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At least 325 records · Page 18Linked to original sources

PubMed2003

Dental erosion -- changing prevalence? A review of British National childrens' surveys.

OBJECTIVES: To investigate the change in the prevalence of dental erosion, over time, by a review of the data from the published national dental surveys of young people in the UK. A subsidiary objective was to investigate the relationship between erosion and possible associated risk factors. DESIGN: The review was based on cross-sectional prevalence studies incorporating a clinical dental examination and structured interviews. SAMPLE: The data were collated from the 1993 UK childrens' dental health survey and the dental report of the two National Diet and Nutrition Surveys (NDNS) of children aged 1(1/2)-4(1/2) in 1992/3 and 4-18 years in 1996/7. The criteria used for data collection were comparable between the three different studies. RESULTS: Comparing the data from the different studies, the prevalence of erosion was seen to increase from the time of the childrens' dental health survey in 1993 and the NDNS study of 4-18-year-olds in 1996/7. There was a trend towards a higher prevalence of erosion in children aged between 3(1/2) and 4(1/2) and in those who consumed carbonated drinks on most days compared with toddlers consuming these drinks less often. Drinks overnight were associated with an increased prevalence of erosion. More 4-6-year-olds with reported symptoms of gastro-oesophageal reflux had erosion compared with symptom-free children. On multivariate analysis, the strongest independent association with erosion was geography, with children living in the North having twice the odds of having erosion compared with those in London and the South-east. CONCLUSIONS: Comparing prevalence data from cross-sectional national studies indicates that dental erosion increases between different age cohorts of young people over time. Dietary associations with erosion are present but weak. Similarly, there is an association apparent between erosion, symptoms of gastro-oesophageal reflux and socio-demographic variables such as region of domicile, social class, and receipt of social benefits.

Adolescent↗

PubMed2002

Risk factors for dental erosion in 5-6 year old and 12-14 year old boys in Saudi Arabia.

MATERIAL AND METHODS: Dental examinations were carried out on 354 boys aged 5-6 years, and 862 boys aged 12-14 years, attending 40 schools in Riyadh. The prevalence of dental erosion was assessed using diagnostic criteria similar to those employed in the 1993 UK National Survey of Child Dental Health. RESULTS: Pronounced dental erosion (into dentine or dentine and pulp) was observed in 34% of 5-6 year olds and 26% of 12-14 year olds. Information on food and drink consumed and dietary habits was obtained by means of a questionnaire. Parents reported that 65% of 5-6 year old boys took a drink to bed. Water was the commonest drink consumed (37%) followed by carbonated soft drinks (21%). One third of parents reported that their son had something to eat in bed or during the night and 60% of this was sweet food or confectionery. Seventy per cent of 12-14 year old boys reported consuming drinks at night; these were mainly water (30%), carbonated soft drinks (27%) and tea or coffee, with sugar (18%). Forty-six per cent of the 12-14 year olds reported that they ate in bed at least once a week and 54% of this was sweet food or confectionery. When the dental examination and questionnaire results were correlated, a statistically significant relationship was found between the number of primary maxillary incisors with pronounced erosion of their palatal surfaces and the consumption of carbonated soft drinks at night (P=0.015). A significant relationship was also found between the number of permanent maxillary incisors with pronounced erosion on their palatal surfaces and the frequency of drinks at night (P=0.020), as well as the duration of drinks retained in the mouth (P=0.038). CONCLUSION: It is concluded that dental erosion is more common in the primary and permanent dentitions of Saudi Arabian boys compared with results for similar age groups from the United Kingdom.

Adolescent↗

PubMed2001

Oral rehabilitation of a bulimic patient: a case report.

Bulimia nervosa is among the most common health problems in contemporary society. It is a self-induced weight loss syndrome associated with distinct dental manifestations involving physical and psychologic symptoms. It is characterized by recurrent binge-purge episodes that occur at least once a day. This article describes the complete-mouth rehabilitation of a bulimic patient with a generalized enamel erosion of her dentition and a poor esthetic appearance. Porcelain-fused-to-metal restorations were used as the definitive treatment. Good esthetics and high self-esteem were the final results. Comprehensive restorative therapy was applied in this clinical case report to achieve both function and esthetics in a demanding situation.

Adult↗

PubMed1996

Prevention of progression of dental erosion by professional and individual prophylactic measures.

The key elements for the establishment of a preventive program for patients suffering from erosion are described on pathophysiologic grounds. These elements aim 1) to diminish frequency and severity of acid challenge, 2) enhance salivary flow, 3) to enhance acid resistance, remineralization and rehardening by fluoride application, 4) to offer chemical protection by buffering substances, 5) to minimize abrasion, 6) to offer mechanical protection. Recommendations for prophylactic measures are made as a conclusion and summarized in the form of check-lists.

Buffers↗

PubMed1994

A review of noncarious dental cervical lesions.

Noncarious dental cervical lesions are categorized as abrasions, attritions, erosions, or abfractions. From these destructive processes, hypersensitive dentin is a common sequela experienced by the dental patient. Cold air and tactile probing are among the stimuli that precipitate this reaction. A complete patient history and clinical evaluation are essential for an accurate diagnosis. Treatment measures for hypersensitive dentin include restoring the lesion with composite resin or glass-ionomer material, the application of dentin bonding agents and/or fluoride, and iontophoresis therapy.

Dentin Sensitivity↗

PubMed1998

Gastroesophageal reflux in children and its relationship to erosion of primary and permanent teeth.

Gastroesophageal reflux (GOR) is often a self-limiting condition but nevertheless is a common cause of morbidity in childhood. Studies of adult patients with hiatus hernias and GOR have suggested that there is an increased incidence of dental erosion in these individuals. The aim of this study was to investigate the relationship between dental erosion and GOR in children. Fifty-three children aged 2 to 16 yr (mean 4.9 yr) with moderate to severe GOR, defined by pH monitoring, were examined for dental erosion. A questionnaire investigating dietary habits, other relevant medical conditions, and erosion risk factors was also completed. Results showed that the prevalence of dental erosion was low, when compared with the UK National Survey, with only 9 (17%) children showing any signs of erosion, and of these only one had erosion involving dentine. These results suggest that dental erosion may not be as great a problem in children with GOR as it is in adults. It may be that refluxing is limited to the oesophagus, and further work is needed to investigate those children that positively reflux into the mouth.

Adolescent↗

PubMed2000

Relative susceptibility of deciduous and permanent dental hard tissues to erosion by a low pH fruit drink in vitro.

OBJECTIVES: The objectives of this study were two-fold: (1) to determine (by surfometry) loss of deciduous and permanent enamel and dentine following 15days' exposure to a single low pH orange drink; and (2) to determine (by surfometry) loss of deciduous and permanent enamel and dentine following exposure to the product 2 versus 4 times per day for 15days. METHODS: This in vitro study employed the validated methodology described by West and co-workers [Journal of Dentistry, 1998;26:329-335.] RESULTS: In all four tissues, erosion was progressive over time, though this pattern was more linear in enamel than in dentine. In general, erosion of enamel was greater in the deciduous tissue, while erosion of dentine was greater in the permanent tissue. However, these differences were rarely of statistical significance. Increasing frequency of exposure resulted in a non-proportional increase in tissue loss. CONCLUSIONS: Differences in susceptibility of deciduous and permanent tissues to erosion by a low pH drink in vitro appear to exist, though these may not be of statistical significance. Care may be indicated in the delivery of dietary advice, since reduced frequency of exposure to a low pH drink does not appear to result in a proportional reduction in tissue loss.

Adolescent↗

PubMed1990

Root lesions.

In the elderly, but increasingly also in middle-aged patients, root lesions are a major problem in everyday practice. Formerly, the cause of these root destructions was usually caries attack due to a failure of patients to practise adequate oral hygiene measures. However, with increasing dental motivation and health consciousness, patients--for example in the USA, Scandinavian countries and Switzerland--cause such lesions by vigorous, badly controlled brushing, often in combination with the consumption of 'healthy' vegetarian, erosive diets. The former problem of carious root destruction due to neglect thus seems to be gradually being replaced by the problem that self-care is not yet thoroughly understood, is exaggerated and is technically inadequate. Faulty brushing may result in severe damage to those gingival sites that require attention cariologically as well as periodontologically. To exploit all possibilities of (secondary) preventive management of patients, careful investigation and analysis of the clinical signs is required to identify the aetiology of the lesions in each case. Fortunately, therapeutic management of root lesions, regardless of their aetiology, is facilitated by modern restorative techniques and materials.

Aged↗

PubMed1995

The 1993 national survey of children's dental health.

The 1993 national survey report shows encouraging evidence of general improvements in children's dental health compared with earlier surveys in 1973 and 1983. There have been dramatic declines in dental caries at all ages and this is evident in the different parts of the United Kingdom and in all social classes. However, among 5-year-old children average caries levels have remained unchanged since 1983, although a higher proportion now have no known decay experience. The amount of decay treated by restoration as a proportion of total caries experience has fallen in all age groups and the disease appears to be becoming concentrated at higher levels in a diminishing number of children who are not obtaining dental care. A disturbing finding was the high prevalence of dental erosion, particularly in the primary dentition. Other findings included more than half of children in Scotland and Northern Ireland having fissure sealants, improved parental knowledge about preventing dental disease, reduced numbers of orthodontic extractions and a reduction of one-third in the rate of traumatised permanent incisors. Children must be regarded as the number one priority for dental services in order to safeguard the dental health of rising generations, and renewed efforts must be made to further reduce their disease levels through population based preventive measures.

Adolescent↗

PubMedDate not supplied

Effect of time on the remineralisation of enamel by synthetic saliva after citric acid erosion.

The aim of this in vitro study was to determine the influence of remineralisation time on rehardening of surface-softened enamel after citric acid erosion. Seven groups of 13 samples of human enamel were eroded in 0.3% citric acid at pH 3.2 for 2 h followed by profilometric measurements. Individual groups of specimens were placed in artificial saliva for 1, 2, 4, 6, 9 or 24 h. A control group was placed in isotonic saline for 24 h. After new profilometric measurements samples were ultrasonicated stepwise up to 480 s with profilometric measurements performed at 5, 30, 120, 240 and 480 s to measure the depth of surface softening. The control group had a softened surface layer of mean thickness 2.9 microm. Mineral deposition was seen at all remineralisation times by scanning electron microscopy. Exposure to artificial saliva for 1, 2 or 4 h produced a partial rehardening of the softened enamel; the additional surface losses produced by ultrasonication were lower and time delayed compared to the control group. Specimens remineralised for 6, 9 and 24 h showed little evidence of surface loss after ultrasonication. The data suggest that a complete rehardening of the softened enamel in vitro is reached after a remineralisation time of 6 h. These data are of clinical relevance to tooth wear. However, there is a need for studies in situ of enamel demineralisation and remineralisation.

Analysis of Variance↗

PubMedDate not supplied

In vitro and clinical evaluations of a dentin bonding system with a dentin primer.

The purpose of this study was to investigate the effect of a dentin primer in improving dentin-to-composite bond strengths mediated by a dentin adhesive. The investigation consisted of both an in vitro tensile bond test, in which fresh bovine dentin was used, and clinical evaluation. In the in vitro bond test, bovine dentin surfaces were treated with the primer (an aqueous solution of HEMA) for different durations (10, 20, 30, and 60 seconds) prior to bonding of the light-cured adhesive and placement of a light-cured composite material. For the clinical evaluation, a total of 33 cervical erosion lesions were restored with the combination of the primer, the adhesive, and the composite. To comply with ADA requirements for the acceptance program of dentin-bonding agents, no enamel etching nor any mechanical retentive locks were performed in those restorations. Significant increases in bond strength were obtained in specimens treated with the primer. Regarding the clinical evaluations in which 30 restorations were available for the 6-month recall and 15 restorations were also available for the 1-year recall, all samples demonstrated a retentive rate of 100%.

Adult↗

PubMedDate not supplied

Use of variable remineralization periods to improve the abrasion resistance of previously eroded enamel.

The objective of the study was to evaluate the period of remineralization needed to re-establish the resistance of eroded enamel against brushing abrasion. Enamel specimens were prepared from 84 polished bovine incisors. The samples were evenly distributed among 7 groups (A-G) and submitted to ten alternating de- and remineralization cycles which included abrasion by toothbrushing. Demineralization was accomplished by immersing the specimens in the erosive soft drink Sprite Light((R)) for 1 min. Remineralization was performed by storing the samples in artificial saliva for either 0 min (A), 10 min (B), 60 min (C) or 240 min (D). After each remineralization, the specimens were brushed in an automatic brushing machine. Group E (erosion and 240 min remineralization, but no brushing) group F (erosion, but no remineralization and no brushing), and group G (brushing, but no erosion and no remineralization) served as controls. After performing the cycles, loss of enamel was determined by profilometry. The following values (mean +/- SD) were obtained and statistically analyzed (p<0.05): group A (5.16+/-1.26 microm), B (2.47+/-0.68 microm), C (1.72+/-0.75 microm), D (1.11+/-0.42 microm), E (0.81+/-0. 23 microm), F (1.04+/-0.31 microm), G (0.22+/-0.15 microm). Only the differences between groups D, E, and F were statistically not significant. Under the chosen in vitro conditions, it is concluded that abrasion resistance of eroded enamel continuously increases with remineralization time. However, even after a period of 1 h of remineralization, abrasion of previously eroded enamel is increased

Analysis of Variance↗

PubMed1993

A comparative analysis of techniques of restoring cervical lesions.

There are several methods of restoring cervical abrasion or erosion lesions, including the use of composite resin, glass-ionomer cement, or a combination of these materials. This paper reports the effectiveness of three different materials and techniques in restoring cervical lesions, using marginal leakage as the means of comparison. Wedge-shaped cervical cavities were prepared so that the gingival cavosurface margin of each cavity involved dentin. Half of the specimens in each group were thermocycled. Differences in marginal leakage were more pronounced at the gingival margin. There was no significant difference between the leakage of thermocycled and nonthermocycled specimens. Microleakage can be expected to be minimal in cavities restored with the "sandwich" technique, in which a glass-ionomer cement liner and composite resin restorative material are placed.

Composite Resins↗

PubMed2001

The oral health of children with clefts of the lip, palate, or both.

OBJECTIVE: The purpose of this study was to assess the prevalence of dental caries, developmental defects of enamel, and related factors in children with clefts. DESIGN: This cross-sectional prevalence study used standard dental indices for assessment. SETTING: Children underwent a dental examination under standard conditions of seating and lighting in the outpatient department of a dental hospital as part of an ongoing audit to monitor clinical outcomes. PARTICIPANTS: Ninety-one children aged 4, 8, and 12 years were included in the study. OUTCOME MEASUREMENTS: Dental caries were assessed by use of the decayed, missing, and filled index for primary teeth (dmft); Decayed, Missing, and Filled index for permanent teeth (DMFT) according to the criteria as used in the national survey of children's dental health in the United Kingdom. Developmental defects were assessed using the modified Developmental Defects of Enamel Index (Clarkson and O'Mullane, 1989). Dental erosion was assessed using the criteria derived for the national survey of children's dental health. RESULTS: Caries prevalence increased with age; 63% of patients at 4 years and 34% at 12 years were caries free. The mean dmft for the 4-year-olds was 1.3 with a mean DMFT for the 12-year-olds of 1.8. All the 4-year-olds had evidence of erosion of enamel in the primary teeth (incisors and first molars) and 56% of the 12-year-olds had erosion of permanent teeth (incisors and first permanent molars). Developmental defects of enamel became more prevalent with age, with at least one opacity in 56% of 4-year-olds and 100% of 12-year-olds. Hypoplasia was not found in the primary dentition but affected permanent teeth in 38% of 8-year-olds and 23% of the 12-year-olds. CONCLUSION: This study has shown that dental disease is prevalent in these patients. These assessments not only provide a baseline on oral health parameters in young people with clefts but underline the need for a more aggressive approach to prevention of oral disease to optimize clinical outcome.

Age Factors↗

PubMed1997

Salivary parameters of relevance for assessing caries activity in individuals and populations.

A review of the non-microbial salivary parameters with respect to their possible association with caries activity is presented. The parameters are limited to those which already are or at least in the near future will obviously be simple enough, also for clinical purposes. Salivary flow rate is undoubtedly the most important single parameter since the cariostatic activity or efficacy of practically all other salivary parameters depends on the flow rate. Flow rate as such has no linear association with dental caries but there seems to exist an individual "threshold" limit which is decisive for enhanced caries activity. This threshold limit varies among different individuals and therefore the so-called normal values for unstimulated or stimulated flow rate are more reliable on a population level than among individuals for screening purposes. In any individual a regular and longitudinal follow-up of the flow rate is of higher clinical value than only a single cross-sectional measurement. Salivary buffer effect has only a weak negative association with caries activity and again, this effect is of greater clinical significance on a population level. Since the decisive processes in caries attack occur within or under the dental plaque, the buffering effect of saliva is limited and obviously more important to screen for erosion-than caries-prone individuals. Although important for dental health, none of the salivary antimicrobial agents as such has shown any strong association with caries activity. The only ones with some evidence of a regulatory role are secretory IgA antibodies, hypothiocyanite ions, and agglutinins. However, the data are controversial and it seems that instead of measuring individual parameters, the assessment of saliva's functional properties (such as the ability to aggregate bacteria, prevent their adhesion to hydroxyapatite or sugar metabolism etc.) is more important for clinical purposes. Of the parameters involved in de- and remineralization process, only salivary fluoride content has some association with caries susceptibility but its diagnostic or predictive value is questionable.

Agglutinins↗

PubMed2006

Influence of rotating-oscillating, sonic and ultrasonic action of power toothbrushes on abrasion of sound and eroded dentine.

OBJECTIVE: This in vitro study aimed to evaluate the susceptibility of sound and eroded dentine to brushing abrasion performed by different rotating-oscillating, sonic and ultrasonic toothbrushes. METHODS: Toothbrushing abrasion (20 cycles, each 30 s) was applied to bovine dentine samples (each subgroup n = 10) exhibiting both a demineralized (each cycle: 1% citric acid, pH: 2.3, 60 s; 30 min remineralization in artificial saliva) and a sound surface area. Toothbrushing was performed in an automatic brushing machine with the rotating-oscillating, sonic and ultrasonic toothbrushes either (a) activated, supplemented by 20 strokes/min of the brushing machine, (b) inactivated, supplemented by 20 strokes/min of the brushing machine or (c) inactivated, supplemented by 80 strokes/min of the brushing machine. A manual toothbrush was applied with 20, 80 or 100 linear strokes/min. Specimens of the control group were not brushed after erosion. After each cycle, the samples were stored in artificial saliva for 4 h. After 20 cycles, loss of sound and softened dentine was determined by profilometry. Mann-Whitney-Wilcoxon test and Bonferroni corrections were applied to the data (p < 0.05). RESULTS: For all groups, demineralized dentin areas exhibited significantly higher abrasion values than the respective sound dentine surfaces. However, mean dentine loss of both softened and sound dentine was higher after use of the rotating-oscillating, sonic and ultrasonic brushes with the activated regime [(a) eroded dentine: 9.94-16.45 microm; sound dentine: 3.31-5.47 microm] than after brushing with the inactivated regimes [(b) eroded dentine: 5.10-5.62 microm; sound dentine: 1.16-1.81 microm; (c) eroded dentin: 7.64-8.89 microm; sound dentine: 1.38-1.69 microm]. CONCLUSION: The results indicate that rotating-oscillating, sonic or ultrasonic action of the power toothbrushes leads to an increased loss of demineralized and sound dentine.

Animals↗

PubMed2003

Abrasive wear on eroded root dentine after different periods of exposure to saliva in situ.

The effect of salivary exposure time on the abrasive wear of acid-eroded dentine was evaluated in situ. One-hundred and twenty bovine root dentine slabs were randomly assigned into six groups (A-F) and placed in intraoral palatal devices, which were worn by 10 volunteers for 4 d. On the first day, no erosive/abrasive procedures were carried out. On the following 3 d, erosive challenges were performed extraorally, two times per day, by immersing the device for 90 s in a soft drink. Subsequently, the group A specimens were immediately brushed (40 strokes), and the others were brushed after the following times: B, 20 min; C, 40 min; and D, 60 min. Group E specimens were only acid-eroded and those of group F were only brushed. Dentine wear was measured with a profilometer. anova and Dunnett's test showed that groups A-D did not differ statistically from the control group E but differed from the control group F. The lowest mean value was found for group F. Regression analysis was unable to show salivary effect on dentine wear reduction. The data suggest that the exposure time of saliva of up to 60 min has no effect on reducing the eroded dentine wear by toothbrushing.

Adult↗

PubMed1999

In vitro quantitative microhardness assessment of enamel with early salivary pellicles after exposure to an eroding cola drink.

To assess the erosive effect of a cola drink on enamel incorporating early salivary pellicles, 72 groups of human enamel slabs were immersed in fresh cola, with groups differing in that slabs were (1) incubated in whole or in clarified saliva, (2) under three regimes of frequency intake (1, 5 and 10 times/day); (3) immersed with or without agitation, and (4) the pellicle was incubated for 20 min, 6 or 24 h. Quantitative assessments were done over an 8-day interval using surface microhardness testing. Results for primary enamel showed a sharp decrease from baseline (344.2+/-32.4 Vickers Units; mean +/-SD) to day 1 (268.9+/-36.8), and reached 155.2+/-68.6 on day 8. Results for permanent enamel were 350.8+/-42.2, 315.9+/-39.2, and 149.8+/-85.2. Microhardness was affected by agitation, level of intake and type of saliva, but not by the pellicle incubation interval nor the type of enamel. The joint effect of static baths and higher immersion frequency was the most important factor in decreasing hardness.

Adult↗