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PubMed1997

Measurement of tooth wear in patients with palatal erosion.

AIM: To develop a reproducible method for the assessment of tooth wear in vivo using a laser profilometer. DESIGN: A controlled study to measure tooth wear. SUBJECTS AND METHODS: Wear was measured over a 6-month period in 13 patients with unexplained palatal dental erosion and compared with a group of 7 controls without any evidence of abnormal wear. MAIN OUTCOME MEASURES: Metal disks were cemented to the tooth surface and impressions taken at 6-month intervals. Wear was estimated by scanning the impressions with a contacting laser profilometer and measuring a change in depth around the disk over a 6-month period using fixed reference points on the metal disks. RESULTS: A statistically significant difference was observed between patients with palatal erosion and the controls. Patients with erosion had a median of 36.5 microns of wear over 6 months (range 17.6-108.2) and the controls had a median of 3.7 microns (range 0.5-15.8). CONCLUSIONS: This paper presents a novel method for measuring erosion using fixed reference points cemented to the palatal surfaces of upper incisor teeth.

Adolescent↗

PubMed1996

The tooth wear index: a flawed epidemiological tool in an ageing population group.

With a greater number of people living longer and tending to retain many natural teeth, the problems associated with tooth wear are likely to place greater demands upon dental professionals in the future. Several attempts have been made to develop an index to measure tooth wear, for use at both the individual and population level. A review of these indices is undertaken, and difficulties experienced with the tooth wear index (TWI) of Smith & Knight (1984) in a large adult dental health survey is discussed. In the elderly population the scoring criteria of the TWI proved to be difficult to apply without additional qualification, and in cases of extreme wear a five-point ordinal scale was found to be inadequate to describe the range of wear observed. The concept of "pathological" levels of wear proposed by the TWI are challenged and modification to the index suggested for use among the elderly population.

Adult↗

PubMed2005

Tooth wear in the mixed dentition: a comparative study between children born in the 1950s and the 1990s.

The aim of this study was to evaluate the degree of tooth wear in posterior deciduous teeth of 100 subjects in the second phase of mixed dentition who were born in the 1950s (50sG) and 100 subjects born in the 1990s (90sG). The degree of abrasion for each posterior deciduous tooth was scored ranging from 0 to 3. The comparison of the degree of abrasion showed significant differences between the two groups for all examined teeth (upper and lower deciduous canines and first and second primary molars) all of which appeared to be more abraded in the 50sG. The findings of the present study indicate that subjects who were born in the 1950s exhibited a significantly greater degree of tooth wear on the posterior deciduous teeth when compared with contemporary subjects, along with a well-recognized lower prevalence of malocclusions. Changes in dietary habits and a diet based on processed foods may be postulated as factors involved with a decrease of dental attrition in contemporary populations. An increase in the prevalence of mouth breathing (tested in the present study) appears to be associated with a decrease in tooth wear in the contemporary population as well.

Child↗

PubMed2000

Patterns of tooth wear associated with methamphetamine use.

BACKGROUND: Methamphetamine (MAP) abuse is a significant worldwide problem. This prospective study was conducted to determine if MAP users had distinct patterns of tooth wear. METHODS: Methamphetamine users were identified and interviewed about their duration and preferred route of MAP use. Study participants were interviewed in the emergency department of a large urban university hospital serving a geographic area with a high rate of illicit MAP production and consumption. Tooth wear was documented for each study participant and scored using a previously validated index and demographic information was obtained using a questionnaire. RESULTS: Forty-three MAP patients were interviewed. Preferred route of administration was injection (37%) followed by snorting (33%). Patients who preferentially snorted MAP had significantly higher tooth wear in the anterior maxillary teeth than patients who injected, smoked, or ingested MAP (P = 0.005). CONCLUSION: Patients who use MAP have distinct patterns of wear based on route of administration. This difference may be explained anatomically.

Administration, Inhalation↗

PubMed2004

Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: The relationship with water fluoridation and social deprivation.

OBJECTIVE: The effect of water fluoridation upon dental erosion/tooth wear in the UK has not been investigated. This study aimed to compare the prevalence of tooth wear in 14-year-old schoolchildren in non-fluoridated and fluoridated districts of North West (NW) England. The influence of deprivation and tooth brushing was also investigated. DESIGN: A random sample of 10% of the 14-year-old population in NW England was selected and stratified according to fluoridation status as determined from water authority postcode listings. METHODS: Tooth wear was scored on the labial, incisal and palatal/lingual surfaces of the 12 anterior teeth and the occlusal surfaces of the first molars. Enamel wear was scored 0, dentine was scored 1 or 2, dependent on whether less than or more than a third of the surface had exposed dentine. Secondary dentine or pulpal exposure scored 3. Townsend deprivation scores were gained from residential post codes. RESULTS: A total of 2,351 children were examined, of which 637 (27%) lived in the one fluoridated district of South Cheshire and 1,714 (73%) lived in 11 non-fluoridated districts. Fifty-three per cent of the children had exposed dentine with significantly more males affected than females (p<0.001). In the fluoridated district, significantly fewer children had exposed dentine on labial and palatal smooth surfaces (p<0.001) but no differences were found for incisal and occlusal surfaces. The interaction of fluoridation and tooth brushing twice per day resulted in a significant (30%) reduction in erosion. Smooth surface wear was more prevalent in children resident in affluent areas. CONCLUSION: Children in non-fluoridated districts are 1.5 times more likely to have smooth surface wear compared with children in fluoridated districts. Fluoridation and use of fluoridated toothpaste twice a day provide added protection from dental erosion. The risk of tooth wear is greater with increasing affluence.

Adolescent↗

PubMed1997

The prevalence, etiology and management of tooth wear in the United Kingdom.

STATEMENT OF PROBLEM: Recent epidemiologic evidence suggests that tooth wear is now a significant problem in both children and adults. There is growing evidence that a major cause of severe wear in patients is regurgitation erosion due to a variety of factors including gastroesophageal reflux disease. PURPOSE: The purpose of this article is to discuss the prevalence of tooth wear in the United Kingdom. Emphasis in management should be on accurate diagnosis, and in some patients, long-term monitoring before embarking on any irreversible, interventive treatment. Even when treatment is necessary, a period of monitoring is helpful to assess the rate of progress of the wear, the effectiveness of preventive measures, and therefore the extent of the treatment necessary.

Adolescent↗

PubMed1998

Tooth wear and temporomandibular joint morphology in a skull material from the 17th century.

Skeletal remnants from the skulls of 69 subjects from the 17th century have been studied focusing on TMJ morphology and tooth wear. Several of the skulls were damaged and altogether 68 condyles and 28 temporal components of the TMJ, and 97 dentate jaws could be examined. Tooth wear was extensive and most of the first molars in both jaws had lost most of their occlusal morphology. This is remarkable with respect to the fact that the great majority of the subjects had died before the age of 35 years, according to the age determination performed. The TMJs showed frequent remodelling but only rarely deformative changes. The frequent observation of a broken up compact bone layer on the condyle was interpreted as a post-mortem artefact. The results indicate adaptive response of the TMJs to the probably heavy masticatory function but do not support the suggested relationship between tooth wear and TMJ osteoarthrosis.

Age Determination by Teeth↗

PubMed1994

The prevalence of tooth wear in 14-year-old school children in Liverpool.

The prevalence of tooth wear was assessed in a random sample of 14 year old school children in Liverpool. A total of 1035 children were examined in 10 schools of whom 526 (50.8 per cent) were male and 509 (49.2 per cent) were female. Three hundred and seven children (30 per cent) had exposed dentine, mainly incisally, and this occurred significantly more often in males than females (P < 0.01). Of these children, 80 (8 per cent) also exhibited exposed dentine on occlusal and/or lingual surfaces. This occurred mainly on the occlusal surfaces of the first mandibular molars and the lingual aspects of the upper incisors. A slight positive association was found between tooth wear and the level of social deprivation in the electoral ward in which the school was located.

Adolescent↗

PubMed1999

The influence of tooth wear on root canal dimensions.

The objective was to investigate the relations between tooth wear and root canal dimensions. The experimental group comprised 100 cuspids (canines), 50 of which had advanced abrasion and 50 were without it The dimensions of root canal were investigated at the light microscope level in order to define their vestibulo-oral and mesio-distal diameters in all three thirds. In the groups of teeth without abrasion the MD diameters of root canaliculi in their cervical thirds were greater than in the teeth with advanced abrasion. In the apical third the MD diameters of canaliculi were highly variable in teeth with no signs of abrasion. In the group of teeth with abrasion the MD and VO diameter values of the cervical thirds were significantly smaller than in the group of teeth without abrasion. In the mid-thirds the values of MD diameters were highly variable in the group of teeth with abrasion, whereas the VO diameter values were much greater than in the teeth without abrasion. As regards to the apical thirds, the VO diameter values were greater than in the control teeth. The data presented herewith contribute to better knowledge about tooth wear and are highly useful in restorative and reconstructive dental procedures.

Cuspid↗

PubMed2004

Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2: The association of diet and habits.

OBJECTIVE: To determine the strength of association (expressed as Odds Ratios) of potential risk factors with erosion and tooth wear in 14-year-old schoolchildren. DESIGN: A random sample of 2,385 children were selected by a stratified two-stage technique based on schools and children. SETTING: Schools in NW England. METHODS: Tooth wear was assessed by one examiner on three surfaces of all 12 anterior teeth (labial, incisal and palatal) and the occlusal surface of all four first molars using a four-point scale. Enamel wear was scored 0, dentine exposure <1/3 scored 1, >1/3 scored 2 and secondary dentine or pulpal exposure, scored 3. A questionnaire enquired about general health, dental health, habits and the frequency of intake of a wide range of foods and drinks. RESULTS: The Odds Ratios for tooth wear on any surface for habits, reflux and certain foods were: bruxism, 1.10; stomach upset, 1.45; pickles 1.86; vinegar 1.36; salt and vinegar crisps 1.33; brown/other sauces 1.57. Similarly, the odds ratios for potentially erosive drinks were: fizzy drinks 1.32; sport drinks 1.58; herbal/lemon tea 3.97. The frequency of intake was bi-modal with 397 children drinking a can per day and 207 drinking two cans per day. A significant number drank acidic beverages at bedtime but this was not associated with dental erosion. CONCLUSION: Although odds ratios greater than unity indicate an association, this was not high for carbonated beverages and many other acidic foods or drinks. Examining at fourteen years may not be ideal, as the determinants of erosion/tooth wear have not acted for long, the indices do not discriminate sufficiently and proportionately few subjects have dentine exposed on smooth surfaces.

Adolescent↗

PubMed2003

Tooth wear: attrition, erosion, and abrasion.

Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification acts through a distinct process that is associated with unique clinical characteristics. Accurate prevalence data for each classification are not available since indices do not necessarily measure one specific etiology, or the study populations may be too diverse in age and characteristics. The treatment of teeth in each classification will depend on identifying the factors associated with each etiology. Some cases may require specific restorative procedures, while others will not require treatment. A review of the literature points to the interaction of the three entities in the initiation and progression of lesions that may act synchronously or sequentially, synergistically or additively, or in conjunction with other entities to mask the true nature of tooth wear, which appears to be multifactorial.

Acids↗

PubMed1998

Anthropology, tooth wear, and occlusion ab origine.

The purpose of this essay is to emphasize that anthropology, the study of man in his environments, is a potent tool for scientific discovery and inspiration in dental science. It attempts to capture flashes of creative anthropological insight which have illuminated studies of tooth wear and occlusion in the past. While it documents contributions, understandings, and misunderstandings from Australian and New Zealand dentists, it is not a hagiography. The real saint of this essay is the Australian aborigine. For when men and women are understood in their environments, much is learned from them which challenges preconceptions of our dental science culture. The essay concludes that new, contemporary Australian culture needs to be studied by anthropological approaches if we are to understand how dental erosion is exacerbating tooth wear and damaging the occlusions of contemporary Australians. Much remains to be discovered about contemporary lifestyles, habits, and diets that lead to dental erosion, the principal cause of contemporary tooth wear in this part of the world.

Female↗

PubMed2001

Syndromes with salivary dysfunction predispose to tooth wear: Case reports of congenital dysfunction of major salivary glands, Prader-Willi, congenital rubella, and Sjögren's syndromes.

Four cases-of congenital dysfunction of the major salivary glands as well as of Prader-Willi, congenital rubella, and Sjögren's syndromes-were identified in a series of 500 patients referred for excessive tooth wear. Although there was evidence of consumption of highly acidic drinks, some occlusal parafunction, and unacceptable toothbrushing habits, salivary dysfunction was the salient factor predisposing a patient to tooth wear in these syndromal cases. The 500 subjects have been characterized either as having medical conditions and medications that predispose them to xerostomia or lifestyles in which workplace- and sports-related dehydration lead to reduced salivary flow. Normal salivation, by buffering capacity, clearance by swallowing, pellicle formation, and capacity for remineralization of demineralized enamel, protects the teeth from extrinsic and intrinsic acids that initiate dental erosion. Thus, the syndromes, unrelated in many respects, underline the importance of normal salivation in the protection of teeth against tooth wear by erosion, attrition, and abrasion.

Adult↗

PubMed1999

Changes in the pattern of tooth wear from prehistoric to recent periods in Japan.

Although a number of studies have been performed on interpopulational variation of tooth wear patterns in recent humans, the major interest in the study of tooth wear so far has been in reconstructing the subsistence and behavior of prehistoric populations, and hence research on wear pattern changes in historic times has been superficial. The present study investigated temporal change in the pattern of wear on the permanent dentition of the Japanese through comparison of the following five groups: prehistoric hunter-gatherers, prehistoric agriculturists, medieval, premodern, and recent populations. The pattern of reduction of occlusal wear severity across these chronological groups was not similar between the anterior and posterior portions of the dentition. Occlusal wear on the anterior teeth was noticeably lighter in the prehistoric agriculturists and later populations than in the prehistoric hunter-gatherers, while clear reduction of occlusal wear on the posterior teeth occurred after medieval times. The temporal variations in the degree of mesiodistal crown diameter loss due to wear and its anterior-posterior gradient within the dentition are generally consistent with those observed in the occlusal wear pattern. Possible causative factors of these temporal changes in the wear pattern are discussed.

Adolescent↗

PubMed1989

Incisal and occlusal tooth wear and wear of some prosthodontic materials. An epidemiological and clinical study.

In the epidemiological studies of this thesis, the aims were to elucidate the prevalence of incisal and occlusal wear in a normal Swedish population, and to present factors related to incisal and occlusal wear in that population. In the clinical studies, the aims were to develop methods for and to perform in vivo studies of wear of prosthodontic materials and to present quantitative and qualitative data of occlusal contact wear in these materials. The epidemiological part of this study 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 results showed that the severity and prevalence of incisal and occlusal wear increased with age. Men presented more teeth with occlusal wear than women. An individual tooth wear index (IA), with the potential to rank individuals with respect to incisal and occlusal wear, has also been introduced. Factors which were found to correlate significantly to increased incisal and occlusal wear were: number of teeth, age, sex, occurrence of bruxism, use of snuff and the saliva buffer capacity. From the in vivo studies, data of occlusal contact wear of gold, porcelain and some resin based materials in four different persons, with earlier histories of occlusal wear of teeth and/or restorations, were presented. The in vivo models combined two methods: removable segments or double crowns, and a replica technique. The combination of a polyvinylsiloxane impression material (President) and an epoxy resin (Metapox) was chosen for the replica model technique. All materials tested showed increased wear rate when the opposing material was porcelain. Gold and porcelain showed equal wear resistance when opposing porcelain. The resin-based materials showed at least a three to four times higher wear rate. No difference in wear resistance could be observed between gold type III and type IV. Gold showed a combined abrasive and fatigue type of wear and porcelain mainly a fatigue type of wear. The resin-based materials showed a fatigue type of wear, sometimes in combination with a tribochemical reaction.

Adult↗

PubMed1985

Tooth wear, solubility and fluoride concentration of molar-tooth surfaces in rats maintained on simultaneous or separate intake of food and fluoridated drinking water.

Eighty rats, 20 days old, were fed a hard pellet diet and deionized or fluoridated (25 parts/10(6) F-) drinking water respectively for 40 days. Half were maintained on simultaneous food and water intake for 3 h, daily, and the remainder on separate intake of food for 3 h followed by drinking water for 3 h, daily. Scanning electron micrographs of the occlusal surface of right maxillary first molars were used for scoring wear. The mandibular and left maxillary molar surfaces were used for solubility and fluoride concentration determinations. Intake of food and water separately did not affect wear significantly, whereas solubility and fluoride concentration of the molar surfaces were significantly increased. Wear, solubility and fluoride of the molar surfaces respectively were highly significantly increased in the rats provided with fluoridated water. Increase in fluoride uptake is due in part at least to the increase in sites available for uptake due to tooth wear. Acid dissolution of worn tooth-surface enamel is greater than that of intact enamel.

Animals↗

PubMed2000

Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months.

STATEMENT OF PROBLEM: Severe tooth wear localized to the anterior maxillary or mandibular teeth with loss of interocclusal space is difficult to manage. PURPOSE: This study evaluated the outcome of composite restorations placed at an increased vertical dimension of occlusion in such patients. METHODS AND MATERIAL: Sixteen patients were restored with 104 restorations in 2 groups. In group A, Durafill composite and Scotchbond Multipurpose dentine adhesive system were used to place direct anterior restorations (N = 52). In group B, Herculite XRV composite and Optibond dentine bonding agent was used (N = 52). The restorations were placed at an increased vertical dimension of occlusion creating a posterior disclusion of 1 to 4 mm. RESULTS: Clinical follow-up showed that the posterior occlusion remained satisfactorily restored after a mean duration of 4.6 months (range 1 to 11 months). Mean follow-up of 30 months has shown a combined success rate of 89.4% for both groups with 93 of the restorations remaining in service. Maintenance in group A was high with 33 failures, but low in group B with 6 failures. Patient satisfaction was reported as good. CONCLUSION: Direct composite restorations may be a treatment option for localized anterior tooth wear.

Adult↗

PubMed1996

Tooth wear--dental erosion.

This article aims to address the issues arising out of the increasing concern by general dental practitioners of erosion-related tooth wear. The prevalence, common presentation, differential diagnosis, likely aetiology, prevention and management of suspected cases of this form of tooth wear are considered.

Adolescent↗