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PubMed1999

Molecular genetics of tooth morphogenesis and patterning: the right shape in the right place.

Development of the mammalian tooth has for many years served as a useful model system for the study of cell-cell interactions in organogenesis. Early development of teeth (tooth buds) shows many morphological and molecular similarities with early development of other organs such as the lung, hair, kidney, etc. There has been much progress toward understanding epithelial/mesenchymal cell signaling in tooth germ formation. Advances in understanding the formation of different shapes of teeth (morphogenesis) at their correct positions in the jaws (patterning) has, until recently, been less forthcoming. We review here the latest ideas on the control of odontogenic patterning and morphogenesis. The stages of early tooth development are well-defined histologically and have been described in numerous textbooks. The progression from localized thickenings of oral epithelium to bud, cap, and bell stages provides an adequate description of the gross morphological changes seen in the epithelial cells of early developing tooth germs. Less obvious are the concomitant changes taking place in the dental (ecto)mesenchymal cells which originate from the cranial neural crest and which condense around the tooth bud epithelium. However, it is very clear that these mesenchymal cells are equal partners with epithelium during the early stages of tooth germ formation and undergo complex changes which, although not obvious histologically, are revealed with molecular (gene) probes. Genes identified as being important for the early communication between the epithelial and ectomesenchymal cells mainly comprise those which code for proteins which act as secreted signals between the cells (ligands) and those that code for nuclear proteins that act to control gene expression in response to the signals. Little is presently known about the changes in structural proteins such as cell adhesion molecules which are involved in mediating the physical interactions between cells and generating the morphological changes.

Animals↗

PubMed2003

Socio-demographic risk indicators for tooth mortality in rural Sri Lankans.

To explore the socio-demographic factors associated with tooth loss in rural inhabitants of Sri Lanka, a random sample of 2178 males aged 20-60 years was selected using multi-stage cluster sampling procedure. The number of missing and present teeth was recorded excluding third molars and the subjects were interviewed to elicit socio-demographic information as well as oral hygiene and tobacco consumption habits. The mean number of teeth lost in the sample was 5.17 +/- 5.43. Tooth loss increased significantly with age. Sinhalese had significantly fewer lost teeth (5.05 +/- 5.38) compared to Tamils (6.54 +/- 6.18) and Muslims (6.02 +/- 5.21) whereas education, income, oral hygiene practices and tobacco use were significantly associated with tooth loss in the bivariate analysis. A forward stepwise multiple regression analysis revealed that age, Muslim ethnicity and quantified tobacco use were positively associated with tooth loss while better socio-economic conditions and good oral hygiene habits were negatively linked with tooth mortality independent of other factors. Age, Muslim ethnicity, quantified tobacco use, income, education, brushing frequency and substance used for cleaning had significantly affected tooth loss. Quantified tobacco use and oral hygiene may be regarded as modifiable socio-demographic risk indicators associated with tooth mortality in Sri Lankans.

Adult↗

PubMed2000

A new function of BMP4: dual role for BMP4 in regulation of Sonic hedgehog expression in the mouse tooth germ.

The murine tooth development is governed by sequential and reciprocal epithelial-mesenchymal interactions. Multiple signaling molecules are expressed in the developing tooth germ and interact each other to mediate the inductive tissue interactions. Among them are Sonic hedgehog (SHH), Bone Morphogenetic Protein-2 (BMP2) and Bone Morphogenetic Protein-4 (BMP4). We have investigated the interactions between these signaling molecules during early tooth development. We found that the expression of Shh and Bmp2 is downregulated at E12.5 and E13.5 in the dental epithelium of the Msx1 mutant tooth germ where Bmp4 expression is significantly reduced in the dental mesenchyme. Inhibition of BMP4 activity by noggin resulted in repression of Shh and Bmp2 in wild-type dental epithelium. When implanted into the dental mesenchyme of Msx1 mutants, beads soaked with BMP4 protein were able to restore the expression of both Shh and Bmp2 in the Msx1 mutant epithelium. These results demonstrated that mesenchymal BMP4 represents one component of the signal acting on the epithelium to maintain Shh and Bmp2 expression. In contrast, BMP4-soaked beads repressed Shh and Bmp2 expression in the wild-type dental epithelium. TUNEL assay indicated that this suppression of gene expression by exogenous BMP4 was not the result of an increase in programmed cell death in the tooth germ. Ectopic expression of human Bmp4 to the dental mesenchyme driven by the mouse Msx1 promoter restored Shh expression in the Msx1 mutant dental epithelium but repressed Shh in the wild-type tooth germ in vivo. We further demonstrated that this regulation of Shh expression by BMP4 is conserved in the mouse developing limb bud. In addition, Shh expression was unaffected in the developing limb buds of the transgenic mice in which a constitutively active Bmpr-IB is ectopically expressed in the forelimb posterior mesenchyme and throughout the hindlimb mesenchyme, suggesting that the repression of Shh expression by BMP4 may not be mediated by BMP receptor-IB. These results provide evidence for a new function of BMP4. BMP4 can act upstream to Shh by regulating Shh expression in mouse developing tooth germ and limb bud. Taken together, our data provide insight into a new regulatory mechanism for Shh expression, and suggest that this BMP4-mediated pathway in Shh regulation may have a general implication in vertebrate organogenesis.

Animals↗

PubMed1999

Immunohistological distributions of fibronectin, tenascin, type I, III and IV collagens, and laminin during tooth development and degeneration in fetuses of minke whale, Balaenoptera acutorostrata.

The immunohistological distributions of fibronectin, tenascin, type I, III and IV collagens, and laminin were observed in the tooth buds of fetuses of minke whale, Balaenoptera acutorostrata. Distributions of extracellular matrices (ECMs) examined in this study except for tenascin were generally similar to those of terrestrial mammalian species during development of the tooth bud. Tenascin in the fetuses of minke whale showed characteristic distributions in the dental lamina and the enamel organ in the early tooth developmental stage. In the physiological degeneration stage of tooth bud development, immunoreactivity of the ECMs were very weakly and limitedly detected in the dental papilla and the surrounding mesenchyme. Immunoreactivity of tenascin and type I and III collagens were positively detected in the developing baleen plate germ which was associated with the degenerating tooth bud. These findings suggested that expressions of the ECMs were related to the formation of the tooth bud and baleen plate germ, and that the lack of the ECMs was related to the degeneration of the tooth bud in the fetal minke whale.

Animals↗

PubMed2001

NSAID impairment of orthodontic tooth movement.

OBJECTIVE: To evaluate the impairment of orthodontic tooth movement caused by nonsteroidal antiinflammatory drugs (NSAIDs). DATA SOURCES: Biomedical literature accessed through MEDLINE (1966-January 2000), EMBASE (1980-January 2000), and International Pharmaceutical Abstracts (1970-January 2000). Key search terms included NSAIDs, orthodontics, and tooth movement. DATA SYNTHESIS: Orthodontic dentistry applies mechanical force to generate tooth movement. Since prostaglandins are mediators of tooth movement, it is reasonable to expect that prostaglandin inhibitors, such as NSAIDs, inhibit or delay tooth movement. An evaluation of studies measuring the extent of NSAID impairment on tooth movement was undertaken. CONCLUSIONS: Results from animal studies have shown that NSAIDs can impair the tooth movement process. Until long-term human data are obtained, acetaminophen remains an appropriate alternative to NSAIDs for treating orthodontic-associated pain.

Animals↗

PubMed2018

Convergent evolution of gene expression in two high-toothed stickleback populations.

Changes in developmental gene regulatory networks enable evolved changes in morphology. These changes can be in cis regulatory elements that act in an allele-specific manner, or changes to the overall trans regulatory environment that interacts with cis regulatory sequences. Here we address several questions about the evolution of gene expression accompanying a convergently evolved constructive morphological trait, increases in tooth number in two independently derived freshwater populations of threespine stickleback fish (Gasterosteus aculeatus). Are convergently evolved cis and/or trans changes in gene expression associated with convergently evolved morphological evolution? Do cis or trans regulatory changes contribute more to gene expression changes accompanying an evolved morphological gain trait? Transcriptome data from dental tissue of ancestral low-toothed and two independently derived high-toothed stickleback populations revealed significantly shared gene expression changes that have convergently evolved in the two high-toothed populations. Comparing cis and trans regulatory changes using phased gene expression data from F1 hybrids, we found that trans regulatory changes were predominant and more likely to be shared among both high-toothed populations. In contrast, while cis regulatory changes have evolved in both high-toothed populations, overall these changes were distinct and not shared among high-toothed populations. Together these data suggest that a convergently evolved trait can occur through genetically distinct regulatory changes that converge on similar trans regulatory environments.

Alleles↗

PubMed2004

Effect of light energy on peroxide tooth bleaching.

BACKGROUND: Light-activated bleaching is a method of tooth whitening. The authors conducted a study to compare the whitening effects and tooth temperature changes induced by various combinations of peroxide bleaches and light sources. METHODS: The authors randomly assigned 250 extracted human teeth halves into experimental groups (n = 10). A placebo gel (control), a 35 percent hydrogen peroxide or a 10 percent carbamide peroxide bleach was placed on the tooth surface and was irradiated with no light (control); a halogen curing light; an infrared, or IR, light; an argon laser; or a carbon dioxide, or CO2, laser. Color changes were evaluated immediately, one day and one week after treatment using a value-oriented shade guide and an electronic dental color analyzer. The outer enamel and inner dentin surface temperatures were monitored before and immediately after each 30-second application of light using a thermocouple thermometer. RESULTS: Color and temperature changes were significantly affected by an interaction of the bleach and light variables. The application of lights significantly improved the whitening efficacy of some bleach materials, but it caused significant temperature increases in the outer and inner tooth surfaces. The IR and CO2 laser lights caused the highest tooth temperature increases. CONCLUSIONS: Dentists performing an in-office bleaching technique with the use of an additional light source to accelerate tooth whitening should consider the specific bleaching agent being used, as well as the potential risks of heating teeth. CLINICAL IMPLICATIONS: A specific combination of bleach and light that demonstrates good color change and little temperature rise should be selected for in-office tooth bleaching.

Argon↗

PubMed2000

Teething and tooth eruption in infants: A cohort study.

OBJECTIVE: Many symptoms are attributed to teething in infants. There is little evidence to support these beliefs, despite their implications for clinical management. We investigated relationships between tooth eruption, fever, and teething symptoms. METHODS: Prospective cohort study. PARTICIPANTS: Twenty-one children 6 to 24 months old attending 3 suburban long-day care centers >/=3 days/week. Measures. 1) Daily temperature recording and examination of alveolar ridges for tooth eruption (dental therapist). 2) Daily questionnaires-symptoms over preceding 24 hours (staff and parents independently). 3) Final questionnaire-beliefs/experiences related to teething (parents). Definitions. Eruption day-the first day a tooth could be seen or felt. Non-toothdays-more than 28 days clear of any eruption day. Toothdays-the 5 days preceding eruption days. RESULTS: Data were collected for 236 toothdays and 895 non-toothdays pertaining to 90 teeth. Child temperatures were similar on toothdays and non-toothdays (36.21 vs 36.18, paired t test). Logistic regression adjusted for age did not show an association between toothdays and temperature (odds ratio [OR] = 1.35, 95% confidence interval [CI] = 0.80, 2.27 for high fever; OR = 1.34, 95% CI = 0.48, 3.77 for low fever). Logistic regression models allowing for within-child cluster effects and age were fitted to daily staff and parent reports of mood, wellness/illness, drooling/dribbling, sleep, diarrhea, strong diapers, red cheeks, and rashes/flushing. Only parent-reported (but not staff-reported) loose stools were significantly associated with tooth eruption (OR = 1.86, 95% CI = 1. 26, 2.73). When the toothday definition was varied to 10 days preceding or 5 days surrounding tooth eruption, this single significant association was no longer apparent (OR = 1.42, 95% CI = 0.98, 2.05 and OR = 1.47, 95% CI = 0.97, 2.21, respectively). All parents retrospectively reported that their own children had suffered a range of teething symptoms. CONCLUSIONS: This study did not confirm the expected strong associations between tooth eruption and a range of teething symptoms in children 6 to 30 months old, although we cannot rule out the possibility that weak associations may exist (Type II error). These findings contrast with strong parent and professional beliefs to the contrary. Such beliefs may preclude optimal management of common patterns of illness and behavior in young children.teething, infants, symptoms, tooth eruption, illness.

Adult↗

PubMed2005

Forty-eight-month periodontal attachment loss incidence in a population-based cohort study: role of baseline status, incident tooth loss, and specific behavioral factors.

BACKGROUND: The objectives of this study were to: 1) test hypotheses that behavioral factors, baseline clinical status, and incident tooth loss are significantly associated with attachment loss incidence (ALI) and 2) quantify the effect of incident tooth loss on conclusions made about ALI. METHODS: The Florida Dental Care Study was a prospective study of persons > or =45 years old. In-person interviews and examinations were conducted at baseline and 48 months, with telephone interviews in between. RESULTS: Of 560 persons with baseline and 48-month examinations, 22% of persons and 1.8% of teeth had ALI. This was highest among persons with no dental visit during follow-up (person-level incidence of 46%; 5.0% tooth-level incidence). Statistically significant covariates in a multivariable regression of ALI were: losing a tooth due to periodontal reasons after baseline, but before the 48-month examination; not receiving a dental cleaning; and baseline factors (worst attachment level of > or =7 mm, not flossing, a molar tooth, current smoker). CONCLUSIONS: A substantial percentage of persons experienced ALI. Baseline attachment level and behavioral factors were significantly associated with ALI. Persons with incident tooth loss were also at increased risk for ALI, and teeth lost during follow-up had worse baseline attachment level. Had these teeth not been lost before the final examination, the ALI estimate could only have been higher. These findings demonstrate that those at greatest risk for ALI are least likely to enter the dental care system, and among those who do, one health outcome (tooth loss) can affect conclusions made about the incidence of another (ALI).

Cohort Studies↗

PubMed2006

Effects of gradually increasing force generated by permanent rare earth magnets for orthodontic tooth movement.

OBJECTIVE: To examine the effects of gradually increasing force generated by permanent rare earth magnets for orthodontic tooth movement by using a novel experimental rat model and computer simulation. MATERIALS AND METHODS: Fifty-five male rats (age 18 weeks) were used as animal experiments. Magnetic (experimental groups) or titanium (control group) cuboids (1.5 x 1.5 x 0.7 mm) were bonded to the lingual surface of the maxillary first molars. The initial distance between materials was 1.0 mm, generating 4.96 gf (experimental group I), or 1.5 mm, generating 2.26 gf (experimental group II). Tooth movement was measured and periodontal structures were observed with microfocus x-ray computed tomography radiographs. RESULTS: The distance between the magnets decreased with time in experimental groups I and II (P < .001), whereas there was no tooth displacement in the control group. Experimental group I showed rapid tooth movement in the initial phase followed by slower tooth movement. Experimental group II showed gradual tooth movement. Horizontal sections on microfocus computed tomgraphy radiographs revealed no pathological changes, such as root resorption, on the compressed side in the experimental groups. CONCLUSIONS: The initial light force and gradual increasing force in magnetic attractive force induced effective tooth movement in rats without inducing any pathological changes.

Analysis of Variance↗

PubMed2006

Tooth abrasion in workers exposed to noise in the Montenegrin textile industry.

A cross-sectional study was performed on 225 textile workers from a wool production company in Montenegro to test the hypothesis of a relationship between exposure to intense industrial noise and tooth abrasion. The group exposed to intense noise (104 dB (A) Leq) consisted of 111 weavers (82 males and 29 females), while the control group (81 dB (A) Leq) consisted of 114 blue-collar workers (32 males and 82 females) in preparation departments. A specialist in dental prosthetics clinically examined all the subjects and additionally analyzed tooth statuses on hard plaster models. Gender, age, socioeconomic status and tooth brushing habits of workers were controlled as confounding factors. Significantly high adjusted odds ratios for tooth abrasion of 3.74 (95% CI = 1.42-7.85; p < 0.01) were found among female workers exposed to intense noise in comparison with the control group. The analysis of the subclass of male workers with severe tooth abrasion (grades III-IV) revealed significantly high adjusted odds ratios for tooth abrasion of 5.48 (95% CI = 1.76-14.50; p < 0.01) among the noise exposed group compared to the control group. This study suggests that extremely high levels of occupational noise might be related to tooth abrasion in exposed textile workers.

Adult↗

PubMed1987

Acute changes in intra-alveolar tooth position and local clearance of 125I from the periodontal ligament.

Changes in intra-alveolar tooth position and local 125I clearance from the periodontal ligament (PDL) were monitored simultaneously in cats. Axial tooth movements, reflecting periodontal ligament volume changes, were measured with an ultrasonic transit time technique. Local blood flow changes in the PDL were studied indirectly by measuring the local clearance of 125I-. Stimulation of the cervical sympathetic trunk caused an intrusive movement of the tooth with a concomitant reduction of the 125I- clearance. Infusion of noradrenaline induced a similar response. Stimulation of the inferior alveolar nerve during systemic treatment with phentolamine caused an extrusive movement of the tooth with a concomitant increase in the clearance of the tracer from the PDL. Intra-arterial infusion of the vasodilator substance P mimicked that response. Fixation of the tooth to the jaw bone, thus preventing an intrusive movement, did not change the reductions in clearance seen on sympathetic stimulation, indicating that this blood flow reduction was not dependent on tooth movement. A qualitative relation between PDL blood flow (as measured by local 125I clearance) and PDL volume (as measured by tooth position) is shown. The two variables measured are suggested to reflect two aspects of blood flow in the PDL.

Alveolar Process↗

PubMed2006

[The relationship between three-dimensional occlusal force and tooth displacement depending on clenching force in function].

This study evaluated the relationship between occlusal force and tooth displacement in function. The three-dimensional tooth displacement transducer Type M-3 was used to measure the tooth displacement path and a three-dimensional small occlusal force sensor was developed to detect the occlusal force. Subjects' teeth were the upper and lower first molars. The three-dimensional tooth displacement and occlusal force of the upper and lower first molars were measured at the same time during light and heavy clenching in vivo. The direction of the tooth displacement and that of the occlusal force of the upper first molar almost coincided and they were along the palato-apical direction. However, in the lower first molar, the direction of occlusal force was in the apical direction, and the tooth displacement path was along the lingual direction. There was no relationship between the direction of occlusal force and clenching intensity at the upper and lower first molars and no relationship was observed between the direction of tooth displacement and occlusal force at the lower first molar. However, the upper molars showed a tendency to move more in the palatal direction as the force increased. In the case of the upper first molar, the energy of force seemed to change with the distortion of the alveolar bone especially around the root surface. However, in the case of the lower first molar, the energy of this occlusal force might be absorbed by the deformation of the mandible.

Adult↗

PubMed2000

Neurophysiology and molecular genetics of Charcot-Marie-Tooth type 1 neuropathy in Croatian children: follow-up study.

AIM: Longitudinal assessment of clinical and neurophysiological abnormalities in childhood and adolescence and incidence analysis of tandem Charcot-Marie-Tooth disease type 1A gene duplication in Croatian children with Charcot-Marie-Tooth type 1 neuropathy. METHODS: Eight Croatian children with Charcot-Marie-Tooth type 1 neuropathy, aged 4-19 years, were studied clinically, neurophysiologically, and neuropathologically during 1-11 years of follow-up. All children were examined at least once, and in 4 children the measurements were repeated. Molecular genetic analysis was performed in all patients and their family members in order to determine the presence of the Charcot-Marie-Tooth disease type 1A duplication on chromosome 17p11.2-p12, using restriction fragment length polymorphic and short tandem repeat markers. RESULTS: Clubfoot was the most frequently observed clinical feature in children under 10 years of age, whereas muscle hypotrophy, scoliosis, and contractures developed in the second decade of life. All patients showed decreased motor nerve conduction velocity (7-30 m/s) and prolonged distal motor latencies on the first and follow-up examinations. Compound muscle action potential amplitude reduction (0.1-1.25 mV) was recorded in the first and second decade of life. In 6 out of 8 children, molecular genetic studies demonstrated the presence of the 1.5 megabase tandem Charcot-Marie-Tooth disease type 1A duplication in 17p11.2-p12, mostly of paternal origin. CONCLUSION: Pronounced neurographic abnormalities and mild clinical features characterize Charcot-Marie-Tooth type 1 neuropathy in the first decade. There were no significant differences in neurographic abnormalities in the first or second decade of life between Croatian children with and without Charcot-Marie-Tooth type 1A duplication.

Adolescent↗

PubMed2000

[Repair of tooth wear; restorative-prosthetic aspects].

Tooth wear is considered to be the third major threat to dental health in the industrialized parts of the world next to caries and periodontal disease. Bruxism can be a cause for excessive tooth wear. Thanks to the successes in the prevention and early treatment of the infectious dental diseases, dentitions last longer as result of which tooth wear is becoming more and more of a problem in the preservation of a physiologic dentition throughout live. Furthermore there seems to be an increasing tendency for the occurrence of severe tooth wear at very early ages. Early recognition of possible contributing factors for tooth wear by the dental team is of utmost importance to enhance success in treating the problem. Prevention of ongoing damage to the remaining tooth structure must be the starting point of every treatment plan. Repair of tooth wear is in many cases a challenge from a restorative/prosthetic perspective: esthetic and phonetic aspects play an important role along with the restorative and prosthetic choices as well as functional considerations the clinician has to deal with.

Bruxism↗

PubMed2002

The clinical efficacy of a new tooth whitening dentifrice formulation: a six-month study in adults.

The objective of this double-blind clinical study was to investigate the tooth whitening efficacy of a formulation variant of a commercially available dentifrice (Colgate Total Plus Whitening Toothpaste) obtained by the addition of high-cleaning silica, relative to that of its currently marketed formulation (Colgate Total Toothpaste). Following a baseline examination for extrinsic tooth stain, qualifying adult male and female subjects from New Jersey and Florida were randomized into two treatment groups which were balanced for gender, age, and level of extrinsic tooth stain. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice using a soft-bristled toothbrush. Examinations for extrinsic tooth stain were repeated after six-weeks', three-months' and six-months' use of the study dentifrices. Eighty-six (86) subjects complied with the protocol and completed the entire study. At the six-month examination, subjects assigned to the new dentifrice formulation group exhibited statistically significantly lower levels of extrinsic tooth stain area and extrinsic tooth stain intensity than did those subjects assigned to the Colgate Total Toothpaste group. Thus, the results of this double-blind clinical study support the conclusion that the new dentifrice formulation variant is efficacious, compared to the control dentifrice, for the removal of extrinsic tooth stain.

Adult↗

PubMed2001

Relationship between the face and the tooth form.

The aim of this study was to re-examine Leon Williams geometric theory and to find the degree of correspondence between the face and the tooth form in the population of Zenica, Bosnia and Herzegovina. Two thousand individuals with intact frontal teeth, in age between 17 and 24 years, were measured for 3 horizontal distances on the face: temporal width (Ft-Ft), zygomatic width (Zyg-Zyg) and gonial width (Go-Go) and for 3 horizontal distances on the both upper incisors: cervical width (CW), contact point width (CPW) and incisal width (IW). The length of the face (Tr-Gn) as well as the length of the central maxillary incisors were also measured. The results revealed: 1. Men had significantly larger dimensions for all facial and tooth dimensions (p < 0.05) than women, except for the cervical tooth width (p > 0.05); the left and the right central incisors were of identical dimensions and forms (p > 0.05). 2. The width of upper central incisors were smaller approximately 1.5 mm than in west Europeans. 3. Upon the relation between the 3 horizontal dimensions measured on the face and upper maxillary incisor, 11 facial forms and 10 upper central tooth forms could be recognised in the study population, but 98% of the population had only 3 tooth and face forms. Face shapes: oval face--83.3%, square-tapered face--9.2% and tapered face--7%; tooth forms: tapered-square incisor--53%, oval incisor--30%, tapered incisor--16%. 4. Reversed and enlarged tooth form was in line associated with the facial form in only 30%, while the most common combination was of the oval face form and the tapered-square central incisor (45%). 5. These results disapprove William's theory and may be helpful for the choice of artificial teeth in complete denture construction and the dental industry.

Adolescent↗

PubMed2000

Impact of demographic, behavioral, and dental care utilization parameters on tooth color and personal satisfaction.

A cross-sectional survey across broad age ranges was conducted to evaluate demographic, behavioral, and treatment parameters that impact tooth color and its perception. The sample included 180 US adults and teenagers, with a comparable representation of males and females in 6 different age strata, ranging from 13 to 64 years. Tooth color (L*a*b*) was measured on the maxillary central incisors using a spectrophotometer, and first-person satisfaction with tooth color was assessed using a five-point qualitative scale. Demographic, behavioral, and oral care parameters were modeled using multiple regression analysis. After adjusting for other explanatory variables, age, gender, coffee/tea consumption, and dental care all significantly affected yellowing (b*) and brightness (L*). Dental-visit frequency was the only factor that significantly predicted self-satisfaction with tooth color, explaining just 3% of the overall variability. First-person dissatisfaction with tooth color was common and found in most demographic and behavioral cohorts. Although age contributed to objectively measured tooth discoloration, personal satisfaction with tooth color was age-independent. These results suggest that the need or demand for esthetic dentistry may be broad-based and transcend stereotypical perceptions.

Adolescent↗