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Severity, distribution, and correlates of occlusal tooth wear in a sample of Mexican-American and European-American adults.

PURPOSE: The objective of this study was to determine the severity, distribution, and correlates of tooth wear in a sample of Mexican-American and European-American adults drawn from a community-based longitudinal aging study on oral health. MATERIALS AND METHODS: The maxillary teeth of 71 subjects enrolled in a longitudinal aging study were assessed using a previously introduced five-point (0 to 4) ordinal scoring system in which each tooth is given a score describing the severity of wear. The tooth wear scores were compared with data concerning demographic factors, functional/parafunctional habits, soft drink consumption, and bite force measurements to determine specific correlates of tooth wear. RESULTS: The mean wear score for all teeth was 1.50 on the five-point scale. There was a significant difference between the mean wear score of anterior teeth (1.85) and posterior teeth (1.17). Bivariate analyses detected a moderate degree of correlation between maxillary tooth wear and age and bite force. Maxillary tooth wear was significantly greater in males and in subjects with reported teeth clenching/grinding. Multivariate analyses revealed that age, gender, bite force, self-reported teeth clenching/grinding, and number of daily meals/snacks had significant correlations with maxillary tooth wear. CONCLUSION: The overall severity of maxillary tooth wear in this sample of Mexican-American and European-American adults was low, with anterior teeth having a greater degree of wear than posterior teeth. Age, gender, bite force, teeth clenching/grinding, and number of daily meals/snacks are potential factors that may have contributed to tooth wear in the study sample.

Adult↗

[Experimental study on selecting optimal time of orthodontic tooth movement into extraction sites].

OBJECTIVE: The purpose of this study was to investigate the physiological process of healing after tooth extraction and the biological reaction of tooth movement into extraction sites with the aim of selecting optimal time of tooth movement into extraction sites clinically. METHODS: Extraction of upper first molars were performed on 30 male Sprague-Dawley rats which were divided equally into 5 groups. Orthodontic appliance was placed at different time after tooth extraction in order to move the maxillary second molars mesially into the extraction spaces. The animals were injected continuously with tetracycline and calcein for two days before appliance activation and animal sacrifice. Undecalcified mesio-distal specimans 65-100 microns of thickness were prepared. The quantification of bone remodeling parameters on tooth movement into extraction sites at different time was performed by histomorphometric measurements and computer image analysis. RESULTS: 1. The bone turnover had two bone modeling processes: resorption under pressure and formation in tension. 2. The bone resorption was more active on the mesial surface (pressure side) than that on the distal surface (tension side). While bone formation was more active on the distal surface (tension side) than that on the mesial surface (pressure side). 3. Both the resorptive parameters and the formative parameters across time were manifested by a peak at day 7 after tooth extraction. CONCLUSION: 1. Orthodontic retraction into extraction sites should be initiated at an early stage after tooth extraction, so that the advantage of bone remodeling in extraction sites was used. 2. The optimal time of tooth movement into extraction sites clinically was about a week after tooth extraction.

Animals↗

A retrospective study on the approach to the tooth in the fracture line of the mandible.

UNLABELLED: The presence of a tooth in the fracture line constitutes a specific problem in mandibular fractures. Therefore, our objective was to characterize the approach to teeth in the fracture line used in the Department of Maxillofacial Surgery, Plovdiv, by retrospectively investigating the association between various preoperative factors and the decision to extract or preserve the tooth. MATERIAL AND METHODS: The following variables were studied based on data from available hospital records: 1) gender and age of patients; 2) local preoperative infections; 3) time from trauma to treatment; 4) degree of fracture displacement; 5) relationship between tooth and fracture line; 6) periapical pathology; 7) periodontal diseases; 8) type of tooth in the fracture line; 9) degree of eruption; 10) method of treatment. RESULTS: 593 fractures with a tooth in the fracture line were included in the study. The tooth was preserved in 69.90 +/- 0.14% of the cases, it was extracted in 29.30 +/- 1.91% and exarticulated in 0.80 +/- 0.38% of all fracture lines. The results demonstrated the existing association between the studied variables and the decision to extract or preserve the tooth. Extraction was generally preferred in the following cases: if a local preoperative infection was present; the time from trauma to treatment was more than 72 hours; there was a significant displacement of the fracture; the dental root was fractured; periapical pathology or periodontal disease was present; the tooth was multi-rooted; or treatment consisted of open reduction and internal fixation. CONCLUSIONS: Making a decision to extract or preserve the tooth in the fracture line is a complex process. Each case, therefore, should be approached individually.

Adolescent↗

Tooth wear among psychiatric patients: prevalence, distribution, and associated factors.

PURPOSE: The purpose of this study was to evaluate the prevalence, distribution, and associated factors of tooth wear among psychiatric patients. MATERIALS AND METHODS: Tooth wear was evaluated using the tooth wear index with scores ranging from 0 to 4. The presence of predisposing factors was recorded in 143 psychiatric patients attending the outpatient clinic at the Prince Rashed Hospital in northern Jordan. RESULTS: The prevalence of a tooth wear score of 3 in at least one tooth was 90.9%. Patients in the age group 16 to 25 had the lowest prevalence (78.6%) of tooth wear. Increasing age was found to be a significant risk factor for the prevalence of tooth wear (P < .005). The occlusal/incisal surfaces were the most affected by wear, with mandibular teeth being more affected than maxillary teeth, followed by the palatal surface of the maxillary anterior teeth and then the buccal/labial surface of the mandibular teeth. The factors found to be associated with tooth wear were age, retirement and unemployment, masseter muscle pain, depression, and anxiety. CONCLUSION: Patients' psychiatric condition and prescribed medication may be considered factors that influence tooth wear.

Adolescent↗

Innervation of mouse molars during the early states of tooth germ development.

The topography of nerves and first molar tooth germs in 11-14-day embryos was studied using silver-impregnated serial sections. Nerve fibers growing toward the developing tooth germ became visible on the 12th day, while the first sign of molar tooth differentiation was found as a thickening of the oral epithelium in 11-day embryos. From the 12th to 13th day the nerve fibers spread, forming a plexus close to the base of the tooth bud, and on the 14th day some entered into the dental follicle of the tooth germ at the early cap stage. However, no nerve fiber was found growing into the dental papilla during the observation period. The observations showed that the earliest nerve fibers running toward the tooth forming area appeared after the histogenesis of the tooth germ started, and the timing and pattern of the innervation of the tooth germs revealed that tooth germs are a useful model for investigating the mechanism of nerve growth into developing peripheral organs.

Animals↗

Two-year incidence of tooth loss among South Australians aged 60+ years.

UNLABELLED: Tooth loss diminishes oral function and quality of life, and national health targets aim to reduce population levels of tooth loss. OBJECTIVES: The purpose of this study was to determine tooth loss incidence and predictors of tooth loss among older adults in South Australia. METHODS: Data were obtained from a cohort study of a stratified random sample of community-dwelling dentate people aged 60+ years. Interviews and oral examinations were conducted among 911 individuals at baseline and among 693 of them (76.1%) 2 years later. Incidence rates and relative risks were calculated for population subgroups and multivariate logistic regression was used to construct risk prediction models. A method was developed to calculate 95% confidence intervals (95% CI) for relative risks (RR) from logistic regression models using a Taylor series approximation. RESULTS: Some 19.5% (95% CI = 15.4-23.6%) of people lost one or more teeth during the 2 years. Men, people with a recent extraction, people who brushed their teeth infrequently, smokers and people born outside Australia had significantly (P < 0.05) greater risk of tooth loss. Baseline clinical predictors of tooth loss included more missing teeth, retained roots, decayed root surfaces, periodontal pockets and periodontal recession. In a multivariate model that controlled for baseline clinical predictors, former smokers (RR = 2.55, 95% CI = 1.48-4.40) and current smokers (RR = 2.06, 95% CI = 0.92-4.62) had similarly elevated risks of tooth loss compared with non-smokers. CONCLUSIONS: The findings from this population suggest that a history of smoking contributes to tooth loss through mechanisms in addition to clinical disease processes alone.

Cohort Studies↗

Mesiodistal tooth crown dimensions of the primary dentition: a worldwide survey.

This analysis reports on a spatial-temporal survey of published studies of primary tooth crown dimensions in humans (80 samples). Mesiodistal data are analyzed for the 10 tooth crown dimensions. The purpose was to evaluate the numerous case reports (descriptive analyses of single samples) in the literature in order to assess patterning of variation 1) in tooth size, 2) among tooth types, 3) across sexes, 4) with space (historical affinity), and 5) with time. Sexual dimorphism is low in the primary dentition, averaging 2% across all 10 tooth types. All size distributions of the samples are positively skewed because of megadont native Australians. Europeans, who are most frequently represented in the literature, have the smallest tooth crowns of any continental grouping assessed. The method by Darroch Mosimann ([1985] Biometrika 72:241-252) of reducing size effects was used, basically standardizing the data variable-wise, and then ordinating groups on their factor scores. Principal components analysis produced just two canonical axes: overall size (68%) and a front-back (i1-i2-c vs. m1-m2) polarity (11%), based on the intergroup (not ontogenetic) covariance matrix. This second component discriminates between groups with relatively large anterior teeth (Europeans) and those where relatively more tooth substance is apportioned to the molars (Africans and Asians). Size differences predominate over shape between sexes from the same groups. Europeans have small teeth with comparatively large anterior dimensions. Asian and sub-Saharan African samples share features of average crown size but large cheek teeth. Indian and European samples show considerable overlap on both canonical axes, with average size overall but comparatively large anterior teeth. The few Amerindian samples are too variable to characterize. Based on comparisons of archaeological and living samples, tooth size reductions are documented here for Europe, India, and the Near East compared to tooth sizes of Neolithic and Mesolithic samples. The temporal changes parallel those documented elsewhere for the permanent dentition. The biological and anthropological relevance of these distributions is discussed.

Dentition↗

Application of lentivirus-mediated RNAi in studying gene function in mammalian tooth development.

RNA interference (RNAi) has recently become a powerful tool to silence gene expression in mammalian cells, but its application in assessing gene function in mammalian developing organs remains highly limited. Here we describe several unique developmental properties of the mouse molar germ. Embryonic molar mesenchyme, but not the incisor mesenchyme, once dissociated into single cell suspension and re-aggregated, retains its odontogenic potential, the capability of a tissue to instruct an adjacent tissue to initiate tooth formation. Dissociated molar mesenchymal cells, even after being plated in cell culture, retain odontogenic competence, the capability of a tissue to respond to odontogenic signals and to support tooth formation. Most interestingly, while dissociated epithelial and mesenchymal cells of molar tooth germ are mixed and re-aggregated, the epithelial cells are able to sort out from the mesenchymal cells and organize into a well-defined dental epithelial structure, leading to the formation of a well-differentiated tooth organ after sub-renal culture. These unique molar developmental properties allow us to develop a strategy using a lentivirus-mediated RNAi approach to silence gene expression in dental mesenchymal cells and assess gene function in tooth development. We show that knockdown of Msx1 or Dlx2 expression in the dental mesenchyme faithfully recapitulates the tooth phenotype of their targeted mutant mice. Silencing of Barx1 expression in the dental mesenchyme causes an arrest of tooth development at the bud stage, demonstrating a crucial role for Barx1 in tooth formation. Our studies have established a reliable and rapid assay that would permit large-scale analysis of gene function in mammalian tooth development.

Animals↗

From conical to spatulate: intra- and interspecific changes in tooth shape in closely related cichlids (Teleostei; Cichlidae: Eretmodini).

The Eretmodini are closely related cichlids endemic to Lake Tanganyika with very divergent oral tooth shapes, ranging from spatulate in Eretmodus to conical in Tanganicodus. To study how closely related cichlids can generate such divergent tooth shapes, we investigated how the enamel organ directs the development of spatulate teeth in Eretmodus cf. cyanostictus (lineage A), both in ontogeny and in adults, and of conical teeth in adult Tanganicodus cf. irsacae, using 3D-reconstructions from serially sectioned tooth germs. The spatulate oral tooth shape that characterizes adult E. cf. cyanostictus (lineage A) is preceded early in ontogeny by a conical tooth shape. We propose two possible hypotheses to account for changes in the folding of the enamel organ (in particular its epithelio-mesenchymal boundary) capable of generating such distinct tooth shapes. Different arguments lead us to favor the hypothesis of an asymmetric growth and differentiation of the enamel organ, such that the tip of a conical tooth corresponds to one "corner" of a spatulate tooth. Applying current molecular models of tooth shape variation, this would imply the existence of asymmetric fields of inhibition. Whether such asymmetric growth reflects the reutilization of a simple mechanism operating in ontogeny has to be clarified.

Adaptation, Biological↗

Tooth-type specific expression of dHAND/Hand2: possible involvement in murine lower incisor morphogenesis.

dHAND/Hand2 is a basic helix-loop-helix transcription factor required for the development of the heart, pharyngeal arches, and vasculature and is expressed during embryogenesis. However, there are no reports on the involvement of the dHAND gene in tooth development. In the present study, the expression of dHAND was examined in developing tooth germs of mice. The dHAND gene was expressed in the mesenchyme of the presumptive incisor region of the lower jaw at an early stage and in the mesenchyme of the lower incisor tooth germ at a later stage. However, the dHAND gene was not expressed in the upper incisor region or the upper and lower molar regions during jaw development. Treatment of tooth germ explants of lower incisors with antisense oligodeoxinucleotide (ODN) against dHAND prevented the differentiation of tooth germ cells, including ameloblasts and odontoblasts, the formation of dentin and enamel, and the proliferation of tooth germ cells and increased the apoptosis of tooth germ cells, suggesting that dHAND is essential for these cells during development. On the other hand, the treatment of tooth germ explants of upper incisor and upper or lower molars did not induce severe effects on their development. Treatment of the explants with basic fibroblast growth factor in association with antisense ODN partially rescued them from the effects of antisense ODN. The present results suggest that the dHAND gene plays important roles in type-specific development of lower incisors, and that basic fibroblast growth factor is involved downstream of the dHAND pathway in tooth germ cells.

Ameloblasts↗

Decelerating and sex-dependent tooth wear in Norwegian red deer.

In ungulates, tooth wear is often suggested as a proximate cause of senescence. Tooth wear is expected to be sex-dependent since energetic requirements and food selection varies largely between sexes in sexually dimorphic ungulates. Furthermore, tooth wear may lower mastication efficiency, and we predict a negative correlation between tooth wear and body weight or condition. We tested these predictions on data on tooth wear (estimated as height of first molar) of 1,311 male and 1,348 female red deer ( Cervus elaphus) aged 3-25 years and harvested along the west coast of Norway. The rate of tooth wear decreased with age. Males wear teeth at a higher rate (from 0.61 mm/year in 4-year olds to 0.45 mm/year in 11-year olds) than females (from 0.52 mm/year in 4-year olds to 0.39 mm/year in 11-year olds). Molar height correlated positively with body weight in both sexes, but not after adjusting for body size. Molar height was strongly dependent on body size in 3-year-old individuals (when tooth wear is minimal). Earlier reports in the literature of a positive correlation between tooth height and body weight may therefore be due to initial size differences rather than differences in condition due to tooth wear.

Aging↗

Temporal changes in the distribution and number of macrophage-lineage cells in the periodontal membrane of the rat molar in response to experimental tooth movement.

In order to evaluate the possible role of macrophages in the remodelling of periodontal tissue in response to tooth movement, temporal changes in the number and distribution of macrophage-lineage cells in the periodontal membrane of the rat molar tooth after experimental tooth movement were examined immunohistochemically using four anti-rat monoclonal antibodies: ED1 (anti-monocyte/macrophage-lineage cells and dendritic cells), ED2 (anti-resident macrophages), KI-M2R (anti-tissue macrophages), and OX6 (anti-class II molecules). The right maxillary first molar tooth of Wistar rats was moved mesially by a closed-coil spring for 1, 3, 5, or 7 days. Sham-treated rats wearing an inactivated appliance for each experimental period and entirely untreated rats were used as controls. Alternate horizontal serial cryostat sections were cut and incubated with antibodies to ED1, ED2, KI-M2R, and OX6. In addition, cells immunopositive for each monoclonal antibody in the periodontal membrane during tooth movement were analysed on the tension and pressure sides. In the control rats, large numbers of cells positively stained with each monoclonal antibody were distributed throughout the periodontal membrane surrounding the distobuccal root. At 1 day after experimental tooth movement, the number of immunopositive cells obtained with all four monoclonal antibodies decreased as compared with those of the control on the mesial/pressure side. During the later experimental time periods, ED1- and OX6-positive cells in the periodontal membrane of this side were significantly increased in number compared with controls, whereas the density and distribution pattern of cells positive with ED2 or KI-M2R remained unchanged. On the mesial/pressure side, which underwent hyalinization, a marked accumulation of OX6- and ED1-reactive cells, but not of ED2- or KI-M2R-reactive cells, was frequently observed in the area of the hyalinized tissue at 5-7 days after the start of tooth movement. On the distal/tension side, no particular change in the distribution of immunopositive cells obtained with any antibody was detected throughout the experimental periods, with the exception that there was a significant increase in the number of ED1-positive cells and in of OX6-positive cells at 1 and 7 days, respectively, after the start of tooth movement. These results suggest that after the start of tooth movement OX6- and ED1-positive cells, which are mostly exudative macrophages, but not ED2- and KI-M2R-positive cells, i.e., resident macrophages, may be actively engaged in bone resorption and the remodelling of tissues on the pressure side of the periodontal membrane.

Animals↗

Identification of tooth-specific downstream targets of Runx2.

Odontogenesis or tooth development is a highly regulated process that involves complex epithelial-mesenchymal signaling interactions that lead to cuspal morphogenesis, cell differentiation and the subsequent formation of the specialized matrices of enamel, dentin, cementum and bone. Although studies on tooth epithelial-mesenchymal signaling interactions have greatly increased our understanding of molecules that regulate tooth initiation and early morphogenesis (review: Jernvall and Thesleff, Mech. Dev. 92 (2000) 19), the precise nature of the molecular events controlling late morphogenesis and terminal cytodifferentiation is not known. We have recently reported a unique phenotype involving dentition in mice lacking a functional Runx2 gene (D'Souza et al., Development 126 (1999) 2911). The markedly hypoplastic tooth organs as well as defects in the maturation of ameloblasts and odontoblasts point to an important and non-redundant role for Runx2 in tooth morphogenesis and cytodifferentiation. In order to identify genes that are affected by the absence of Runx2, a cDNA library was generated from Runx2(-/-) and Runx2(+/+) first molar organs. Thus far, our analysis has revealed several tooth-specific downstream target genes of Runx2 that include extracellular matrix proteins, kinases, receptors, growth factors, mitochondrial proteins and transcription molecules. Sequence analysis of 61 differentially expressed genes revealed that 96.03% of the clones matched previously described genes in the GenBank/EBML database and 3.96% did not match any entries in the database. Our preliminary expression analysis of one of the differentially expressed clones which encodes for a zinc finger transcription factor termed Zfp reveals that the gene is temporally regulated during tooth development. In conclusion, we have successfully generated a library enriched in genes expressed in Runx2(+/+) molar tooth organs and performed preliminary studies to assess the role of Zfp in tooth development.

Animals↗

Tooth width ratios in crowded and noncrowded dentitions.

Discrepancies in tooth width ratios could affect the excellence in the finishing of orthodontic cases. This study compares tooth width ratios in crowded and noncrowded dental arches. Tooth widths were measured from 143 dental casts (40 crowded and 33 spaced in male individuals and 43 crowded and 27 spaced in female individuals). Simultaneous crowded or spaced arches were selected. Tooth width measurements were made with a sliding caliper with a Vernier scale neared 0.1 mm. Inter- (0.990) and intraexaminer (0.993) reliability with mean differences of 0.03 mm (-0.03; 0.07) and 0.01 mm (-0.04; 0.05), respectively, were attained. Bolton analysis was applied to calculate the tooth width ratios (anterior and total). Descriptive statistics, Student's t-test, and analysis of variance were applied. There was no significant difference between the anterior and total tooth width ratios according to sex (P > .05). Both anterior and total ratios were significantly greater in subjects with crowding (P = .003 and P = .026, respectively), but no statistical difference by arch type in anterior and total tooth mass excess was found (P > .05). Differences among subjects with noncrowded and crowded dentitions were of 0.39 and 0.51 mm for the excess of anterior and total upper tooth mass, respectively, with respect to lower mass excess. Although the anterior and overall ratios and the differences between the upper and lower tooth width sums are greater in subjects with crowding, no clinically significant difference is observed (less than one mm).

Adolescent↗

Influence of protrusive tooth contact on tapping point distribution.

This study investigated the influence of protrusive tooth contacts (tooth contacts during mandibular protrusion) on the tapping point distribution. Nine healthy subjects volunteered for this study and the protrusive tooth contact pattern, as well as the retrusive tooth contact pattern, was altered on four maxillary occlusal splints. The first splint was adjusted to make the sagittal incisal path of protrusion and retrusion equivalent to that of the natural dentition. The second and third splints had partial and complete elimination of the protrusive tooth contact, respectively. The fourth splint had complete elimination of both protrusive and retrusive tooth contacts. The subjects were asked to use each splint continuously for 1 week. The tapping point distribution was measured on the 7th day after insertion of each splint. The four experimental occlusal conditions were found to have a significant effect on the tapping point distribution. The complete elimination of the protrusive tooth contact caused an anterior tapping point location and an increase in the tapping point area. The former tendency was found to be independent of the presence of the retrusive tooth contact. In conclusion, it was suggested that the protrusive tooth contact plays a significant role in maintaining the consistency and stability of the tapping point.

Adult↗

Relationship between tooth shade value and skin color: an observational study.

STATEMENT OF PROBLEM: There is limited scientific information on the relationship between tooth shade and skin color. This lack of knowledge may impact the ability of the prosthodontist to select artificial teeth that complement the facial complexion of the patient. PURPOSE: This observational study explored the possibility of a relationship between tooth shade and skin color. MATERIALS AND METHODS: A total of 119 individuals aged 18 to 80 years participated in this observational study. Two investigators calibrated for examining tooth shade performed all examinations. A Vita-Lumin shade guide was used to examine either the maxillary right or left central incisor, one of which had to be restoration- and caries-free for study inclusion. Tooth shades were divided into 4 categories according to value, and skin tones were divided into 4 categories (fair, fair/medium, medium, and dark) with the use of L'Oreal True Illusion compact makeup shades as a guide. Categorical modeling with chi-square analysis and Fisher's exact tests was used to analyze the data (alpha=.05). RESULTS: No interaction among age, skin color, and tooth shade or gender, skin color, and tooth shade was found; however, age was associated with tooth shade (P<.001). Older persons were more likely to have teeth with lower values (darker). Among those aged 60 and older, 85% had teeth in the medium and low range values compared with 17% of those younger than 31. Significant tooth shade differences were discovered among patients with different skin colors (P<.05). Among those with low values (darker teeth), 50% were of fair complexion and 17% were of dark complexion (P<.001). CONCLUSION: Within the limitations of this study, tooth shade value and skin color were inversely related. Older adults were more likely to have darker teeth (lower value).

Adolescent↗

Laminin alpha5 is required for dental epithelium growth and polarity and the development of tooth bud and shape.

In tooth development, the oral ectoderm and mesenchyme coordinately and reciprocally interact through the basement membrane for their growth and differentiation to form the proper shape and size of the tooth. Laminin alpha5 subunit-containing laminin-10/11 (LM-511/521) is the major laminin in the tooth germ basement membrane. Here, we have examined the role of laminin alpha5 (Lama5) in tooth development using laminin alpha5-null mouse primary dental epithelium and tooth germ organ cultures. Lama5-null mice develop a small tooth germ with defective cusp formation and have reduced proliferation of dental epithelium. Also, cell polarity and formation of the monolayer of the inner dental epithelium are disturbed. The enamel knot, a signaling center for tooth germ development, is defective, and there is a significant reduction of Shh and Fgf4 expression in the dental epithelium. In the absence of laminin alpha5, the basement membrane in the inner dental epithelium becomes discontinuous. In normal mice, integrin alpha6beta4, a receptor for laminin alpha5, is strongly localized at the basal layer of the epithelium, whereas in mutant mice, integrin alpha6beta4 is expressed around the cell surface. In primary dental epithelium culture, laminin-10/11 promotes cell growth, spreading, and filopodia-like microspike formation. This promotion is inhibited by anti-integrin alpha6 and beta4 antibodies and by phosphatidylinositol 3-kinase inhibitors and dominant negative Rho-GTPase family proteins Cdc42 and Rac. In organ culture, anti-integrin alpha6 antibody and wortmannin reduce tooth germ size and shape. Our studies demonstrate that laminin alpha5 is required for the proliferation and polarity of basal epithelial cells and suggest that the interaction between laminin-10/11-integrin alpha6beta4 and the phosphatidylinositol 3-kinase-Cdc42/Rac pathways play an important role in determining the size and shape of tooth germ.

Animals↗

A method of estimating tooth life expectancy.

One of the most important outcome measures for dental services is the increase in tooth life expectancy which is brought about by the interventions provided. Thus, a convenient and accurate index of tooth survival is critical both to clinical decision making and to more general assessments of public dental health policies. This paper describes a simple method of approximating tooth life expectancy (TLE). The method is based on the assumption that tooth survival follows a simple declining exponential function. Assuming a constant mortality rate, TLE is the integral of the survival function, expressed as S(t) = e-mu t, where t is time and mu the constant mortality rate. Using 3-year tooth-specific mortality rates for 491 subjects aged 50 years or more, tooth-specific life expectancies for the population as a whole where found to range from 27 years for upper canines to 71 years for lower incisors. Individuals with a mean periodontal attachment loss greater than 4 mm and people on low incomes had significantly lower tooth life expectancies than their periodontally fit and more wealthy counterparts. This technique can be used to obtain disease-specific or intervention-specific tooth life expectancies. Thus, gains in TLE for individuals with different oral, social and behavioural characteristics can be calculated. The declining exponential approximation of tooth life expectancy has the potential to become a powerful tool in the evaluation of dental services and treatments.

Cuspid↗