The prevalence, aetiology and clinical appearance of tooth wear: the Nigerian experience

A national survey of tooth wear on facial and oral surfaces and risk factors in young Nigerian adults

Objective:

The objective of this study is to assess the prevalence of tooth wear and to identify risk factors in a sample of young Nigerian adults.

Materials and Methods:

Participants were individuals aged 18–35 years, attending dental clinics located in eight centers representing the six geopolitical zones of the country. Calibrated examiners measured tooth wear using basic erosive wear examination (BEWE) index. Individuals were characterized by the highest BEWE score recorded for any facial/oral tooth surface. Previously validated questionnaire was used to gather information on demographics and risk factors.

Results:

A total of 1349 participants were examined. The prevalence of tooth wear was 60.2%. Bivariate analysis showed significant differences in the prevalence of tooth wear with age, educational level, and occupation (P ≤ 0.05). There were significant differences in tooth wear among the participants from the different states. Tooth wear was found to increase with smoking. Tooth wear was associated with brushing frequency, use of chewing stick, and other local cleaning agents. Multiple regression analysis showed that age, brushing frequency, brushing after breakfast added statistically significantly to the prediction of tooth wear (P < 0.05).

Conclusion:

Tooth wear was common in the population. The frequency of tooth brushing, use of chewing sticks and other local tooth cleaning agents may be contributory.

Predicting tooth surface loss using genetic algorithms-optimized artificial neural networks

Our aim was to predict tooth surface loss in individuals without the need to conduct clinical examinations. Artificial neural networks (ANNs) were used to construct a mathematical model. Input data consisted of age, smoker status, type of tooth brush, brushing, and consumption of pickled food, fizzy drinks, orange, apple, lemon, and dried seeds. Output data were the sum of tooth surface loss scores for selected teeth. The optimized constructed ANN consisted of 2-layer network with 15 neurons in the first layer and one neuron in the second layer. The data of 46 subjects were used to build the model, while the data of 15 subjects were used to test the model. Accepting an error of ±5 scores for all chosen teeth, the accuracy of the network becomes more than 80%. In conclusion, this study shows that modeling tooth surface loss using ANNs is possible and can be achieved with a high degree of accuracy.

Prevalence and associated factors of dental erosion in children and adolescents of a private dental practice

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.

Tooth loss, chewing habits, and food choices among older Nigerians in Plateau State: a preliminary study

OBJECTIVE

To determine the association between tooth loss, chewing habits, and food choices among older Nigerians.

METHODS

A questionnaire was administered by an interviewer to 500 randomly selected Nigerians, aged 50 and above, drawn from households in Plateau State in the North Central part of Nigeria. Intake of fruits/vegetables, and hard food items such as nuts, roast corn and nontender meat, was assessed. The subjects were then examined clinically to chart their dentitions.

RESULTS

The sample comprised of approximately equal numbers of men and women from predominantly rural and semi-urban communities. Those participants who had more than 20 teeth selected fruits/vegetables more frequently than those with fewer teeth; in addition, they chewed hard foods more frequently. On the other hand, a larger proportion of people with 20 or fewer teeth indicated that they avoided certain food items because of their teeth/mouth conditions. One-way anova showed that the people who selected fruits/vegetables daily or weekly compared to occasionally or rarely had significantly more teeth on average. Multivariable logistic regression analysis, controlling for age, gender, income, and education showed that the number of remaining teeth was significantly associated with the selection of vegetables/fruits and other hard food items.

CONCLUSION

Tooth loss affects selection of specific foods by older Nigerians in Plateau State and thus, could impact on the nutritional status of these individuals.

Dietary behavior and knowledge of dental erosion among Chinese adults

Objectives

To study the dietary behavior and knowledge about dental erosion and self-reported symptoms that can be related to dental erosion among Chinese adults in Hong Kong.

Methods

Chinese adults aged 25-45 years were randomly selected from a list of registered telephone numbers generated by computer. A telephone survey was administered to obtain information on demographic characteristics, dietary habits, dental visits, and knowledge of and presence of self-reported symptoms that can be related to dental erosion.

Results

A total of 520 participants were interviewed (response rate, 75%; sampling error, ± 4.4%) and their mean age was 37. Most respondents (79%) had ever had caries, and about two thirds (64%) attended dental check-ups at least once a year. Respondents had a mean of 5.4 meals per day and 36% had at least 6 meals per day. Fruit (89%) and lemon tea/water (41%) were the most commonly consumed acidic food and beverage. When asked if they ever noticed changes in their teeth, most respondents (92%) said they had experienced change that can be related to erosion. However, many (71%) had never heard about dental erosion and 53% mixed up dental erosion with dental caries.

Conclusion

Hong Kong Chinese adults have frequent intake of food and many have experienced symptoms that can be related to dental erosion. Their level of awareness of and knowledge about dental erosion is generally low, despite most of them have regular dental check-ups. Dental health education is essential to help the public understand dental erosion and its damaging effects.

Glass ionomer cements and their role in the restoration of non-carious cervical lesions

Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs) have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called "sandwich" or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions.

Methodological considerations concerning the development of oral dental erosion indexes: literature survey, validity and reliability

Within the context of preventing non-communicable diseases, the World Health Report (2002) and the WHO Global Oral Health Program (2003) put forward a new strategy of disease prevention and health promotion. Greater emphasis is placed on developing global policies in oral health promotion and oral disease prevention. The Decayed, Missing, Filled Teeth (DMFT) index does not meet new challenges in the field of oral health. Dental erosion seems to be a growing problem, and in some countries, an increase in erosion of teeth is associated with an increase in the consumption of beverages containing acids. Therefore, within a revision of the WHO Oral Health Surveys Basic Methods, new oral disease patterns, e.g. dental erosion, have to be taken into account. Within the last 20 years, many studies on dental erosion have been carried out and published. There has been a rapid growth in the number of indexes quantifying dental erosion process in different age groups. However, these indexes are not comparable. This article discusses quality criteria which an index intended for assessing tooth erosion should possess.

Tooth surface loss in adult subjects attending a university dental clinic in Trinidad

OBJECTIVES

To determine the prevalence of tooth surface loss (TSL) in a sample of subjects attending a university dental clinic in Trinidad and to investigate the relationship to tooth brushing, medical history, parafunction and dietary habits.

DESIGN

Tooth surface loss was measured clinically by the index used in the 1998 UK, Adult Dental Health Survey.

SETTING

Trinidad, West Indies.

PARTICIPANTS

Convenience sample of adult subjects attending The University of the West Indies Dental School Polyclinic, Mount Hope.

METHODS

A questionnaire was administered and tooth surface loss measured clinically.

MAIN OUTCOME MEASURES

mild, moderate and severe tooth surface loss.

RESULTS

155 subjects were examined (mean age 40.6 years) of whom 72% had some degree of TSL with the majority (52%), exhibiting mild, 16% with moderate and 4% with severe TSL. There were associations found between TSL and age (OR=3.14), reflux (OR=1.37), parafunction (OR=1.06), weekly consumption of citrus fruits (OR=1.31) and soft drinks (OR=1.78), daily consumption of alcohol (OR=1.40) and a vegetarian diet (OR=2.79).

CONCLUSIONS

Tooth surface loss in this Trinidadian population group appears to be common. Data supports an association between TSL and age, reflux parafunction and certain dietary patterns.

A Bayesian perspective on the reliability of homeopathic repertories

An interim assessment of likelihood ratio of homeopathic symptoms shows that there are serious flaws in Kent's repertory. The system of expressing relationship between symptoms and expected results from medicines by type-face is unclear and unreliable. Bayesian methods can improve this and expand the possibilities of the repertory including the possibility of interpreting the absence of expected symptoms.

Tooth wear in maxillary anterior teeth from 14 to 23 years of age

Using a planimetric method, the size of horizontal wear facets on maxillary anterior teeth was studied longitudinally in the permanent dentition of 35 subjects at ages 14, 18, and 23?years. The study subjects had not previously undergone any orthodontic treatment and had Class I occlusion. We studied the association between the amount of wear and reported parafunctions and maximal bite force. Total wear areas in age groups 14, 18, and 23 years were 29.5 mm2 (SD 11.4), 39.1 mm2 (SD 12.7), and 45.0 mm2 (SD 13.0), respectively. The total wear area increased significantly both from 14 to 18 years of age and from 18 to 23 years of age (p <0.0001). Between 18 and 23?years of age, the maxillary canines showed strongest wear, although the central incisors had largest wear facets. It can be concluded that wear of permanent anterior teeth is a continuous phenomenon in adolescence and young adulthood.

The prevalence of dental erosion in Nigerian patients with gastro-oesophageal reflux disease

Background

In various people of the Western world, gastro-oesophageal reflux (GOR) has been reported to be a common problem. Various studies have also assessed the relationship between GOR and dental erosion. The authors are not aware of such studies in Nigerians. It is therefore the aims of the present study to estimate the prevalence of GOR; to estimate the prevalence of dental erosion in patients with GORD; to document the oral findings in patients diagnosed with GORD and to compare these findings with previous studies elsewhere.

Methods

A total of 225 subjects comprising of 100 volunteers and 125 patients diagnosed with GORD were involved in this study. History of gastric juice regurgitation and heartburn were recorded. Oral examination to quantify loss of tooth structure was done using the tooth wear index (TWI) designed by Smith and Knight (1984).

Results

Twenty patients with GORD presented with dental erosion in the maxillary anterior teeth with TWI scores ranging from 1–3. The prevalence of erosion was found to be statistically significant between GORD patients (16%) and control (5%) (p < 0.05), but not significant between endoscopic diagnostic groups (p > 0.05).

Conclusion

The present study supports the consideration of dental erosion as the extra-oesophageal manifestation of GORD. However the association between GORD and burning mouth sensation needs more investigation.