using methods of surface profile (SP) analysis and energy-dispersive X-ray fluorescence spectrometry (EDXRF). One hundred standardized dentin slabs obtained from bovine incisor roots were used. Dentin slabs measuring 5x5 mm were ground flat, polished and half of each specimen surface was protected with nail polish. For 60 min, the dentin surfaces were immersed in 50 mL of 5 different drinks (Gatorade®, Del Valle Mais orange juice®, Coca-Cola®, Red Bull® and white wine), 20 blocks in each drink. The pH of each beverage was measured. After the erosive challenge, the nail polish was removed and SP was analyzed. The mineral concentration of dentin surfaces was determined by means of EDXRF. Data were analyzed statistically by ANOVA and Tukey's test (α=0.05). SP analysis showed that Red-Bull had the highest erosive potential (p<0.05). EDXRF results exhibited a decrease in phosphate in the groups immersed in Red-Bull, orange juice and white wine (p<0.05), and no significant difference in calcium content between the reference surface and eroded surface. In conclusion, this study demonstrated that all studied beverages promoted erosion on root dentin and Red Bull had the highest erosive potential. There was no correlation between pH of beverages and their erosive potential and only the P content changed after erosive challenge.

Prevalence and severity of dental erosive wear among a group of Norwegian 18-year-olds

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.

Dental erosion prevalence and associated risk indicators among preschool children in Athens, Greece

OBJECTIVES

The aims of the study were to investigate dental erosion prevalence, distribution and severity in Greek preschool children attending public kindergartens in the prefecture of Attica, Greece and to determine the effect of dental caries, oral hygiene level, socio-economic factors, dental behavior, erosion related medication and chronic illness.

MATERIAL AND METHODS

A random and stratified sample of 605 Greek preschool children was clinically examined for dental erosion using the Basic Erosive Wear Examination Index (ΒΕWE). Dental caries (dmfs) and Simplified Debris Index were also recorded. The data concerning possible risk indicators were derived by a questionnaire. Zero-inflated Poisson regression was generated to test the predictive effects of the independent variables on dental erosion.

RESULTS

The prevalence of dental erosion was 78.8 %, and the mean and SE of BEWE index was 3.64 ± 0.15. High monthly family income was positively related to ΒΕWE cumulative scores [RR = 1.204 (1.016-1.427)], while high maternal education level [RR = 0.872 (0.771-0.986)] and poor oral hygiene level [DI-s, RR = 0.584 (0.450-0.756)] showed a negative association.

CONCLUSIONS

Dental erosion is a common oral disease in Greek preschool children in Attica, related to oral hygiene and socio-economic factors.

CLINICAL RELEVANCE

Programs aimed at erosion prevention should begin at an early age for all children.

Dental erosion and its growing importance in clinical practice: from past to present

Since the mid-1990s, the focus of studies on tooth wear has steadily shifted from the general condition towards the more specific area of dental erosion; equally, a shift has occurred from studies in adults to those in children and adolescents. During this time, understanding of the condition has increased greatly. This paper attempts to provide a critical overview of the development of this body of knowledge, from earlier perceptions to the present. It is accepted that dental erosion has a multifactorial background, in which individual and lifestyle factors have great significance. Notwithstanding methodological differences across studies, data from many countries confirm that dental erosion is common in children and young people, and that, when present, it progresses rapidly. That the condition, and its ramifications, warrants serious consideration in clinical dentistry, is clear. It is important for the oral healthcare team to be able to recognize its early signs and symptoms and to understand its pathogenesis. Preventive strategies are essential ingredients in the management of patients with dental erosion. When necessary, treatment aimed at correcting or improving its effects might best be of a minimally invasive nature. Still, there remains a need for further research to forge better understanding of the subject.

Eating disorders and oral health: a matched case-control study

The aim was to compare the oral health status of patients with eating disorders (EDs), with sex- and age-matched controls, with a view to identify self-reported and clinical parameters that might alert the dental healthcare professional to the possibility of EDs. All patients who entered outpatient treatment in an ED clinic during a 12-month period were invited to participate. Of 65 ED patients who started psychiatric/medical treatment, 54 agreed to participate. Eating disorder patients and controls answered a questionnaire and underwent dental clinical examinations. Multivariate analysis identified significantly higher ORs for ED patients to present dental problems (OR = 4.1), burning tongue (OR = 14.2), dry/cracked lips (OR = 9.6), dental erosion (OR = 8.5), and less gingival bleeding (OR = 1.1) compared with healthy controls. Sensitivity and specificity for the correct classification of ED patients and controls using the five variables was 83% and 79%, respectively. The ED patients with vomiting/binge eating behaviors reported worse perceived oral health (OR = 6.0) and had more dental erosion (OR = 5.5) than those without such behavior. In ED patients with longer duration of the disease, dental erosion was significantly more common. In conclusion, oral health problems frequently affect ED patients, and this needs to be considered in patient assessment and treatment decisions.

Patterns in consumption of potentially erosive beverages among adolescent school children in the Netherlands

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.