Basic Erosive Wear Examination Research Articles

Evaluation of oral health status in pregnant women and its correlation with calcium and phosphate levels.

This study aimed to analyze the oral health conditions of pregnant women. The analysis involves evaluating two key indices: the decayed, missing, and filled teeth (DMFT) index and the basic erosive wear examination (BEWE) index. Furthermore, this study investigated potential correlations between calcium (Ca) and phosphate (P) levels within specific time intervals and the aforementioned oral health indices.

Comparative Analysis of Dental Health Outcomes from Two Outreach Camps in Zanzibar, Tanzania: 2019 and 2023

Background: In low- and middle-income countries, oral health is frequently marginalized due to limited dental care access. This cross-sectional study assesses the outcomes of dental outreach camps in Zanzibar, Tanzania, organized in 2019 and 2023, to understand their impact on addressing local oral health needs over a four-year span. Methods: The study involved a thorough examination and analysis of clinical dental health data from both outreach camps. In 2019, 224 patients were examined, and in 2023, the number increased to 354. The assessment covered various dental health parameters, including dental caries, DMFT/dmft indices, enamel fluorosis, dental trauma, oral mucosa lesions, and non-carious tooth surface loss. Results: The analysis demonstrated a significant reduction in dental caries among adolescents and teens, decreasing from 62.5% in 2019 to 35.59% in 2023 (p < 0.0001). Similarly, the prevalence of teeth missing due to caries showed marked reductions from 40.2% to 9.04% in adolescents and teens (p < 0.0001) and from 25.89% to 11.86% among preschool and school-aged children (p = 0.004). Moreover, a significant change was observed in the Basic Erosive Wear Examination (BEWE) scores, with cases showing no erosive tooth wear (BEWE = 0) decreasing from 49.1% to 33.3% (p = 0.016), and cases with initial loss of enamel surface texture (BEWE = 1) increasing from 47.3% to 61% (p = 0.044). Conclusions: The outreach camps conducted in 2019 and 2023 showed tangible improvements in certain dental health metrics, particularly a reduction in dental caries and missing teeth due to caries among adolescents and teens. However, the uptick in non-carious tooth surface loss points to emerging dental health concerns. These results underline the importance of sustained and targeted dental health interventions to improve oral health outcomes in underserved communities such as Zanzibar.

Clinical and digital assessment of tooth wear

The aim of this study was to compare the assessment of tooth wear performed on digital models with the one conducted at the clinical examination. Seventy-eight volunteers (29 males and 49 females, age range 20–30 years) with at least 24 teeth, normal oral function, and a neutral transverse relationship were examined. During the clinical examination, dental wear was registered according to the Basic Erosive Wear Examination (BEWE) index. Subsequently, the BEWE index was blindly applied by two examiners on digital models obtained from the volunteers. Data were analyzed using weighted Cohen’s kappa coefficient and correlation tests with a confidence interval of 95%. All volunteers showed signs of tooth wear. Anterior teeth showed increased severity of tooth wear than first molars. Early loss of tooth substance could be identified on the digital models, including in areas with challenging direct intraoral visual access. Approximately 50% of the scores based on clinical examination agreed with those based on examination of digital models (k = 0.543, p < 0.01). A moderate, positive correlation was observed between scores registered clinically and on digital models (Spearman's rho = 0.560, p < 0.001). Considering the rather low agreement between the clinical and digital scores, alternatives to using BEWE on digital models are needed.

Risk indicators for the severity of erosive wear in deciduous dentition of Mexican schoolchildren aged 5 to 7 years.

The objective of this work was to estimate the prevalence and severity of erosive tooth wear (ETW), and to identify risk indicators of deciduous dentition of a group of schoolchildren from public schools in Tlalnepantla de Baz, State of Mexico. A cross-sectional study was carried out in 352 schoolchildren from 5 to 7 years old. The severity of the ETW was evaluated using the Basic Erosive Wear Examination (BEWE). Risk indicators were evaluated through a survey which included food and beverage consumption, consumption habits, vitamin C consumption, gastroesophageal reflux, heartburn, belching, xerostomia, vomiting and teeth grinding. Multinomial logistic regression models were fitted. The prevalence of ETW was 99.7% (n = 351). Regarding severity, 46.6% were at a null/mild level, 27.3% moderate, and 26.1% severe. Males were more likely to present severe ETW (odds ratio (OR) = 2.23, 95% confidence interval (CI), 1.27-3.93; p = 0.005). The risk indicators for the severity of ETW were the frequent consumption of citrus fruits (OR = 2.09, 95% CI, 1.12-3.89; p = 0.021), fruit juice (OR = 1.99, 95% CI, 1.06-3.75; p = 0.033), processed beverages (OR = 2.15, 95% CI, 1.23-3.78; p = 0.008) and hot sauce (OR = 1.82, 95% CI, 1.03-3.20; p = 0.036). The prevalence of ETW in the deciduous dentition was very high (99.7%) and ~1/3 for severe ETW. The dietary factors associated with severe ETW are part of the regular consumption of Mexican school-age children, which impact their oral health condition. It is important to establish intervention strategies from the infant stage, focused on both children and their caregivers.

Oral Health and Behavior Patterns of Women with Eating Disorders-A Clinical Pilot Study.

Chronic stomach regurgitation associated with eating disorders (EDs) poses a high risk for tooth erosion. This study investigated oral health conditions, behavioral patterns, and tooth erosion in women with EDs. 16 ED and 13 healthy women were enrolled; 14 ED and 10 healthy control subjects completed the study. Subjects completed demographic, medical, oral, and behavioral health history questionnaires. Dental caries status was recorded as Decayed, Missing and Filled Teeth (DMFT)index and the severity of tooth erosion as Basic Erosive Wear Examination (BEWE) scores. Saliva was collected for flow rate, pH, and buffering capacity analysis. The ED group had a lower stimulated saliva flow rate and higher DMFT index but no significant difference in BEWE scores compared to the controls (t-test, significance level 0.05). Five of the fourteen ED subjects exhibited extensive tooth erosion, which may have been exacerbated by their tooth-brushing behavior. Although some ED subjects showed extensive tooth erosion in this pilot study, the average BEWE score of the ED group was not significantly different from the controls. Extensive tooth erosion in ED may relate to the low stimulated salivary flow. A larger-scale clinical study is necessary to validate these results.

Erosive tooth wear and salivary parameters among competitive swimmers and non-swimmers in Egypt: a cross-sectional study

IntroductionCompetitive swimmers spend considerable time practicing their sport. Prolonged exposure to chlorinated water can alter salivary parameters and might compromise oral health. This study aimed to determine erosive tooth wear status and its related risk factors among competitive swimmers as compared to non-swimmers.Materials and methodsA cross-sectional study consisting of 180 athletes (90 competitive swimmers versus 90 competitive rowers “non-swimmers”) was conducted. Participants were interviewed on the common erosion risk factors. The Basic Erosive Wear Examination system was used to assess the status of erosive tooth wear. Stimulated saliva sample was collected before and after a training session and pool pH was evaluated using pH strips for 7 days. Data were analyzed using descriptive statistics and multivariable analysis.ResultsThe prevalence of dental erosion was significantly higher among competitive swimmers (60%) with higher BEWE scores compared to non-swimmers (25.6%). The salivary flow rate was reduced significantly after training sessions in both groups while salivary pH increased among swimmers. Evaluation of pool water revealed a continuous reduction in the pH level, reaching a very acidic pH level of 3.24.ConclusionErosive tooth wear is more prevalent among competitive swimmers. Years of practice and regular consumption of acidic drinks increase the odds of developing erosive lesions. A high incidence of erosive lesions may be attributed to a reduction in swimming pool pH level. Salivary parameters showed variations between groups after training sessions.

Prevalence of tooth wear diseases in patients with diabetes and its impact on the quality of life in Dakshina Kannada population: a cross sectional study

Background Early detection and management of tooth wear (TW) has not been given due consideration in the dental profession. Thus, this study aimed to explore the prevalence of TW in adults with diabetes in Dakshina Kannada population using the Basic Erosive Wear Examination (BEWE) and recording its impact on quality of life using the Oral Health Impact Profile (OHIP-14). Methods In total, 236 dentate adults with diabetes and TW, who visited the Manipal College of Dental Sciences, Mangalore were recruited to the study. Assessment of TW was done using BEWE during examination of each participant and was categorized as none, mild, moderate, and severe. Impact of TW on quality of life was assessed using the OHIP-14. Results Overall, 81 (34.30%) individuals had a poor score on the basic erosive tooth index, 82 (34.70%) had a medium score, . The level of TW, both moderate and severe (high), affected quality of life. Erosion, abrasion and attrition were seen in a large proportion of the study population. The diabetic status of the individual was collected from their medical file. The HbA1C level was found to range from good, fair and poor control. The quality of life among the study population was affected because of TW and diabetes. Few participants had hypertension along with diabetes. The majority of study participants were on oral hypoglycaemic agents. Participants used tooth brushes and tooth paste and brushing frequency varied between once or twice daily. Conclusions In the study population, there were moderate and severe TW patterns. Quality of life was found to be impacted by TW. Dental professionals must give proper consideration to the influence of TW on quality of life in addition to clinical findings. This will make it easier to offer preventive or restorative management depending on the situation.

Erosive Tooth Wear in Subjects with Normal Occlusion: A Pioneering Longitudinal Study up to the Age of 60.

The aim of this study was to assess the erosive tooth wear (ETW) at early and mature adulthood in subjects with natural normal occlusion. The sample consisted of 23 untreated subjects with normal occlusion. Dental models were taken longitudinally from the same subjects at 13 (T0), 17 (T1) and 60.9 years of age (T2) at a university. Evaluation of ETW was performed using a modified Basic Erosive Wear Examination (BEWE) index. Interphase changes were evaluated using Friedman and Dunn's test. Ordinal logistic regression was used to assess the influence of sex, dental arch, tooth and dental surfaces on the erosive tooth wear. Linear regression was used to evaluate whether the ETW degree at T1 could discriminate the degree of ETW at T2. The significance level adopted was 5%. ETW showed a significant increase with aging. The median ETW index at T0, T1 and T2 was 2, 4 and 7, respectively. ETW was greater in males in the incisors and canines and on the incisal/occlusal and lingual tooth surfaces. No significant differences were found between the maxillary and mandibular arches. Subjects with severe ETW at mature adulthood had greater tooth wear at age 17. In conclusion, ETW significantly increased during aging in subjects with normal occlusion. The greater the degree of tooth wear at early adulthood, the greater the tooth wear at mature adulthood. Preventive care should be recommended during early adulthood in patients demonstrating erosive tooth wear in order to avoid worsening with aging.

Relationship between Dental Erosion and Beverage Consumption Pattern in Overweight and Obese Patients

This study aims to investigate the relationship between dental erosion and frequency of non-alcoholic beverage intake in normal-weight, overweight, and obese individuals.&#x0D; The study involved 264 subjects aged 18–60 years with normal weight (control group), overweight and obesity. The frequency of non-alcoholic beverage intake has been assessed. The grade of erosive tooth wear has been measured using the BEWE index (Basic Erosive Wear Examination). When comparing the control and overweight groups, a statistically significant difference has been found between the group with no erosive wear, score 0, and the one with initial enamel surface loss, score 1, (χ2 = 18.633, p &lt; 0.05). When comparing the control and obese groups, a significant difference has been found between the groups with score 0 (χ2 = 19.179, p &lt; 0.05), score 2 (χ2 = 0.160, p &lt; 0.05) and score 3 (χ2 = 0.160, p &lt; 0.05), as well as when comparing the subjects in the control group with score 0 by sex (χ2 = 3.360, p &lt; 0.05). The Kruskal–Wallis test has indicated a statistically significant difference among the three studied groups depending on body weight (BMI), (χ2 = 19.036, p &lt; 0.001), as well as on the non-alcoholic beverage consumption in the individuals affected by erosive wear (χ2 = 57.403, p &lt; 0.001). A relationship between the frequency of intake related to these beverages and the dental erosive wear has been established.

Fluid Intake and the Occurrence of Erosive Tooth Wear in a Group of Healthy and Disabled Children from the Małopolska Region (Poland).

Background: The aim of this study was to analyse the relationship between the type and amount of fluid intake and the incidence of erosive tooth wear in a group of healthy children and children with disabilities. Methods: This study was conducted among children aged 6-17 years, patients of the Dental Clinic in Kraków. The research included 86 children: 44 healthy children and 42 children with disabilities. The prevalence of erosive tooth wear using the Basic Erosive Wear Examination (BEWE) index was assessed by the dentist, who also determined the prevalence of dry mouth using a mirror test. A qualitative-quantitative questionnaire on the frequency of consumption of specific liquids and foods related to the occurrence of erosive tooth wear, completed by the children's parents, was used to assess dietary habits. Results: The occurrence of erosive tooth wear was determined for 26% of the total number of children studied, and these were mostly lesions of minor severity. The mean value of the sum of the BEWE index was significantly higher (p = 0.0003) in the group of children with disabilities. In contrast, the risk of erosive tooth wear was non-significantly higher in children with disabilities (31.0%) than in healthy children (20.5%). Dry mouth was significantly more frequently identified among children with disabilities (57.1%). Erosive tooth wear was also significantly more common (p = 0.02) in children whose parents declared the presence of eating disorders. Children with disabilities consumed flavoured water or water with added syrup/juice and fruit teas with significantly higher frequency, while there were no differences in quantitative fluid intake between groups. The frequency and quantity of drinking flavoured waters or water with added syrup/juice, sweetened carbonated, and non-carbonated drinks were associated with the occurrence of erosive tooth wear for all children studied. Conclusions: The group of studied children presents inappropriate drinking behaviours regarding the frequency and amount of beverages consumed, which, especially in a group of children with disabilities, may contribute to the formation of erosive cavities.

Evaluation of Salivary Pepsin Levels and Dental Erosion in Patients With Gastroesophageal Reflux Disease.

Background Gastroesophageal reflux disease (GERD) is a common gastrointestinal condition affecting many individuals worldwide. GERD is characterized by esophageal symptoms and may contribute to various extraesophageal symptoms, including dental erosion (DE). This study aimed to estimate the levels of pepsin in the saliva of GERD patients to evaluate and compare the activity of pepsin between the GERD and healthy groups and investigate the prevalence of DE in the GERD group. Methodology In this case-control study, 40 patients with GERD, diagnosed with an endoscope, and 35 healthy subjects were included.Patients and healthy individuals were subjected to the GERD questionnaire (GerdQ). A dental assessment was performed using the Basic Erosive Wear Examination (BEWE).A total score of the BEWE risk level was obtained by summing the scores obtained in each sextant (no risk = ≤2, low risk = 3-8, medium risk = 9-13, and high risk = >13). Five milliliters of unstimulated saliva were collected in a sterile tube. The salivary pepsin levels examined using the enzyme-linked immunosorbent assay were recorded for both groups. Results DE was significantly more frequent in GERD patients compared to healthy subjects. Overall, 32 (80%) GERD patients and 11(31.4%) healthy individuals had DE risk. The mean salivary pepsin was 43.60 ± 10.61 ng/mL in the GERD group and 20.60 ± 9.27 ng/mL in the healthy group. A statistically significant difference was found in pepsin levels between the two groups (p < 0.001). Conclusions The study concluded that GERD patients had a higher prevalence of DE than healthy individuals. Our findings suggest that elevated salivary pepsin levels and their role as a factor responsible for DE need further evaluationto understand the mechanisms of pepsin-mediated damage leading to DE.

Association of salivary parameters and erosive tooth wear in preschool children.

The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).

Incidence and progression of erosive tooth wear according to tooth type in schoolchildren of Mexico City.

This study aimed to estimate the cumulative incidence and the progression of erosive tooth wear (ETW) according to tooth type over a follow-up period of 18 months in adolescents living in Mexico City. We examined 10,776 teeth from 424 participants and used the Basic Erosive Wear Examination index (BEWE) to assess ETW. Our results showed that the overall cumulative incidence rate of ETW was 5.9% (587 from 9933 teeth), and the progression of ETW was 10% (85 from 843 teeth). Notably, the cumulative incidence of initial texture loss (BEWE = 1) was 29.1% for maxillary central incisors, and 30.4% of mandibular first molars progressed to loss of hard tissues (BEWE ≥2).

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

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. 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. 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. 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.

Causative Factors of Tooth Wear among Patients Visiting a Tertiary Care Hospital in Lahore

Background: Tooth wear, or as it is also often referred to as non-carious tooth surface loss (TSL), can be described simply as ‘the pathological non-carious loss of tooth tissue’. Tooth wear is often multifactorial in nature, making clinical diagnosis difficult. Identification of the etiology is essential for the successful management of the pathology. Methods: A total of 120 patients of both male and female with tooth wear were selected from dental OPD. Patients with age group 25-65years with tooth wear in at least two teeth according to basic erosive wear examination (BEWE) were included. Questionnaire covering primary risk factors that might cause tooth wear was used Data was analyzed using SPSS version 24.0. Results: Out of the 120 tooth wear patients, 69(57%) were male and 51(43%) were females. tooth wear presented more in males as compared to females. 42.24% patients reported with habit of tea consumption and 32.5% with cold drinks. 45% males and 43.4% females had gastric reflex disease. 60.9% male patients had problem of bruxism and clenching. Conclusion: This study reported that TSL has a multifactorial etiology. Parafunction, gastro esophageal reflux disease (GORD) and consumption of carbonated drinks were the most commonly observed causative factors. Keywords: Tooth wear, Erosion, Abrasion, Attrition, Causative factor

Tooth wear and oral-health-related quality of life in dentate adults

ObjectivesThis study estimated the extent to which tooth wear, adjusted for (oral) health risk indicators, impacts adversely on the Oral-Health-Related Quality of Life (OHRQoL) of dentate adults. Methods: A cross-sectional study was conducted and had a convenience sample of 570 adults ≥18 years old with at least one bilateral molar occlusal contact. Participants answered a self-applied questionnaire (ICC=0.71) consisting of four domains: socio-demographics, oral care attendance, (oral) health conditions and lifestyle, complaints and oral-health-related quality of life (OHIP-14). Tooth wear was clinically assessed using the Basic Erosive Wear Examination index by two examiners, whose inter-examiner reliability were k=0.76-0.80. Results: The outcome was a high score on the OHRQoL (median split ≥ 7). The prevalence of tooth wear was 75.0%. Only 30.2% of adults reported impacts on at least 1 performance parameter affected ‘fairly often’ or ‘very often’. The hierarchical logistic regression showed that participants 35−54 years old (OR=2.1), who were ever prevented from regular oral health care due to costs of care (OR=3.6), who ingested acidic beverages ≥ daily (OR=1.7), who had tooth sensitivity (OR= 2.9) and those having the impression that their teeth have changed appearance (OR= 5.9) were significantly more likely to report lower OHRQoL than their counterparts. The severity of tooth wear was not significant when considering moderate and severe cases together. Conclusions: Although the prevalence of tooth wear was high, its severity and impact on OHRQoL were limited. However, distal and proximal indicators for tooth wear were mediators for impaired OHRQoL and treatment needs. Clinical significancePrevalence and severity of tooth wear had limited impact on OHRQoL in adults. Distal and proximal indicators for tooth wear were mediators for impaired OHRQoL. The understanding of these relationships offers an opportunity to assess in depth the treatment needs and quality of life of patients affected by tooth wear.

Home Oral Care Domiciliary Protocol for the Management of Dental Erosion in Rugby Players: A Randomized Clinical Trial.

People performing regular physical activity are at high risk of dental erosion especially in cases of high sport drinks intake. Biomimetic hydroxyapatite-based oral hygiene products, like toothpastes and mouthwashes, have been investigated in recent years for their remineralizing activity on the teeth. The aim of the present study was to evaluate the efficacy of two different oral hygiene protocols, respectively consisting of the combination of a hydroxyapatite-based toothpaste plus mouthwash (Trial group) or toothpaste alone (Control Group). At baseline (T0), as well as at 15 days (T1), 30 days (T2) and 90 days (T3), the following clinical indexes were assessed: Basic Erosive Wear Examination (BEWE), Schiff Air Index (SAI), Visual Analogue Scale (VAS), Plaque Index (PI) and Bleeding Index (BI). In general, for all the indexes assessed, a progressive intragroup reduction was noticed from the baseline to the subsequent timepoints, with no intergroup differences. Accordingly, the use of the hydroxyapatite-based toothpaste, alone or in combination with the mouthwash containing hydroxyapatite as well, is an effective method for the domiciliary management of dental erosion in physically active individuals like rugby players.

Risk prediction models for erosive wear in preschool-aged children: a prospective study

BackgroundDespite increasing prevalence, age-specific risk predictive models for erosive tooth wear in preschool-age children have not been developed. Identification of at-risk groups and the timely introduction of behavioural change or treatment will stop the progression of erosive wear in the permanent dentition. This study aimed to identify age-specific risk factors for erosive wear. Distinct risk prediction models for 3-year-old and 5-year-old children were developed.MethodsA prospective cohort study included school-based clinical examinations and parent administered questionnaires for consented 3 and 5-year-old healthy children. Calibrated examiners measured the following health parameters under standardised conditions: erosion, using the Basic Erosive Wear Examination Index (BEWE), caries using the International Caries Detection and Assessment System (ICDAS), plaque and calculus according to the British Association for the Study of Community Dentistry (BASCD) scores, dental traumatic injuries and soft tissue lesions, salivary testing and BMI. Other health conditions were collected via a parent-administered questionnaire that explored oral- and general-health. Non parametric tests were utilised to explore the temporal relation of erosion with, demographic factors, oral hygiene habits, general health and dietary habits. Variables showing significance with a difference in BEWE cumulative score over time were utilised to develop two risk prediction models. The models were evaluated by Receiver Operating Characteristics analysis.ResultsRisk factors for the 3-year-old cohort (N = 336) included erosive wear (χ2(1, 92) = 12.829, p < 0.001), district (χ2(5, 92) = 17.032, p = 0.004) and family size (χ2(1, 92) = 4.547, p = 0.033). Risk factors for the 5-year-old cohort (N = 441) also included erosive wear (χ2(1, 144) = 4.768, p = 0.029), gender (χ2(1, 144) = 19.399, p < 0.001), consumption of iced tea (χ2(1, 144) = 8.872, p = 0.003) and dry mouth (χ2(1, 144) = 9.598, p = 0.002).ConclusionsPredictive risk factors for 3-year-old children are based on demographic factors and are distinct from those for 5-year-old children based on biological and behavioural factors. Erosive wear is a risk factor for further wear in both age cohorts.

Home Oral Care with Biomimetic Hydroxyapatite vs. Conventional Fluoridated Toothpaste for the Remineralization and Desensitizing of White Spot Lesions: Randomized Clinical Trial.

Introduction: Biomimetic hydroxyapatite-based toothpastes have been investigated in recent years for their remineralizing activity on dental surfaces. The aim of the present study was to evaluate the efficacy of toothpaste containing biomimetic hydroxyapatite versus a 1450 pppm fluoride one in promoting the remineralization and desensitization of white spot lesions. Methods: 40 patients were randomly assigned to two different domiciliary oral hygiene treatments: toothpaste containing 1450 ppm of fluoride (control group) and toothpaste containing biomimetic hydroxyapatite (experimental group). Dental sensitivity/pain and dental erosion were assessed at baseline and after 15, 30, and 90 days using the following indexes: Schiff Air Index (SAI), Visual Analogue Scale (VAS), and Basic Erosive Wear Examination (BEWE). Results: Data were submitted for statistical analysis. SAI significantly decreased after 3 months (T3) of treatment only in the Trial group (p < 0.05). VAS values significantly decreased at T2 in the trial group (p < 0.05) with a further significant reduction at T3 (p < 0.05). BEWE scores did not significantly vary during the follow up neither in the trial nor in the control group. Conclusions: The hydroxyapatite-based toothpaste tested caused a reduction of hypersensitivity/pain values higher than conventional fluoride toothpaste.

Dental Erosion Evaluation with Intact-Tooth Smartphone Application: Preliminary Clinical Results from September 2019 to March 2022.

Dental erosion is a process of deterioration of the dental hard tissue; it is estimated that about 30% of permanent teeth are affected in adolescence. The Intact-Tooth application allows for the better estimation of the problem, inserting itself in the diagnosis process, and better care and prevention for the patient. It provides him with scientifically validated protocols, which the patient can consult at any time. The purpose of this report was to conduct an initial evaluation on the use of the application, which has been available since September 2019: the analysis of the collected data allowed the first investigation of the incidence of the problem and the degree of susceptibility in the registered patients. Photos of 3894 patients with dental erosion were uploaded, through which the degree of susceptibility and the BEWE (basic erosive wear examination index) index could be assessed; of these, 99.72% had a susceptibility grade of 0 to 8, while 0.28% had a medium-high susceptibility grade; this result is related to the age and sex of the patients. The management of patients through the help of the application could promote the diagnosis and treatment of enamel diseases and encourage the self-learning of the learning machine, thanks to the number of clinical cases uploaded.