Severity Of Erosive Tooth Wear Research Articles

Erosive tooth wear and caries experience in children and adolescents with obesity

Clinical SignificanceA large consumption of fermentable carbohydrates, for instance the high intake of sweetened beverages, is an important risk factor for overweight and obesity. As lemonades and fruit juices present high sugar content and quite low pH-values, overweight and obese children might also have an increased risk for dental caries and erosive tooth wear. ObjectivesThe aim was to analyze the prevalence and severity of erosive tooth wear and caries experience in children and adolescents with overweight, obesity and extreme obesity compared to children with normal weight and to determine a possible association between erosive tooth wear and caries experience. Methods223 children (4–17 years, n = 1476 primary and n = 4110 permanent teeth) were examined using standardized dental indices (BEWE, ICDAS, DMFT). Demographic and socio-economic data, eating habits, oral hygiene, fluoride supply and details of medical history were obtained from a questionnaire. Weight classification was based on age- and gender-specific relative body mass indices (BMI). Statistical analyses were done by Chi2-tests, Kruskal-Wallis tests, logistic and linear regressions. To determine a possible association between erosive tooth wear and caries experience Chi2-tests (prevalence to prevalence) and Spearman correlations (severity to severity) were performed (p < 0.05). ResultsErosive tooth wear and caries experience in primary and permanent teeth were significantly increased in children with obesity and extreme obesity compared to normal weight children (p < 0.05). Higher BMI, age, gender, and the consumption of erosive snacks/beverages were identified as statistically significant risk factors for erosive tooth wear. Higher BMI, age, socio-economic factors, poor toothbrushing habits, and consumption of cariogenic beverages were identified as significant caries risk factors. Erosive tooth wear and caries showed a weak correlation in children with (extreme) obesity (Φ = 0.110 to 0.248). ConclusionsHigher BMI of children and adolescents is significantly associated with a higher risk for erosive tooth wear and caries.

Prevalence of gingival recession and study of associated related factors in young UK adults

ObjectivesTo determine the prevalence of gingival recession (GR) and associations with dentine hypersensitivity (DH), erosive toothwear (BEWE), gingival bleeding (BOP) and periodontal pocketing (PPD) in young European adults. Materials and MethodsThis is a secondary analysis using data collected from 350 UK participants enrolled in a European cross sectional study of 3187 young adults. GR, BOP, PPD, DH (participant and clinician assessment) and BEWE were recorded. A questionnaire assessed demographics, oral hygiene and lifestyle habits. Results349 participants completed the study. GR, BOP and PPD showed the same pattern of distribution, prevalence increasing from incisors to molars in upper and lower arches for buccal and palatal scores. Every participant exhibited recession affecting at least 1 tooth, 42% having a maximum recession of 4–8 mm. There was a significant and linear association demonstrating an increase in maximum recession with age. DH and BEWE produced a similar pattern to buccal periodontal indices, the premolars being most affected. Maximum recession correlated significantly with maximum DH (participant and Schiff), PPD, BOP, BEWE (scores of 2/3), BMI (≥25 kg/m2) and unsystematic brushing motion. 94% of the study population exhibited some BOP at one or more sites. 5% of the population had periodontal pocketing ≥4 mm, 46% had DH and 80% BEWE 2/3. ConclusionWidespread recession and gingivitis with minimal periodontal disease was observed. Every participant exhibited at least one tooth with recession. Many teeth did not exhibit DH despite prevalent recession and severe erosive toothwear. Recession correlates to a number of oral and lifestyle variables. Clinical SignificanceRecession in young adults is multifactorial and highly prevalent. It can result in DH and consequential increase in demand for treatment relating to both pain and aesthetics. Further research is needed to understand the underlying aetiology to prevent recession occurring.

The role of the diet in tooth wear.

An acidic diet has been associated with erosive tooth wear. However, some people who consume dietary acids develop erosive tooth wear and some do not. This review paper provides an overview of the risk factors of dietary acid consumption which increase the likelihood of developing severe erosive tooth wear. Increased frequency of dietary acid consumption, particularly between meals appears to be the predominant risk factor. However, habitually drinking acidic drinks by sipping them slowly or swishing, rinsing or holding acidic drinks in the mouth before swallowing will also increase risk of progression. Consuming fruit over long time periods at a single sitting and dietary acids being served at increased temperatures have also been implicated. Additions of fruit or fruit flavourings to drinks and regular consumption of vinegars, pickles, acidic medications or acidic sugar-free sweets are potential hidden risk factors that should be discussed with patients at risk of erosive tooth wear progression. Behaviour change is difficult to achieve but specific, targeted behavioural interventions and offering alternatives may increase success.

The relationship between dentine hypersensitivity, dietary acid intake and erosive tooth wear

ObjectivesTo assess the interplay between dietary acid intake, toothbrushing and erosive tooth wear as aetiological factors in self-reported DH Materials and methodsThis is a secondary analysis on previously collected data from 600 participants with (n=300) and without (n=300) severe erosive tooth wear. Participants recruited from restorative clinics of King’s College London Dental Institute (REC Ref 14/EM/1171) were questioned on their self-reported DH, frequency and timing of dietary acid intake, habits associated with consumption of dietary acids and tooth brushing habits. Erosive tooth wear was assessed using Basic Erosive Wear Examination (BEWE). Differences in diet and brushing habits between those with self-reported DH and those without were analysed using descriptives and logistic regression in SPSS vers. 24. ResultsOf those reporting with DH (n=272), a greater number spent ≥10min eating fruit per sitting, (n=46) and had a drinking habit such as sipping, swishing or holding drinks in the mouth (n=72) compared to those without DH (n=26 OR 2.72, 95%CI [1.32–5.61], p=0.007 and n=38 OR2.33, 95%CI [1.40–3.88], p=0.001, respectively). More DH participants used a soft toothbrush (n=36) compared to those without DH (n=18 OR 2.35, 95%CI [1.20–4.59], p=0.013). No association was observed with frequency of daily toothbrushing or dietary acid intake. ConclusionContact time between the tooth and the acid may be a more important risk factor for DH compared to frequency of dietary acid intake or frequency of toothbrushing. Other possible aetiological factors should be considered. Clinicaltrials.gov numberNCT02449434 Clinical significanceIncreased contact time with dietary acids and sipping swishing or holding drinks in the mouth prior to swallowing should be addressed as an aetiological factor in DH. Toothpaste abrasivity and toothbrush filament stiffness may play a greater role in DH compared to frequency of toothbrushing.

Prevalence of dental erosion among 18-year-old adolescents in the borderland districts of Lviv (Ukraine) and Lublin (Poland)

Recent epidemiological studies have shown an association between dental erosion occurrence and changes in lifestyle and dietary habits in both developed and developing countries, and now affects different regions of the world. Furthermore, in current literature, studies have shown that the prevalence of erosive tooth wear has increased particularly among the younger population. The aim of the study was to assess the prevalence and severity of erosive tooth wear among 18-year-old adolescents in the districts of Lviv (Ukraine) and Lublin (Poland). College students (254 subjects) aged 18, living in the Lviv and Lublin districts were examined. Erosive lesions presented in the teeth were assessed on the basis of the BEWE (Basic Erosive Wear Examination) index. Among the 137 patients living in the Lublin district, 70 were females and 67 were males, while in the Lviv district, 60 women and 57 men were examined. In both districts, the following numbers of rural patients were examined: 66 in Lublin district and 56 in Lviv district; for urban inhabitants, the numbers were 71 in Lublin and 61 in Lviv. Analysing the BEWE values, it was noted that higher BEWE values, and resulting from them significant differences were observed in both male and female groups living in Lublin, compared with Lviv inhabitants. Based on clinical examination and statistical analysis, the occurrence of lesions of an erosive character in at least one sextant were observed in 59.85% of patients from Lublin district, and in 42.74% of patients from Lviv district. On the basis of the conducted study in the Polish and Ukrainian groups of 18-year-old adolescents living on the borderland, it can be stated that dental erosion is a problem noticeable in both groups of cohorts, but with higher prevalence in the Lublin district.

A personal perspective and update on erosive tooth wear - 10 years on: Part 2 - Restorative management.

The management challenge with erosive tooth wear is that the condition involves erosion and contributions from attrition and abrasion, both of which impact on the longevity of restorations. Severe erosive tooth wear results in visibly shorter teeth, exposure of dentine and adaptive changes which complicate restorative management. There is increasing evidence to suggest if the risk factors, such as reducing the frequency of acidic foods and drinks, are reduced the progression of tooth wear slows and follows a normal pattern of wear. But once teeth become shorter patients often seek advice from dentists on restorative intervention. Composite restorations are successful in some patients but they often involve regular maintenance with repairs and rebuilds, which for some patients is unacceptable. Full coverage crowns, although destructive of tooth tissue, remain an option for restorations.

Prevalence and risk factors of erosive tooth wear in 3–6 year old German kindergarten children—A comparison between 2004/05 and 2014/15

ObjectivesThe aims of this study were (1) to investigate prevalence, severity and distribution of erosive tooth wear in German kindergarten children aged 3–6 years in 2014/15 in comparison to an earlier survey from 2004/05 and (2) to identify and compare possible risk factors. Methods775 children aged 3–6 years from 27 kindergartens were examined in 2014/15 and compared to the data from 2004/05 (432 children/21 kindergartens). Erosive tooth wear was examined using the O’Sullivan-Index. Additionally, data were converted into the Basic Erosive Wear Examination (BEWE)-index. Information about dietary habits, chronic illness and oral hygiene practices were obtained by questionnaires. Statistical analyses were done by Chi2-, Mann-Whitney U Tests and regression analyses (p<0.05). ResultsCompared to 2004/05 (31.3%) prevalence of erosive tooth wear was significantly increased in 2014/15 (45.4%). In 2004/05 and 2014/15, prevalence increased significantly with increasing age of the children: 3-year-olds: 22.5%/14.2%; 4-year-olds: 27.4%/32.9%; 5-year-olds: 30.5%/58.8%; 6-year-olds: 38.1%/71.7%. Children with erosive tooth wear presented more affected teeth and a higher severity of erosive tooth wear, respectively, in 2014/15 compared to 2004/05. The BEWE score sum was significantly higher in 2014/15 (3-year-olds: 3.4±2.1, 4-year-olds: 4.2±3.1, 5-year-olds: 4.6±2.9, 6-year-olds: 5.9±3.3) than in 2004/05 (3-year-olds: 2.0±1.2, 4-year-olds: 2.7±1.8, 5-year-olds: 2.7±2.4, 6-year-olds: 4.2±4.2). In 2014/15, age and male gender were significant with respect to the presence of erosive tooth wear. Severity of erosive tooth wear was dependent on the regular consumption of fruit juices and lemonade/coke. ConclusionThe prevalence of erosive tooth wear in German kindergarten children has increased in the last ten years.

Association of erosive tooth wear and dental caries in Northern Finland Birth Cohort 1966 \u2013 an epidemiological cross-sectional study

BackgroundThe main aim of this cross-sectional study was to investigate the prevalence and severity of erosive tooth wear and its association with dental caries and socio-demographic factors among middle-aged Finnish adults.MethodsOf the total Northern Finland Birth Cohort 1966 (n = 12,058), a convenience sample (n = 3181 adults) was invited for an oral health examination of which 1962 (61.7 %) participated, comprising the final study group. Clinical examinations were carried out by trained and calibrated dentists. Erosive tooth wear was assessed by sextants using the Basic Erosive Wear Examination Index (BEWE, 0–18) and dental caries at surface level using the ICDAS criteria (0–6). Socio-demographic data were obtained from a postal questionnaire. A logistic regression model was generated to test the association of the variables.ResultsThe prevalence of erosive tooth wear was 75 % and the mean of the BEWE sum score was 3.4 (SD 3.30). Almost half of the members needed non-invasive or invasive measures to prevent further progression of the condition. Of those with erosive lesions, 14.6 % suffered from severe erosive tooth wear. There was a strong positive relationship between the presence of severe erosive tooth wear (BEWE sum score ≥9) and male gender and restorative treatment need.ConclusionsErosive tooth wear is a common finding in Finnish adult population; almost one in ten suffer from severe erosive tooth wear. Restorative treatment need seems to be associated with severe erosive tooth wear.

Gain-of-function mutations in signal transducer and activator of transcription 1 (STAT1): Chronic mucocutaneous candidiasis accompanied by enamel defects and delayed dental shedding

Gain-of-function mutations in signal transducer and activator of transcription 1 (STAT1): Chronic mucocutaneous candidiasis accompanied by enamel defects and delayed dental shedding

Prevalence of erosive tooth wear and associated risk factors in 2–7‐year‐old German kindergarten children

The aims of this study were to (1) investigate prevalence and severity of erosive tooth wear among kindergarten children and (2) determine the relationship between dental erosion and dietary intake, oral hygiene behaviour, systemic diseases and salivary concentration of calcium and phosphate. A sample of 463 children (2-7 years old) from 21 kindergartens were examined under standardized conditions by a calibrated examiner. Dental erosion of primary and permanent teeth was recorded using a scoring system based on O'Sullivan Index [Eur J Paediatr Dent 2 (2000) 69]. Data on the rate and frequency of dietary intake, systemic diseases and oral hygiene behaviour were obtained from a questionnaire completed by the parents. Unstimulated saliva samples of 355 children were analysed for calcium and phosphate concentration by colorimetric assessment. Descriptive statistics and multiple regression analysis were applied to the data. Prevalence of erosion amounted to 32% and increased with increasing age of the children. Dentine erosion affecting at least one tooth could be observed in 13.2% of the children. The most affected teeth were the primary maxillary first and second incisors (15.5-25%) followed by the canines (10.5-12%) and molars (1-5%). Erosions on primary mandibular teeth were as follows: incisors: 1.5-3%, canines: 5.5-6% and molars: 3.5-5%. Erosions of the primary first and second molars were mostly seen on the occlusal surfaces (75.9%) involving enamel or enamel-dentine but not the pulp. In primary first and second incisors and canines, erosive lesions were often located incisally (51.2%) or affected multiple surfaces (28.9%). None of the permanent incisors (n = 93) or first molars (n=139) showed signs of erosion. Dietary factors, oral hygiene behaviour, systemic diseases and salivary calcium and phosphate concentration were not associated with the presence of erosion. Erosive tooth wear of primary teeth was frequently seen in primary dentition. As several children showed progressive erosion into dentine or exhibited severe erosion affecting many teeth, preventive and therapeutic measures are recommended.