Prevalence of dental attrition and its relationship with dental erosion and salivary function in young adults

OBJECTIVES

The aim of this study was to estimate the prevalence of dental attrition in a young adult population and to explore associated factors.

METHOD AND MATERIALS

Dental students aged 18 to 40 years old with a minimum of 24 natural teeth were invited to take part in this cross-sectional study. Their demographic information, medical history, perceived stress, frequency of dietary acid intake, and frequency of oral habits were obtained through several questionnaires. Assessment of each type of tooth wear (erosion, attrition, and abrasion) was performed according to the tooth wear evaluation system (TWES 1.0). All participants underwent salivary tests. Statistical analysis was performed by chi-squared or Mann-Whitney tests and logistic regression models.

RESULTS

In total, 178 participants (88 women and 90 men) with a median age of 22 years were included and of those 74.7% (95% confidence interval [CI], 68% to 81%) had dental attrition. Univariate analysis revealed positive associations for male sex, age, body mass index, awake bruxism frequency, and erosive tooth wear with the presence of dental attrition. Multivariable logistic regression (Nagelkerke r2 = 0.31) indicated that dental attrition was associated with erosive tooth wear (adjusted odds ratio [aOR], 6.3; 95% CI, 2.8 to 14.2), body mass index (aOR, 1.3; 95% CI, 1.1-1.5), and age (aOR, 1.2; 95% CI 1.0 to 1.3).

CONCLUSION

Dental attrition is present in most young adults of Catalonia. The associated factors were erosive tooth wear, body mass index, and age. Slight alterations of salivary parameters do not seem to predict dental attrition. (Quintessence Int 2023;54:168-175; doi: 10.3290/j.qi.b3622405).

Three-dimensional evaluation of sleep bruxism-related splint wear using a dental laboratory scanner: A preliminary clinical study

BACKGROUND

The wear depth on the occlusal splint (OS) is reportedly associated with the sleep bruxism (SB) level, as evaluated using portable polysomnography (PSG) recordings. However, the OS is deformed owing to SB forces, possibly preventing the accurate quantification of the wear facets.

OBJECTIVES

We aimed to introduce a newly developed system to quantify the wear facets on the OS using a dental laboratory scanner (D810) and investigate the association between the wear facets, as evaluated with this system, and the SB level.

METHODS

Ten healthy individuals who were diagnosed with SB based on portable PSG recordings participated in this study. They were asked to wear the OS for 2 months. The first day after a 2-week adaptation period was defined as the reference day, and sequential scanning of the OS surface was performed on days 15, 30, and 45. Changes in the OS surface from the reference day allowed dimensional evaluation of the wear facets in terms of maximum wear depth, wear area, and wear volume. Multiple regression analyses were conducted to test whether each of these variables could be predicted by any of the SB-related variables.

RESULTS

The total duration of SB episodes per hour of sleep and the maximum muscle activity were significantly associated with the wear area, as measured with our system (adjusted R-squared was .78, p < .01).

CONCLUSION

Our system allows dimensional analysis of the wear facets on the OS surface in association with the SB level.

Association between the severity of possible sleep bruxism and possible awake bruxism and attrition tooth wear facets in children and adolescents

OBJECTIVE

To evaluate the association between the severity of possible sleep bruxism (PSB) and possible awake bruxism (PAB) and attrition tooth wear facets (ATWF) in children/adolescents.

METHODS

Four hundred-thirty-four children/adolescents enrolled in schools in Lavras, Brazil, participated in this cross-sectional study. Caregivers answered a questionnaire about their childrens' PSB. Children/adolescents answered a questionnaire about the occurrence of PAB.

RESULTS

ATWF among individuals without PSB and PAB was lower than those with moderate/severe PSB (p = 0.038) and moderate/severe PAB (p = 0.003). ATWF in anterior teeth was lower among individuals without PSB compared to those with mild (p = 0.015) and moderate/severe PSB (p = 0.032). ATWF in posterior teeth was lower among individuals without PAB compared to those with mild (p = 0.046) and moderate/severe PAB (p = 0.017).

CONCLUSION

The number of attrition tooth wear facets is proportional to the severity of PSB and PAB.

Regressive changes of crown-root morphology and their volumetric segmentation for adult dental age estimation

Cone‐beam computed tomography (CBCT) enables the assessment of regressive morphological changes in teeth, which can be used to predict chronological age (CA) in adults. As each tooth region is known to have different correlations with CA, this study aimed to segment and quantify the sectional volumes of the tooth crown and root from CBCT scans to test their correlations with the chronological age (CA). Seventy‐five CBCT scans from individuals with age between 20 and 60 years were collected retrospectively from an existing database. A total of 192 intact maxillary anterior teeth fulfilled the eligibility criteria. The upper tooth volume ratio (UTVR), lower tooth volume ratio (LTVR), and sex were used as predictor variables. The UTVR and LTVR parameters were both found to be differently correlated to CA and independent from each other. Regression models were derived from each tooth, with the highest R² being the maxillary lateral incisor (R² = 0.67). Additional single predictor models using each ratio were capable of reliably predicting the CA. The segmentation approach in volumetric adult dental age estimation proved to be beneficial in enhancing the reliability of the regression model.

Estimation of Age by Evaluating the Occlusal Tooth Wear in Molars: A Study on Dakshina Kannada Population

Purpose

Assessment of teeth to estimate age in the living as well as the dead is well documented in the literature. Though applied in conjunction with other parameters in Gustafson’s technique, attrition of teeth solely is an underexplored indicator for age estimation mainly in India. Most of the studies using attrition of teeth have been conducted in bioarchaeology, and in populations where studies are being conducted in forensic contexts, the results are debatable. Thus, the present study aimed to evaluate the accuracy of age estimation using the Average Stage of Attrition (ASA) method by Li and Ji in adults of the Dakshina Kannada region.

Materials and Methods

This cross-sectional study assessed the degree of attrition in both maxillary and mandibular first and second molars of 136 adults of Dakshina Kannada origin (age range: 20–70 years) according to the 10 stages given by Li and Ji to derive population-specific linear regression equations.

Results

Univariate analysis of prediction of age with attrition showed a significant association of attrition score with age, stratified by sex, arch as well as in total (p-value <0.001) with a standard error of estimate of 9.231 years. The estimated age was within ±5 years of the actual age in 44.2% of the females and 50.0% of the males. A comparative review of 23 studies done to estimate age from attrition score clinically is documented in the manuscript.

Conclusion

The findings of this study suggest that evaluation of tooth wear by the Average Stage of Attrition (ASA) method can be used as a non-invasive means to aid in the determination of age in adults of Dakshina Kannada origin. Although the error increases with age, this method provides a measurable means of seriation into older and younger categories.

Influence of masticating cycles and chewing patterns on inadvertent enamel wear caused by zirconia brackets

Little information is available about enamel wear caused by zirconia brackets, an inadvertent side effect of orthodontic treatment. The purpose of this study was to examine potential enamel damage induced by contact with zirconia brackets. Sliding and impact wear simulations were performed using bovine enamel specimens positioned at a 25° slant to a zirconium ball to determine wear behaviour. Different chewing patterns, tapping and grinding, were simulated. Specimens were profiled using confocal laser scanning microscopy, and the mean maximum depth and surface roughness were measured. Scanning electron microscopy was also performed. The mean maximum depth of wear values differed according to the number of mastication cycles, with a higher number of cycles producing higher depths of wear. The facet wear depth was significantly greater with the tapping pattern than with the grinding pattern. Scanning electron microscopic observation of the wear facets revealed that surface textures at the edges were rougher than those at the centre of all facets. The results of this study indicated that enamel wear was induced by contact with zirconia brackets during the early period of mastication, and that the patterns and number of cycles of mastication affected the wear progression of enamel.

Tooth wear in Swedish adults-A cross-sectional study

BACKGROUND

Tooth wear has been recognised as a growing oral health problem in children and adolescents, with erosion often cited as the main cause of the tooth wear. Most studies on tooth wear have been conducted on children and adolescents, and only few studies focus on adults. Our aim was to study the prevalence of different types of tooth wear in an adult population and investigate related factors to tooth wear.

METHODS

A total of 831 adults in Sweden participated in the study by completing a questionnaire about oral health, a clinical examination, saliva sample and intraoral photographs. Tooth wear was estimated according to the Basic Erosive Wear Examination index, and the aetiology was determined based on the clinical appearance.

RESULTS

Almost 80% of the individuals had signs of erosion, and over 90% had signs of attrition. A high level of tooth wear was found in 4.6% of the individuals, few of who reported having received information about both attrition and erosion. Significantly, more men had tooth wear. Daily consumption of fruit had a stronger correlation to tooth wear than acidic drinks.

DISCUSSION & CONCLUSION

A high level of tooth wear was found in 4.6% of the individuals, and it was more common in men than women. Aside from attrition, tooth wear due to erosion was a frequent finding in adults. Only a few of the individuals with a high level of tooth wear reported to have received information about tooth wear from their dentist or dental hygienist.

Influence of tobacco chewing on oral health: A hospital-based cross-sectional study in Odisha

Background

Smokeless tobacco use in the Indian subcontinent is a part of many religious and cultural rituals and has gained a degree of social acceptance. The deleterious effects of smokeless tobacco are not as well-known as those produced by smoking.

Objectives

The study was carried out to assess the influence of tobacco chewing on the oral health of adult patients attending the dental outpatients department of Khordha district headquarter, Odisha.

Methods

A hospital-based cross-sectional study was conducted among 25-64-year-old patients attending the dental outpatient department of Gopabandhu Khordha district headquarter hospital. A total of 512 study participants, who were age and sex matched, were stratified into four age groups such as 25-34 years, 35-44 years, 45-54 years, and 55-64 years old. Oral health status of the participants was assessed using modified WHO Oral Health Assessment Form (2013). Pearson's Chi-square test, binary and multinomial logistic regression was performed to determine the relationship between oral health problems and tobacco chewing.

Results

Among the tobacco chewers, 59.8% had gingival bleeding, 40.6% had periodontal pockets, 30.1% had loss of attachment, 48.4% had attrition, and 4.3% had potentially malignant disorders. Compared to the nonchewers, these oral problems were significantly higher among the chewers. Whereas dental caries experience was significantly lower among the chewers (40.6%) compared to the nonchewers (54.7%). Compared to the nonchewers, chewers had 1.71 times increased odds for gingival bleeding, 1.71 times increased odds for periodontal pockets, 2.39 times increased odds for loss of attachment, and 2.49 times increased odds for attrition, which were statistically significant.

Conclusion

Hence, the study revealed that tobacco chewing definitely had an influence on oral health, with statistically significant increase in oral health problems in chewers compared to nonchewers. Moreover, loss of attachment and potentially malignant disorders increased significantly with the frequency of tobacco chewing. Periodontal pockets, attrition, and loss of attachment significantly increased with the duration of the chewing habit.

Associations among Bruxism, Gastroesophageal Reflux Disease, and Tooth Wear

The relationship between bruxism and tooth wear is contentious in the literature. The pathophysiological processes of tooth wear may be complicated by the relationship between bruxism and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate the associations among bruxism, GERD, and tooth wear. Two complementary studies were performed: a case-control study to verify the linkage between GERD and bruxism and a cross-sectional study on the same cohort to establish the connection between GERD and tooth wear in bruxism patients. A cohort of 363 consecutive bruxism patients and 363 matched control participants were recruited. Gastroesophageal reflux disease was diagnosed in accordance with the Montreal criteria. Tooth wear was scored based on the index recommended by Smith and Knight. Logistic regression analyses were performed. After adjustment, GERD was identified as a risk factor of bruxism. Bruxism with reflux symptoms for extensive time-periods was associated with severe tooth wear for the whole dentition (odds ratio, 4.70, 95% confidence interval, 2.04–10.83). Increased odds ratios for severe tooth wear were also found in all tooth locations and palatal/lingual and occlusal/incisal surfaces of bruxism patients with GERD for extensive time-periods. In conclusion, strong associations were identified among bruxism, GERD, and tooth wear.

Estimation of the rate of tooth wear in permanent incisors: a cross-sectional digital radiographic study

This study used conventional digital radiography to estimate the rate of tooth wear (TW) of maxillary and mandibular central incisors based on a cross-sectional study design. The crown length of 1239 permanent maxillary and mandibular central incisors from 346 persons (age groups: 10, 25, 40, 55 and 70 years ± 3) were measured by three calibrated dentists. Study teeth were intact incisally, had clearly visible incisal edges and cementoenamel junctions and had natural tooth antagonists. Measures were based on digital radiographic images (N = 666) archived in MiPACS within the electronic health record (axiUm(®)) from the College of Dentistry patient database. Incisor crown length decreased at a linear rate in both arches over the 60 years represented by the age groups. The average crown length for maxillary incisors in the youngest age group was 11.94 mm, which decreased by an average of 1.01 mm by median age 70. For mandibular incisors, the average crown length in the youngest age group was 9.58 mm, which decreased by an average of 1.46 mm in the oldest age group. Males and females showed similar rates of TW. Regardless of age, females demonstrated smaller mean crown height for maxillary incisors than males (P < 0.0001). Measures by the examiners demonstrated good agreement, with an interclass correlation coefficient of 0.869 and an average intra-examiner correlation of 99.5%, based on repeated measurements (n = 100). TW was estimated to average 1.01 mm for maxillary central incisors and 1.46 mm for mandibular central incisors by age 70 years.

Tooth wear: prevalence and associated factors in general practice patients

OBJECTIVES

To estimate the prevalence of tooth wear and to investigate factors associated with tooth wear in patients from general practices in the Northwest United States.

METHODS

Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients (n= 1530) visiting general dentists from the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) (n=80). Prevalence ratios (PRs) of moderate to severe occlusal and incisal tooth wear by patient characteristics were estimated using cluster-adjusted multiple binomial regression for adults (18+ years) and children/adolescents (3-17 years).

RESULTS

For adults, the mean number of teeth with wear facets was 5.4 [95% confidence interval (CI) =4.6-6.2] and 51% of the adults had four or more teeth with wear. Participants 45-64 and 65+ years old were 1.3 (95% CI=1.1-1.6) and 1.4 (95% CI=1.1-1.8) times as likely to have 4+ teeth with moderate to severe wear facets as participants 18-44 years old. Adult males had a 20% (PR=1.2; 95% CI=1.1-1.4) higher prevalence of wear than adult females. Adults who were using, or had ever used occlusal splints had higher prevalence of tooth wear compared to those who never used such appliances (PR=1.3; 95% CI=1.0-1.5). Adults with any periodontal bone loss also had a 20% higher prevalence of wear than adults without periodontal disease (PR=1.2; 95% CI=1.0-1.4). For children/adolescents, the mean number of teeth with moderate to severe wear facets was 1.6 (95% CI=0.9-2.6) and 31% of the children had one or more teeth with wear facets. The adjusted prevalence ratio of tooth wear (1+ teeth with wear facets) for boys was 1.6 times as high (95% CI=1.1-2.4) as compared with girls. The prevalence of wear for children 12+ years old was 50% (PR=0.5; 95% CI=0.3-0.8) lower than that of children <12 years old. Angle's class II was associated with higher tooth wear prevalence (PR= 1.8; 95% CI=1.3-2.6) than class I. Children with posterior or anterior open bite had lower prevalence of wear than their counterparts (PR=0.6; 95% CI=0.3-1.0). No associations were observed between tooth wear and orthodontic treatment, missing teeth, and race/ethnicity.

CONCLUSION

Tooth wear is a prevalent condition in this population. Among adults, higher prevalences of tooth wear were observed among those who were older, males, had used occlusal splints and had periodontal disease. Among children, higher prevalences were associated with younger age, male gender, class II malocclusion and the absence of open bite. Submitted on behalf of the Northwest PRECEDENT network, with support from NIDCR grants DE016750 and DE016752.