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A correlation of tooth wear and age among modern Igloolik eskimos.

The level of molar wear can be estimated reliably by measuring the cusp height. A correlation between age and the level of molar wear, expressed by a normalizing index (TWI) of cusp height, was found to exist in a sample of modern Igloolik Northwest Territories Eskimos. Not only was it possible to derive linear regression models to test the degree of correlation in the sample of 46 female and 39 male maxillary casts of Igloolik Eskimos, but the models were capable of accurately predicting the age of natives of the neighboring Hall Beach community. Sexual dimorphism in molar wear, perhaps attributable to differential bruxism, was demonstrated for the Igloolik sample. Based on the combined estimate of slopes for each maxillary molar pair for females and males, it was discovered that the male maxillary molars are worn approximately 30% more rapidly than female maxillary molars.

Adolescent↗

Orthodontics and the creation of localised inter-occlusal space in cases of anterior tooth wear.

Creation of inter-occlusal space using conventional orthodontics can be achieved by a number of techniques. It is important that the most appropriate is chosen for each clinical case. Failure to do so may result in protracted treatment or ultimate failure. Alternative orthodontic techniques may offer advantages over conventional techniques in some circumstances. However, they should be seen as replacement for conventional methods, rather as an extra option for some patients. For all treatment options it is important that the orthodontist works closely with his restorative colleagues to ensure that the correct and most appropriate treatment option is chosen.

Cuspid↗

Evaluation of a profilometrical method for monitoring erosive tooth wear.

The in vivo monitoring of erosive wear is difficult because lesions mostly progress relatively slowly and reliable reference points are difficult to obtain. To date, only a few methods for clinical monitoring of erosive loss have been described, which either require extensive equipment or do not provide sufficient sensitivity. The aim of the present study was to evaluate, using study models (epoxy resin material), a procedure that permits the reliable and accurate monitoring of erosive substance loss within acceptable observation periods. The method is the profilometric measurement of erosive tissue loss using acid-resistant markers, which represent both a reference area and a structure for the defined retracing of a given erosive lesion surface. The study model magnified values slightly (2.8%; not significant), the precision was < 4 microm, and the repeatability was good (95% limits of repeatability ranging from -4.7 to 5.2 microm). The estimated detection threshold for erosive loss is 15 microm, which appears to be adequate for monitoring. The method is indicated for special dental care in cases of severe dental erosion (e.g. eating disorders) and for clinical studies.

Dental Enamel↗

Dental erosion, soft-drink intake, and oral health in young Saudi men, and the development of a system for assessing erosive anterior tooth wear.

The aim of the study was to investigate some aspects of the oral health of male Saudi military inductees with special reference to soft-drink consumption, dental erosion, caries and fluorosis prevalences; a second aim of the study was to develop a system for assessing dental erosion. The material comprised a random selection of 95 individuals with a mean age of 20.9 years (range, 19-25 years). A questionnaire survey was made of each individual's dietary and oral hygiene habits and general and oral health, in addition to clinical, study cast, radiographic, and photographic examinations. The results showed that soft-drink consumption in the sample (x = 247 1/year) far exceeded that found in Western populations and that professional and self-administered dental care were generally scant. Twenty-eight percent of the maxillary anterior teeth showed pronounced dental erosion. Fluorosis was a common finding, and the number of untreated carious cavities was high. DMFT (mean = 10.0; DT = 7.7; MT = 0.5; FT = 1.8) and DMFS (mean = 18.3; DS = 12.6; MS = 2.5; FS = 3.2) were higher than those of comparable Western populations and showed an approximately threefold increase over a period of about 18 years as compared with that previously reported in a similar Saudi sample. In view of the high frequencies of dental erosion, untreated carious cavities, and fluorosis reported here and the strong indication of an increasing caries prevalence, the need for serious recognition of the implications in the planning of future dental health care program is stressed.

Adult↗

Cervical tooth wear and sensitivity: erosion, softening and rehardening of dentine; effects of pH, time and ultrasonication.

BACKGROUND: Cervical dentine wear is commonly observed and may be associated with dentine hypersensitivity. Erosion is thought to play a part in both conditions but compared to enamel has been little studied in dentine. AIM: The aims of these studies in vitro were to: (i) determine the effects of citric acid on dentine at different pH values and over time; (ii) measure the depth of dentine demineralisation or softening using ultrasonication; (iii) determine whether softened dentine can be remineralised or rehardened using artificial saliva. METHODS: Groups of flat dentine specimens prepared from unerupted human third molar teeth were: (a) exposed to citric acid at pH 3.2 for periods up to 4 h with mineral water as control; (b) exposed to citric acid at pH 2.54, 3.2, 4.5, 5.5 and 6.0 for 2 h and then subjected to ultrasonication stepwise up to 480 s; (c) exposed to citric acid at pH 2.54, 3.2, and 4.5, placed into artificial saliva for 24 h and then subjected to ultrasonication as in (b). Loss of dentine was measured by profilometry, after, each phase of erosion, ultrasonication and immersion in artificial saliva. RESULTS: Depth of erosion significantly increased non-linearly with time and significantly decreased with increasing pH. Ultrasonication had minimal albeit significant effects on control specimens. Removal of softened dentine increased with ultrasonication time. Depth of softening significantly increased with increasing erosion time to 2 h, plateauing at 2 microm. Depth of softening increased to 2 microm from pH 2.54 to pH 3.2 and decreased at higher pH values thereafter. 24 h in artificial saliva provided no protection to the soften zone against ultrasonicaion. Citric acid at all pH values and exposure times removed the dentine smear layer to expose tubules. Ultrasonication did not remove the smear layer on control specimens but removed all deposits formed after exposure to artificial saliva. CONCLUSION: It is concluded that dentine is susceptible to erosion even at relatively high pH, the tubule system is readily exposed and dentine, unlike enamel, shows little propensity to remineralise.

Analysis of Variance↗

Understanding wear in dentistry.

Tooth wear is an increasing problem in dentistry. Traditionally, it has been divided into three categories: abrasion, attrition, and erosion. However, most clinical cases of tooth wear involve more than one of these processes. It is often easier to make a diagnosis by looking for the signs of the fundamental wear processes rather than trying to categorize the individual case. Wear can be caused by direct surface-to-surface wear, an intervening slurry, or a corrosive environment. Wear occurs during mastication, but also at other times, often at night. Although it may be possible to institute a preventive regimen, this will not always help the patient if his or her prime concern is esthetics. The same processes that cause tooth wear will cause wear to restorative materials. To diagnose and prevent wear, its processes must be understood.

Adult↗

Skull pathology in East Greenland and Svalbard polar bears (Ursus maritimus) during 1892 to 2002 in relation to organochlorine pollution.

East Greenland and Svalbard polar bears (Ursus maritimus) are heavily polluted with long-range transported organochlorines such as PCBs (polychlorinated biphenyls). To investigate the negative health impacts, a time-trend study of skull pathology was conducted on 269 East Greenland and 241 Svalbard polar bears. The skulls were sampled during 1892-2002 and 1964-1992, respectively. Seven different pathological changes were found: adonti, displacement of teeth, caries, osseous proliferations, exostosis, tooth wear and periodontitis. Only tooth wear and periodontitis was in a prevalence that allowed statistical treatment. The most severe cases of tooth wear and periodontitis were accompanied by a substantial loss of alveolar bone structure. The prevalence of tooth wear and periodontitis increased significantly with age (p<0.001) with incisor wear being more severe than in canines, premolars and molars (p<0.001). No sex difference was found for tooth wear (p=0.22) while a significant difference between sexes was found for periodontitis (p=0.01) with males having higher prevalence than females (odds ratio of 2.5 for males:females). In East Greenland, the prevalence of tooth wear was significantly higher in polar bears collected in the pre pollution period (<1960) than in bears sampled during polluted periods (1960-1980 and 1981-2002) (p<0.001). Regarding periodontitis, the prevalence was not significantly different between pre-pollution and pollution periods (p=0.309). Polar bears from Svalbard had significantly higher prevalence of tooth wear (p<0.001) and periodontitis (p=0.02) than polar bears from East Greenland. The tooth wear and periodontitis odds ratios for Svalbard:East Greenland were 135 and 2.6, respectively. Hence, we found a clear age/sex link and geographical difference but no evidence for an association between skull pathology and exposure to organochlorines in East Greenland and Svalbard polar bears.

Animal Diseases↗

Occlusal wear of teeth and restorative materials. A review of classification, etiology, mechanisms of wear, and some aspects of restorative procedures.

This paper is a literature review of various aspects of the wear of occluding tooth surfaces. It presents classification and terminology of occlusal tooth wear, and discusses etiology and differential diagnosis. It may be difficult to differentiate among abrasion, attrition, and erosion because there is nearly always a combination of the various processes. These processes of wear are described, and the in vitro and in vivo wear of some restorative materials is discussed. Treatment of severe tooth wear is considered difficult; prophylactic measures are therefore important. Some guidelines for restorative treatment of patients with extensive occlusal tooth wear are given, with special emphasis on the type of treatment, the vertical dimension of occlusion, the space available, and choice of material for the restorations.

Dental Materials↗

[Tooth diseases in the medieval population of Gracanica near Valjevo].

The analyses of the pattern of dental disease in the Late Medieval Serbian population from cemetery excavations in the archaeological site Grachanica were based on the study of tooth wear, ante-mortem tooth loss, caries, hypoplasia, alveolar resorption, abscesses and calculus. The total sample of all available skeletons with almost complete permanent dentition numbers 45 individuals. Dental sample comprises 178 maxillary teeth and 337 mandibular teeth. The presence of dental caries was scored taking into consideration the size of the lesion (four degrees) and its position on the tooth. The degree of tooth wear was graded into one of four categories: atrition of enamel only; atrition involving dentin; atrition up to the level of fissure at the occlusal surface of the molar teeth, and exposure of the pulp chamber. The cystic defects within the alveolar bone were recorded according to their aetiology, size and position. Radiographic study had not been done in order to detect periapical destruction, so the presence of such destruction was recognizable in advanced stages associated with the appearance of fistula penetrating the compact alveolar bone usually at the buccal side. The condition of the alveolar crest resorption, as the evidence of periodontal disease, was graded into three categories, and the distance from the cemento-enamel junction to the alveolar crest was measured. The analysis of dental pathology profile consisted of the two reporting methods: individual count method (prevalence of disease based on the number of individuals affected) and tooth count method (distribution of lesions frequency on tooth type and class). The Grachanica dentition exhibits a dental pathology profile typical of agricultural medieval populations in this region. Tooth wear was the most frequent, affecting 95% of individuals. Dental caries and ante-mortem teeth loss exhibit also high frequency (51% and 69%). Dental pains of low prevalence include abscesses (13%) and enamel hypoplasia (20%). In the material examined, the carious process was responsible for pulp exposure to infection in all cases of abscess formation. The results obtained suggest that food processing technology and nature of diet allowed use of abrasive in the food and that oral hygiene was at the low level. On the other hand, there were not a lot of people who were subjected to stress-induced growth disruptures. The findings reported here contribute to understand how dietary change and life conditions are related to the changing patterns of dental diseases in medieval populations.

History, Medieval↗

Wear of teeth due to occupational exposure to airborne olivine dust.

OBJECTIVES: To clarify whether high tooth wear of employees in a mining industry that extracts the mineral olivine could be associated with airborne dust exposure in their working environment. METHOD: The cumulative exposure to airborne mineral dust for the workers in the company was calculated on the basis of their period of employment multiplied by the airborne olivine-dust concentrations, which have been monitored continuously during the past 20 years for all divisions of the company. After invitation, 85% of the employees (n = 191) were examined clinically and their dentitions were photographed and duplicated in plaster casts. Four clinicians, working independently, examined the sets of casts/photographs for tooth wear and ranked these from most to least. Two groups of employees were compared with regard to tooth wear, i.e. the 30% with the highest (case) and the lowest (control) estimated dust exposure levels. Tooth wear in the case and control groups was compared using a non-parametric test based on rankings (Mann-Whitney test). RESULTS: Tooth wear differed significantly between the workers in the low and the high mineral dust exposure groups (p < 0.001). The differences were also apparent within three age subsets, although statistical significance was reached only in the 34-44 years subset (p = 0.002). Considerable individual variation was noted within the three exposure groups. CONCLUSION: Workers with high exposure to airborne olivine dust may contract considerable tooth wear.

Adolescent↗

Tooth surface loss: does recreational drug use contribute?

OBJECTIVE: This pilot study was designed to measure tooth wear in a sample of 13 subjects who regularly use amphetamine-like drugs (Ecstasy, amphetamines) and compare the observed wear with a matched sample of nondrug users. DESIGN: The two groups, both composed of 13 undergraduate students, were matched for age and sex. Other factors influencing tooth wear were controlled by matching the groups on their responses to a questionnaire asking about recognised common causes of tooth wear. The participants teeth were examined and the degree of wear scored according to a tooth wear index. RESULTS: Severity of occlusal tooth wear of the lower first molar teeth was significantly greater in the drug user group than in the control group (P<0.05). No other statistically significant differences between the groups were found. CONCLUSION: Regular use of amphetamine-like drugs could be associated with increased posterior tooth wear.

Adolescent↗

Dental senescence in a long-lived primate links infant survival to rainfall.

Primates tend to be long-lived, and, except for humans, most primate females are able to reproduce into old age. Although aging in most mammals is accompanied by dental senescence due to advanced wear, primates have low-crowned teeth that wear down before old age. Because tooth wear alters crown features gradually, testing whether early dental senescence causes reproductive senescence has been difficult. To identify whether and when low-crowned teeth compromise reproductive success, we used a 20-year field study of Propithecus edwardsi, a rainforest lemur from Madagascar with a maximum lifespan of >27 years. We analyzed tooth wear in three dimensions with dental topographic analysis by using Geographical Information Systems (GIS) technology. We report that tooth wear exposes compensatory shearing blades that maintain dental function for 18 years. Beyond this age, female fertility remains high; however infants survive only if lactation seasons have elevated rainfall. Therefore, low-crowned teeth accommodate wear to a point, after which reproductive success closely tracks environmental fluctuations. These results suggest a tooth wear-determined, but rainfall-mediated, onset of reproductive senescence. Additionally, our study indicates that even subtle changes in climate may affect reproductive success of rainforest species.

Aging↗

The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders.

STATEMENT OF PROBLEM: It is unclear whether patients with temporomandibular disorders (TMD) who report high levels of bruxism have more severe signs and symptoms of TMD and more advanced tooth wear than patients with TMD who report lower levels of bruxism. PURPOSE: The purpose of this study was to determine whether there was a significant association between tooth wear, the parafunctional oral habit of bruxism, temporomandibular joint (TMJ) pain, and muscle pain severity in a TMD population. MATERIAL AND METHODS: A total of 84 subjects previously diagnosed with TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD) and who met 10 specific inclusion/exclusion criteria underwent a thorough multiaxial examination and classification recommended by the National Institute of Dental and Craniofacial Research (NIDCR). Measurement of tooth wear facets by use of a 4-point scale were graded in 10 zones on mandibular casts. One calibrated examiner performed all scoring. Bruxism was assessed in a standardized pretreatment questionnaire and in the dental history and interview (RDC/TMD) to indicate how frequently (0 = never to 3 = very often) subjects performed a list of oral habits, which included bruxism. The Kappa reliability coefficient (range from: -1.0 to 1.0) was used to correct for chance agreement, and was computed for each of the 10 study sites designated for rating. Subjects were also compared for muscle and joint pain. Muscle pain was a summed measure derived from the dental examination findings (range 0 to 20), calculated from the presence or absence of pain induced by palpation of 20 predetermined muscle sites. Similarly, joint pain was a summed measure of the presence or absence of pain in the TMJs induced by palpation of the joints on the outer surface and in the external auditory canal in 5 different positions of the mandible. A Pearson product-moment correlation was used to compute the summed severity of tooth wear and the subjects' age. Analysis of covariance was used to determine whether the number of wear facets was significantly higher in patients with TMD who reported a history of bruxism, compared with patients with TMD who reported no or minimal bruxism, after controlling for the effect of age. Multivariate analysis of variance was used to determine whether the number of painful muscles of mastication and joint sites on standardized examination were significantly higher in patients with TMD with a history of bruxism (alpha=.05). RESULTS: In the population tested, tooth wear was modestly correlated with age (r =.40, P<.001). Of the 84 subjects studied, 11.9% reported no bruxing activity, 32.1% reported some or occasional bruxing activity, and 47.6% had frequent bruxism activity; the remaining 8.4% were eliminated from analysis because they provided inconsistent responses. Bruxism activity was not correlated with muscle pain on palpation and was inversely associated with TMJ pain on palpation. Tooth wear was not significantly correlated with bruxism, TMJ pain, or muscle pain. CONCLUSIONS: In this TMD population, tooth wear factors did not differentiate patients with bruxism from those without. The amount of bruxism activity was not associated with more severe muscle pain and was associated with less pain in the TMJ on palpation.

Adult↗

Periodontal and dental lesions in raccoons from a farming and a recreational area in Illinois.

Dental health was evaluated in two populations of raccoons (Procyon lotor) in western Illinois (USA); one was from a rural agricultural area with low human density and the other from a nearby state park heavily used by humans and raccoons. From 1989 through 1993, 300 raccoons were live-trapped in the agricultural area and 246 raccoons were live-trapped in the park. Oral health was assessed using gingival and calculi indices and by measuring loss of attachment and tooth wear. Raccoons from the park were significantly older and smaller, but not thinner, than raccoons from the farmed area. Gingival and periodontal indices, tooth wear, tooth loss, and caries increased significantly from juveniles to yearlings to adults, at both sites. Males had higher levels of gingivitis and loss of periodontal attachment than females, but were similar on other dental measures. There were no seasonal differences between raccoons in dental indices. Animals with high scores for one oral measure tended to have high values for all indices. Dental health was generally good for juveniles and yearlings from both sites. Among adults, periodontal indices and the prevalence of caries were significantly higher in the park, but prevalence of broken or missing teeth was similar for both populations. There was no association between body condition, and a higher dental score or more missing or broken teeth.

Age Factors↗

Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related?

AIMS: The purpose of this study was to assess the prevalence of tooth wear, symptoms of reflux and salivary parameters in a group of patients referred for investigation of gastro-oesophageal reflux disease (GORD) compared with a group of control subjects. MATERIALS AND METHODS: Tooth wear, stimulated salivary flow rate and buffering capacity and symptoms of GORD were assessed in patients attending an Oesophageal Laboratory. Patients had manometry and 24-h pH tests, which are the gold standard for the diagnosis of GORD. Tooth wear was assessed using a modification of the Smith and Knight tooth wear index. The results were compared to those obtained from a group of controls with no symptoms of GORD. RESULTS: Patients with symptoms of GORD and those subsequently diagnosed with GORD had higher total and palatal tooth wear (p<0.05). The buffering capacity of the stimulated saliva from the control subjects was greater than patients with symptoms of GORD (p<0.001). Patients with hoarseness had a lower salivary flow rate compared with those with no hoarseness. CONCLUSIONS: Tooth wear involving dentine was more prevalent in patients complaining of symptoms of GORD and those diagnosed as having GORD following 24-h pH monitoring than controls. Patients had poorer salivary buffering capacity than control subjects. Patients complaining of hoarseness had lower salivary flow rate than controls.

Adult↗

Effect of food consistency on temporomandibular joint morphology: an experimental study in pigs.

AIMS: To investigate whether there are any correlations between increased masticatory loading, degree of tooth wear, and the size, form, and macroscopic surface of the temporomandibular joints (TMJs). METHODS: The degree of tooth wear and different TMJ variables were compared in 2 groups of domestic pigs. One group of 8 pigs had been raised indoors (ID group), and the other group of 9 pigs had been raised outdoors (OD group). The pigs in the ID group were fed a soft diet and were not provided any straw in their pens. The OD group was fed a solid diet and could also grub in the soil, resulting in an exposure to more abrasive components and to greater chewing demands. All pigs were sacrificed at the age of 22 months. RESULTS: The pigs in the OD group exhibited significantly more tooth wear compared to the ID group. No difference in mediolateral size of the condyles could be found between the 2 groups. Form and surface changes of the TMJs varied substantially between individuals, but not between the 2 groups. No correlation could be found between the degree of tooth wear and any of the TMJ variables. CONCLUSION: Exposure to a tougher diet containing more abrasive substances has a significant impact on the degree of tooth wear but seems to have no consequences either for the size of the TMJ condyles or for form or surface changes of the TMJs.

Animal Feed↗

Dental erosion, oral hygiene, and nutrition in eating disorders.

OBJECTIVE: To determine the influence of oral hygiene practices and additional fluoride on erosive tooth wear in eating disorders. The proportional dietary intake of carbohydrates, fats, and proteins was also investigated. METHOD: Tooth wear was measured with the use of the tooth wear index (TWI). All subjects completed a questionnaire on past dental history as well as a 1-week diet sheet. A total of 33 subjects participated in the study, 20 of whom were follow-ups, allowing the progress of dental erosion to be made. All subjects were referred from the Department of Clinical Psychology. RESULTS: Oral hygiene practices between subjects with and without severe erosion were not significantly different. Only 8 bulimics spent more time brushing after vomiting than at other times. The pH of vomitus from 6 subjects ranged between 2.9 and 5.0, with a mean of 3.8, well below the critical pH for enamel demineralization to occur. Of the 20 follow-up subjects, 12 (60%) exhibited worsening tooth wear. The mean values for daily carbohydrate, protein, and fat intake were not significantly different at baseline and at recall, and the proportional dietary intake was similar to recommended energy provision at 47%, 40%, and 13%, respectively. DISCUSSION: The contribution by toothbrush abrasion to the overall wear in the eroded dentition of bulimics is not significant. Therefore, immediate post-vomiting oral hygiene practices can be recommended. The proportional nutritional intake values of carbohydrates, fats, and proteins in this group of bulimics are acceptable.

Adult↗