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PubMedDate not supplied

Changes of masticatory movement characteristics after prosthodontic rehabilitation of individuals with extensive tooth wear.

The masticatory cycles of 11 men (mean age 51.5 years) with extensive tooth wear were investigated before and after rehabilitation with fixed partial dentures. Parameters such as the tooth wear index (IA) and masticatory mandibular movement were recorded. Before treatment, the patients were also given a questionnaire related to possible background factors of importance to tooth wear. At baseline a mean score of 48.6 (range 0 to 100) for the tooth wear index (IA) was found. The clinical recall examination 3 years after prosthodontic rehabilitation displayed obvious wear of restorative material for two patients, and, in another patient, one of the fixed partial dentures had to be remade because of fracture of abutment teeth. Following rehabilitation, the duration of the masticatory mandibular opening movement increased and mandibular movement velocity decreased. The mandibular closing angle, near to occlusal contact, became steeper after prosthodontic treatment, indicating a changed mandibular movement pattern.

Adult↗

PubMed2005

Tooth wear: diet analysis and advice.

Diet analysis and advice for patients with tooth wear is potentially the most logical intervention to arrest attrition, erosion and abrasion. It is saliva that protects the teeth against corrosion by the acids which soften enamel and make it susceptible to wear. Thus the lifestyles and diet of patients at risk need to be analysed for sources of acid and reasons for lost salivary protection. Medical conditions which put patients at risk of tooth wear are principally: asthma, bulimia nervosa, caffeine addiction, diabetes mellitus, exercise dehydration, functional depression, gastroesophageal reflux in alcoholism, hypertension and syndromes with salivary hypofunction. The sources of acid are various, but loss of salivary protection is the common theme. In healthy young Australians, soft drinks are the main source of acid, and exercise dehydration the main reason for loss of salivary protection. In the medically compromised, diet acids and gastroesophageal reflux are the sources, but medications are the main reasons for lost salivary protection. Diet advice for patients with tooth wear must: promote a healthy lifestyle and diet strategy that conserves the teeth by natural means of salivary stimulation; and address the specific needs of the patients' oral and medical conditions. Individualised, patient-empowering erosion WATCH strategies; on Water, Acid, Taste, Calcium and Health, are urgently required to combat the emerging epidemic of tooth wear currently being experienced in westernised societies.

Alcoholic Beverages↗

PubMedDate not supplied

The mandibular speech envelope in subjects with and without incisal tooth wear.

PURPOSE: The purpose of this study was to describe a mandibular envelope of motion during speech for 2 subject groups. One subject group had experienced no tooth wear and the other had incisal tooth wear. The speech envelope was to be described with regard to its maximal dimensions in the vertical, anteroposterior, and lateral directions, and its most superior and anterior positions in relation to intercuspal position. MATERIALS AND METHODS: An electromagnetic method of jaw tracking was employed to record mandibular speech movements for 60 subjects whose teeth exhibited no tooth wear and 30 subjects with incisal dental attrition. The test speech exercise contained all of the word sounds that occur in the English language. The test was recorded 3 times, and mean values for parameters were reported. RESULTS: The speech envelope of the tooth wear group was significantly smaller (Student's t test, P < 0.01) in all 3 dimensions than that of the normal group. The tooth wear group speech envelope was also located closer to the intercuspal position in the vertical dimension (P < 0.01) and was not as anteriorly placed (P < 0.01). In the normal group, correlations were found between the vertical incisor overlap and the most superior speech position (r = 0.48, P < 0.0001), and between the horizontal incisor overlap and the most anterior mandibular speaking position (r = 0.63, P < 0.0001). CONCLUSION: The envelope of mandibular movement during speech differed in dimension and position between the 2 groups investigated.

Adult↗

PubMedDate not supplied

Does tooth wear status predict ongoing sleep bruxism in 30-year-old Japanese subjects?

PURPOSE: This study investigated whether tooth wear status can predict bruxism level. MATERIALS AND METHODS: Sixteen Japanese subjects (eight bruxers and eight age- and gender-matched controls; mean age 30 years) participated in this study. From dental casts of these subjects, the tooth wear was scored by Murphy's method. Bruxism level in these subjects was also recorded for 5 consecutive nights in the subject's home environment using a force-based bruxism detecting system. The relationship between the tooth wear score and bruxism data was evaluated statistically. RESULTS: Correlation analysis between the Murphy's scores of maxillary and mandibular dental arch and bruxism event duration score revealed no significant relationship between tooth wear and current bruxism. CONCLUSION: Tooth wear status is not predictive of ongoing bruxism level as measured by the force-based bruxism detection system in 30-year-old Japanese subjects.

Adult↗

PubMed2000

Using partial recording to assess tooth wear in older adults.

OBJECTIVES: To establish whether partial recording can be used for the measurement and reporting of tooth wear data in samples of adult populations, whilst maintaining the usefulness of the index. METHODS: Using whole mouth coronal tooth wear data from a large random population sample of 1200 dentate older adults in England, several different partial recording systems were investigated to establish which teeth would maintain a high level of sensitivity for the most economic use of codes and index teeth. Tooth wear data were recorded on a surface-by-surface basis on all teeth in the sample using the tooth wear index. RESULTS: Five different partial mouth recording systems were assessed, including half-mouth scoring, assessment of just upper or just lower anterior teeth, assessment of all anterior teeth and use of six index teeth. The 12 anterior teeth were the ones most often affected by moderate or severe wear, and when all 12 teeth were used as the index teeth few wear cases were missed, and all the most extensive and severe cases of coronal wear were classified as having some wear. A limited index of only six anterior teeth (three uppers and three lowers) was almost as sensitive, but allowed less flexibility when reporting the extent of coronal wear. Other systems for partial recording were less sensitive. CONCLUSIONS: Partial recording using six or 12 anterior teeth is appropriate for measuring and reporting tooth wear data in large population surveys.

Age Distribution↗

PubMed2002

Tooth wear in children with Down syndrome.

BACKGROUND: Several studies have described the impact that dental caries and periodontitis may have on the dentitions of individuals with Down syndrome, but there are few reports about the effects of tooth wear. This investigation aimed to compare the aetiology, prevalence and severity of tooth wear in 49 cytogenetically confirmed Down syndrome children with 49 non-Down syndrome controls. METHODS: This study involved three aspects: an oral examination, including obtaining dental impressions; a dietary analysis spanning three days; and a questionnaire seeking information about habits, medical problems and medications. Tooth wear severity was scored on a 4-grade scale (none-to-little; moderate; severe; very severe), while aetiology was classified as being due to attrition mainly, erosion mainly, or a combination of both. Double determinations established scoring method reliability and chi-square tests assessed associations between samples. RESULTS: Tooth wear was significantly more frequent (p<0.01) in the Down syndrome than the non-Down syndrome sample (67.4 per cent cf 34.7 per cent), with more of the Down syndrome children showing severe to very severe wear (59.2 per cent cf 8.2 per cent). Significantly more Down syndrome children (p<0.05) displayed a multifactorial aetiology of tooth wear, i.e., both attrition and erosion (46.7 per cent cf 28.6 per cent), although no particular dietary link was established. Gastric reflux and vomiting were reported in over 20 per cent of the Down syndrome sample. CONCLUSIONS: Given the potential consequences of high levels of tooth wear, associated with tooth grinding and an acidic oral environment in Down syndrome children, educational programmes aimed at increasing awareness of carers and health professionals are needed urgently.

Adolescent↗

PubMed2002

Risk indicators for tooth wear in New Zealand school children.

AIM: To investigate the prevalence and severity of tooth wear in the primary dentition of a representative sample of New Zealand school children and relate these to possible risk factors. DESIGN: A cross-sectional study. SETTING: Primary schools in Dunedin, New Zealand. PARTICIPANTS: 104 children of both sexes, aged between 5 and 8 years, randomly selected. METHODS: Clinical examinations of the buccal, occlusal/incisal and lingual surfaces of deciduous canines and molars. MAIN OUTCOME MEASURE: Degree of wear and the presence of dentinal cupping of teeth. Information on weaning and consumption of fruit-based drinks at bed time, frequency of consumption of fruits, yoghurt, pickled foods, fizzy and fruit-based drinks. RESULTS: The prevalence of tooth wear was similar in boys and girls and there were no significant differences between sides of the arches. A high percentage (82%) of children had at least one primary tooth with dentine exposed. While maxillary canines showed the greatest prevalence of dentine exposed, maxillary molars displayed the greatest prevalence of cupping. Severe tooth wear was less prevalent among children weaned after 12 months (14.3%) than those weaned earlier (27.9% P < 0.01). There were no statistically significant associations between wear and the consumption of fruit, yoghurt, pickled foods, fizzy drinks or fruit-based drinks. CONCLUSIONS: Tooth wear associated with dentine exposure is common in 5-8 year old children. This is not significantly associated with dietary factors, but appears to be related to early weaning from the breast.

Beverages↗

PubMedDate not supplied

Oral clearance of an acidic drink in patients with erosive tooth wear compared with that in control subjects.

PURPOSE: The aim of this study was to compare the clearance of an acidic drink in patients with tooth wear caused by regurgitation erosion to that in patients without tooth wear. MATERIALS AND METHODS: Oral clearance was measured using antimony electrodes at 4 soft tissue sites around the mouth in the patients with erosion caused by regurgitation and compared to a matched control group. The data were analyzed for pH at the resting state, the time below 5.5, and the lowest recorded pH. In addition, the resting hydration levels and viscosity of fluid from the minor salivary glands, the pH of resting saliva, and the flow rate and buffering capacity of stimulated saliva were compared between the 2 groups of patients. RESULTS: The pH recorded at the tip of the tongue reached a lower level in the controls than in those in the erosive tooth wear group (P < .05) and the time that the pH remained below 5.5 was longer in the controls than those with tooth wear (P < .05). The flow rate from the minor salivary glands (P < .05) and the viscosity of resting saliva appeared to differ between the two groups (P < .001). CONCLUSION: Oral clearance at the tip of the tongue, measured as a function of the lowest pH reached and the time below 5.5, was quicker in those with erosive tooth wear than the controls. It is suggested that this may be a result of a feedback mechanism from constant exposure of the oral environment to low pH.

Acids↗

PubMed1998

Case report: tooth wear associated with an unusual habit.

Pathological tooth wear is an increasing problem affecting a significant proportion of the population. Although different wear mechanisms have been described, most reports in the literature concentrate on cases in which the predominant mechanisms were erosion and attrition. This article presents an unusual case of abrasive tooth wear caused by a sand eating habit which the patient had adopted as a child. Different causes of "abrasive" wear are discussed and the difficulties in management of this case are also presented.

Adult↗

PubMedDate not supplied

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↗

PubMed1998

The prevalence of tooth wear in a cluster sample of adolescent schoolchildren and its relationship with potential explanatory factors.

OBJECTIVE: To assess the prevalence of tooth wear in adolescents and its relationship with diet, saliva and gastro-oesophageal reflux. DESIGN: Single centre cluster sample epidemiological study. SETTING: A school in London in the summer of 1996. SUBJECTS: 11-14-year-old schoolchildren. MAIN OUTCOME MEASURES: The Smith and Knight tooth wear index (TWI), salivary factors, diet and symptoms of gastro-oesophageal reflux were recorded for all subjects. RESULTS: Results were obtained from 210 subjects. One subject refused to provide a saliva sample and 11 subjects provided insufficient saliva for analysis of buffering power (n = 198). 57% (95% confidence intervals 50.3-63.7%) of subjects had tooth wear on more than ten teeth and a median 12% (interquartile range 6-18%, 95% confidence intervals 8-14%) of surfaces were affected. However, dentine involvement was rare. The median intake of carbonated drinks was 2 cans (interquartile range 1-3) a day. However, there was no correlation with TWI (r = -0.09, P = 0.19). There was no relationship between tooth wear index (TWI) and salivary flow rate (r = -0.02, P = 0.78) or buffering capacity (r = -0.02, P = 0.76). A trend was observed for those with a reported history of regurgitation (n = 27) to have a higher maxillary TWI (median 8, interquartile range 2-13) compared with those who did not (5, 2-9, P = 0.06). CONCLUSIONS: Tooth wear is common in adolescents and the relationship with dietary acid, salivary buffering and symptoms of gastro-oesophageal reflux is complex and requires further investigation.

Adolescent↗

PubMedDate not supplied

Etiology and diagnosis of tooth wear: a literature review and presentation of selected cases.

PURPOSE: This article presents an overview of etiologies associated with tooth wear. MATERIALS AND METHODS: Specific types of wear based on clinical findings and patient history are described. RESULTS: The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors. Examples of tooth wear related to these factors with regional specificity are presented. CONCLUSION: The dental practitioner should recognize the characteristic signs of tooth wear, as they may be the first to discuss the problem with the patient. Management should be based on accurate diagnosis.

Adolescent↗

PubMed1990

An individual tooth wear index and an analysis of factors correlated to incisal and occlusal wear in an adult Swedish population.

The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.

Adult↗

PubMed1997

A longitudinal study of tooth wear in orthodontically treated patients.

The primary objective of this study was to determine whether there is a relationship between incisal/occlusal tooth wear during the mixed dentition and subsequent wear of the adult dentition. Pretreatment orthodontic records taken during the mixed dentition (T1), as well as follow-up records taken an average of 20 years later (T2), were available for 223 orthodontically treated patients. Incisal/occlusal tooth wear was measured on a tooth-by-tooth basis from T1 and T2 stone casts with a four-category scoring system. Multiple regression analysis (R2 = 0.33) indicated that wear could be predicted at a given age during adulthood from wear observed on the deciduous mandibular canines and molars at T1 (p < 0.0001). This predictive relationship was modified by the age at which the T1 wear was observed (p = 0.029) and possibly by the sex of the patient (p = 0.10). These results indicate that adult tooth wear is not independent of the tooth wear that occurred as a child. Bruxism is suggested as a possible common etiologic mechanism that may account for the relationship between childhood and adult tooth wear.

Adolescent↗

PubMed2000

Age estimation by occlusal tooth wear.

The purpose of the present investigation was to test the accuracy of a new scoring system in recording tooth wear for age estimation. The material consisted of dental stone casts of 383 volunteers who had sound premolars and molars with normal occlusion. The degree of occlusal wear for all premolar and molar teeth was scored with the new system. The high intra- and inter-examiner concordances showed that the new score system was very reliable. The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. Tooth wear scores of males were higher than those of females. Calculating tables for age estimation were designed and the accuracy of age estimation was obtained with the General Linear Models procedures. Our system could provide estimation of an individual's age within +/-3 years in 42.4% of males and 49.4% of females, within +/-5 years in 61.8% of males and 63.3% of females. When the subjects were divided into two age groups and data were re-treated, the accuracy of age estimation was increased. Collectively, it was shown that our new system for scoring tooth wear is a reliable and accurate method for age estimation.

Adolescent↗

PubMed1989

Tooth wear in Australian aboriginal populations from the River Murray Valley.

The study of tooth wear among prehistoric and recent populations has frequently been concerned with the rate and pattern of wear over the dental arches. In this report we considered the question of tooth wear variation among collections of Australian Aboriginal crania recovered from several sites along the Murray River in Southeastern Australia. These crania represent the remains of relatively recent populations from about 2,000 years ago until the early 19th century. The degree of tooth wear for each dental arch was recorded by an established method of determining the ratio of exposed dentin. The pattern or distribution of wear over each arch was summarized by principal component analysis. The mean wear degree and pattern were compared among four geographical grouping of crania separated by up to 700 miles of river frontage. Our results showed, as expected, a significant difference between the well-defined population at the Lower Murray site (Swanport) and the three upriver groups. However, there were significant differences among these three collections as well. Sexual dimorphism was noted but was only significant in the Lower Murray group; the mean wear was greater and also more variable among the males. At the second of the Middle Murray sites the pattern of wear was different and the degree of wear was significantly less than in the other groups. A possible explanation for this diversity may be environmental and subsistence base differences. The evidence from the Lower Murray supports this possibility, but the differences among the other three groups are not as clearly established. However, our results do suggest that the Murray Black collection, from which these crania were obtained, may not be as homogeneous a group as previously believed.

Australia↗

PubMed1992

Tooth wear and facial morphology.

This review sets out to explore the relationship between tooth wear and facial morphology, with particular reference to the occlusal vertical dimension. Evidence from anthropological and archaeological investigations suggests that severe tooth wear may not only affect the teeth and occlusion, but may also have more wide ranging effects on overall dentofacial morphology. Studies on contemporary subjects confirm this finding, and the literature on the nature of these effects is reviewed. It is concluded that the adult dentofacial complex is not a static entity, but can compensate for the dental effects of wear. The consequences of this with respect to reconstruction of the worn dentition are discussed, and it is proposed that the dynamic nature of this complex may be employed to help simplify the treatment of severe tooth wear.

Adult↗

PubMed1999

Craniofacial morphology and tooth wear: a longitudinal study of orthodontic patients.

Previous research has suggested that a relationship exists between craniofacial morphology and tooth wear. The primary objective of this study was to determine whether an individual's craniofacial morphology during childhood is related to the degree of tooth wear that occurs in that same individual's adult dentition. Pretreatment orthodontic records taken during the mixed dentition (T1) and follow-up records taken an average of 20 years later (T2) were available for 165 orthodontic patients. Incisal/occlusal tooth wear was measured on a tooth-by-tooth basis from T1 and T2 casts using a four-category scoring system. Measures of craniofacial morphology were made from the T1 lateral cephalometric radiograph. Multiple regression analysis indicated that adult wear was associated with the T1 cephalometric measures of ANB (p = 0.017) and the interaction between ramal height and sex (p = 0.039). These results suggest that the craniofacial morphology observed during childhood has a small but significant relationship to adult tooth wear.

Adult↗