Polyphenols for Preventing Dental Erosion in Pre-clinical Studies with in situ Designs and Simulated Acid Attack.

Dental erosion is a chemical process characterized by acid dissolution of dental hard tissue, and its etiology is multifactorial. Dietary polyphenols can be a strategy for dental erosion management, collaborating to preserve dental tissues through resistance to biodegradation. This study describes a comprehensive review to interpret the effects of polyphenols on dental erosion of pre-clinical models with in situ designs and simulated acid attacks on enamel and dentin samples. We aim to evaluate evidence about Polyphenols' effects in the type of dental substrate, parameters of erosive cycling chosen in the in situ models, and the possible mechanisms involved. An evidence-based literature review was conducted using appropriate search strategies developed for main electronic databases (PubMed, Scopus, Web of Science, LILACS, EMBASE, LIVIVO, CINAHL, and DOSS) and gray literature (Google Scholar). The Joanna Briggs Institute checklist was used to evaluate the quality of the evidence. From a total of 1900 articles, 8 were selected for evidence synthesis, including 224 specimens treated with polyphenols and 224 control samples. Considering the studies included in this review, we could observe that polyphenols tend to promote a reduction in erosive and abrasive wear compared to control groups. However, as the few studies included have a high risk of bias with different methodologies and the estimated effect size is low, this conclusion should not be extrapolated to clinical reality.

A Brief History of Tooth Wear.

Historical publications that have significantly improved the understanding of tooth wear mechanisms are reviewed with a focus on descriptions of the lesions, the evolution of their classification systems, and considerations addressing the main risk factors. Surprisingly, most important advances are often the oldest. Likewise, they are currently only marginally known, which requires a major dissemination effort.

General and erosive tooth wear of 16-year-old adolescents in Kuantan, Malaysia: prevalence and association with dental caries.

BACKGROUND: The objective of this study was to determine the prevalence and severity of general tooth wear (GTW), i.e. tooth wear irrespective of etiology and erosive tooth wear (ETW), i.e. tooth wear predominantly due to erosion; and also to investigate the relationship between ETW and dental caries experience in 16-year-old adolescents in Kuantan, Malaysia. METHODS: A multi-staged cluster sampling method was employed. A total of 598 16-year-old adolescents participated in this study. Participants' demographic profile was assessed through a self-administered questionnaire. Clinical examinations were carried out under standardized conditions by a single examiner. The level of GTW was recorded using the modified Smith and Knight's Tooth Wear Index (TWI) whilst ETW were recorded using the Basic Erosive Wear Examination (BEWE) index. This index was developed to record clinical findings and assist in the decision-making process for the management of erosive tooth wear. Dental caries was recorded using the D3MFT index whereby D3 denotes obvious dental decay into dentine detected visually. RESULTS: The prevalence of GTW, ETW and dental caries, i.e. percentage of individuals found to have at least one lesion, was 99.8%, 45.0% and 27.8% respectively. Two thirds of affected teeth with GTW were observed to have a TWI score of 1 whereas almost all of the affected teeth with ETW had a BEWE score of 2. The mean D3MFT was 0.62 (95% CI 0.50, 0.73) with Decayed (D) teeth being the largest component, mean D3T was 0.36 (95% CI 0.30, 0.43). There was no significant association between socio-demographic factors and prevalence of ETW. Logistic regression analysis also showed no significant relationship between the prevalence of ETW and D3MFT (p > 0.05). CONCLUSIONS: Almost all adolescents examined had GTW but they were mainly early lesions. However, nearly half were found to have ETW of moderate severity (BEWE score 2). No significant relationship between the occurrence of erosive tooth wear and caries was observed in this population.

Influence of inter-dental tissues and root surface condition on complete root coverage following treatment of gingival recessions: a 1-year retrospective study.

AIM: To explore the influence of inter-dental tissues and root surface condition on complete root coverage following surgical treatment of gingival recessions. METHODS: Three hundred and eighty-six single recessions treated over 28 years were assessed. Patient-level and periodontal variables, presence/loss of inter-dental tissues, and presence/absence of non-carious cervical lesions (NCCLs) were recorded. Root coverage was assessed 1-year post-surgery. Multilevel analysis was performed to identify predictors of CRC. RESULTS: Based on type of root coverage procedure four patient groups were created: free gingival graft (FGG) (n = 116), coronally advanced flap (CAF) (n = 107), CAF+connective tissue graft (CTG) (n = 131), and guided tissue regeneration (GTR) (n = 32). Percentages of complete root coverage (CRC) were 18.1% for FGG, 35.5% for CAF, 35.1% for CAF+CTG, and 18.8% for GTR. There was an OR = 0.26 (p < 0.0001) of achieving CRC in cases with loss of inter-dental tissue compared with cases with no inter-dental tissue loss. Similarly, cases with presence of NCCL showed an OR = 0.28 (p < 0.0001) of achieving CRC compared with cases without a NCCL. FGG achieved less CRC then CAF+CTG (p = 0.0012; OR = 0.32). CONCLUSIONS: NCCLs, just like inter-dental tissue loss, are significant negative prognostic factors in achieving CRC following root coverage procedures.

Oral health of elite athletes and association with performance: a systematic review.

BACKGROUND: We aimed to systematically review the epidemiology of oral disease and trauma in the elite athlete population and to investigate the impact of oral health on sporting performance. METHODS: Authors searched Ovid MEDLINE (1950 to October 2013), Ovid EMBASE (1980 to October 2013), EBSCO SPORTDiscus (up to October 2013) and OpenGrey (http://www.opengrey.eu). No date or language restrictions were applied. Papers were included if they evaluated the oral health of professional athletes. The methodological quality of papers was evaluated using a modification of the Newcastle-Ottawa scale. RESULTS: The literature search led to 9858 potentially relevant citations. Following a set of predefined exclusion criteria, 34 studies remained. Twenty-six studies reported on dental trauma, which ranged in prevalence from 14% to 47% varying by sport and country. Sixteen studies considered the oral health of athletes and reported high prevalence of oral diseases: dental caries 15-75%, dental erosion 36-85%, periodontal disease 15%. In four studies, a range between 5% and 18% of athletes reported negative impact of oral health or trauma on performance. The methodological quality of included studies was generally low. CONCLUSIONS: Within the limits of the review, oral health of athletes is poor. We hypothesise that poor oral health associates with self-reported performance; however, this needs to be tested. Further studies on representative samples of athletes are needed to assess the size of the problem of poor oral health as well as to investigate the possible impact on performance using objective measures of performance.

Toothbrushing after an erosive attack: will waiting avoid tooth wear?

The purpose of this study was to determine if storage for up to 4 h in human saliva results in a decrease of erosive tooth wear (ETW) and in an increase of surface microhardness (SMH) of enamel samples after an erosive attack with subsequent abrasion. Furthermore, we determined the impact of individual salivary parameters on ETW and SMH. Enamel samples were distributed into five groups: group 1 had neither erosion nor saliva treatment; groups 2-5 were treated with erosion, then group 2 was placed in a humid chamber and groups 3-5 were incubated in saliva for 30 min, 2 h, and 4 h, respectively. After erosion and saliva treatments, all groups were treated with abrasion. Surface microhardness and ETW were measured before and after erosion, incubation in saliva, and abrasion. Surface microhardness and ETW showed significant changes throughout the experiment: SMH decreased and ETW increased in groups 2-5, regardless of the length of incubation in saliva. The results of groups 3-5 (exposed to saliva) were not significantly different from those of group 2 (not exposed to saliva). Exposure of eroded enamel to saliva for up to 4 h was not able to increase SMH or reduce ETW. However, additional experiments with artificial saliva without proteins showed protection from erosive tooth wear. The recommendation to postpone toothbrushing of enamel after an erosive attack should be reconsidered.

Rehabilitation of a patient with an elusive medical history and loss of occlusal vertical dimension.

In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay.

[Optimization of treatment of wedge-shaped tooth defects with hyperesthesia].

Development of tooth wedge-shaped defect leads to a gradual loss of hard tissue and is characterized by pain. Most often patients complain of pain and aesthetic defect that adversely affects the emotional status and quality of life. Search for adequate means and methods of treatment providing increased resistance of dental hard tissues and reducing hyperesthesia is challenging for dentists. Wedge-shaped defect and hyperesthesia as concomitant symptom was found in the city of Ufa in the 5.65 and 63.0% of dental patients, respectively. Analysis of the questionnaires revealed a relationship between the sociological parameters (gender, age, profession) and the patient's quality of life. Improvement of all clinical manifestations was observed in the result of complex treatment.

Influence of different ultra-soft toothbrushes on erosive tooth wear.

OBJECTIVE: To investigate the influence of different ultra-soft toothbrushes on the progression of erosive tooth wear (ETW). METHODS: Bovine enamel and dentin specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3% citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, with the different toothbrushes tested (A- Edel White: flexible handle, tapered bristles; B- Oral-B Gengiva Detox: regular handle, criss-cross tapered bristles; C- Colgate Gengiva Therapy: flexible handle, tapered bristles, high tuft density; d- Oral-B Expert Gengiva Sensi: regular handle, round end bristles, high tuft density; E- Oral-B Indicator Plus: soft brush, round end bristles (control). Surface loss (SL, in µm) was assessed by optical profilometry. The toothbrush characteristics were evaluated by a surgical microscope. Data were statistically analyzed (α=0.05). RESULTS: For enamel, toothbrush C showed the highest SL (means±SD: 9.86 ± 1.28) and it did not differ significantly from A (8.60 ± 0.50), both with flexible handles. The lowest SL was observed for the toothbrush Control E (6.76 ± 0.63), which differed significantly from A and C, but not from the other toothbrushes. For dentin, the highest SL was found for toothbrush D (6.97 ± 1.05) and it did not differ significantly from E (6.23 ± 0.71). The lowest SL was observed for B (4.61 ± 0.71) and C (4.85 + 0.83), without significant differences from A (5.01 ± 1.24). CONCLUSIONS: The ultra-soft toothbrushes had different impacts on the progression of ETW on the dental substrates. On enamel, higher ETW values were observed for the flexible handle toothbrushes, while for dentin, round-end bristles (ultra-soft and soft) caused more ETW. CLINICAL SIGNIFICANCE: Knowledge about the effect of different ultra-soft toothbrushes on ETW can help clinicians to recommend the most suitable types for their patients, bearing in mind that toothbrushes can impact enamel and dentin differently.

Prevalence of dental attrition and its relationship with dental erosion and salivary function in young adults.

OBJECTIVES: The aim of this study was to estimate the prevalence of dental attrition in a young adult population and to explore associated factors. METHOD AND MATERIALS: Dental students aged 18 to 40 years old with a minimum of 24 natural teeth were invited to take part in this cross-sectional study. Their demographic information, medical history, perceived stress, frequency of dietary acid intake, and frequency of oral habits were obtained through several questionnaires. Assessment of each type of tooth wear (erosion, attrition, and abrasion) was performed according to the tooth wear evaluation system (TWES 1.0). All participants underwent salivary tests. Statistical analysis was performed by chi-squared or Mann-Whitney tests and logistic regression models. RESULTS: In total, 178 participants (88 women and 90 men) with a median age of 22 years were included and of those 74.7% (95% confidence interval [CI], 68% to 81%) had dental attrition. Univariate analysis revealed positive associations for male sex, age, body mass index, awake bruxism frequency, and erosive tooth wear with the presence of dental attrition. Multivariable logistic regression (Nagelkerke r2 = 0.31) indicated that dental attrition was associated with erosive tooth wear (adjusted odds ratio [aOR], 6.3; 95% CI, 2.8 to 14.2), body mass index (aOR, 1.3; 95% CI, 1.1-1.5), and age (aOR, 1.2; 95% CI 1.0 to 1.3). CONCLUSION: Dental attrition is present in most young adults of Catalonia. The associated factors were erosive tooth wear, body mass index, and age. Slight alterations of salivary parameters do not seem to predict dental attrition. (Quintessence Int 2023;54:168-175; doi: 10.3290/j.qi.b3622405).

Prevalence of tooth wear and associated factors: A birth cohort study.

OBJECTIVES: To investigate the prevalence of tooth wear and associated factors in adults from the 1982 Pelotas Birth Cohort. METHODS: A subsample of the 5,914 individuals from the 1982 Pelotas Birth Cohort was randomly selected to be interviewed and clinically examined at the age of 31. Tooth wear was evaluated using a simplified version of the Tooth Wear Index (TWI), considering the absence or presence of tooth wear in dentin of first molars and anterior teeth (incisors and canines). Independent variables were socioeconomic, demographic, unhealthy behavior, and mental health. Crude and adjusted Poisson regression models were employed. A significant level of P ≤ 0.05 was adopted. RESULTS: A total of 537 individuals were evaluated. A tooth wear prevalence of 61.6% was observed. Females presented a statistically significant lower tooth wear in dentin prevalence ratio (PR) compared to males in the adjusted analysis (PR 0.76; 95% CI: 0.67-0.86). Acid beverage consumption (PR 1.22; 95% CI: 1.01-1.49) and consumption of alcoholic beverages (PR 1.19; 95% CI: 1.04-1.35) were positively associated with tooth wear. CONCLUSION: Almost 2/3 of the surveyed individuals presented tooth wear in dentin. Being a male, higher consumption of alcohol and acidic beverages were factors associated with tooth wear. CLINICAL SIGNIFICANCE: There was a high prevalence of tooth wear in dentin in the adult population. Data has also shown the etiological complexity of tooth wear, reinforcing the importance of an early diagnosis and the establishment of preventive measures to decrease the potentially hazardous effect of tooth wear over time.

Fluid Intake and the Occurrence of Erosive Tooth Wear in a Group of Healthy and Disabled Children from the Malopolska Region (Poland).

Background: The aim of this study was to analyse the relationship between the type and amount of fluid intake and the incidence of erosive tooth wear in a group of healthy children and children with disabilities. Methods: This study was conducted among children aged 6-17 years, patients of the Dental Clinic in Kraków. The research included 86 children: 44 healthy children and 42 children with disabilities. The prevalence of erosive tooth wear using the Basic Erosive Wear Examination (BEWE) index was assessed by the dentist, who also determined the prevalence of dry mouth using a mirror test. A qualitative-quantitative questionnaire on the frequency of consumption of specific liquids and foods related to the occurrence of erosive tooth wear, completed by the children's parents, was used to assess dietary habits. Results: The occurrence of erosive tooth wear was determined for 26% of the total number of children studied, and these were mostly lesions of minor severity. The mean value of the sum of the BEWE index was significantly higher (p = 0.0003) in the group of children with disabilities. In contrast, the risk of erosive tooth wear was non-significantly higher in children with disabilities (31.0%) than in healthy children (20.5%). Dry mouth was significantly more frequently identified among children with disabilities (57.1%). Erosive tooth wear was also significantly more common (p = 0.02) in children whose parents declared the presence of eating disorders. Children with disabilities consumed flavoured water or water with added syrup/juice and fruit teas with significantly higher frequency, while there were no differences in quantitative fluid intake between groups. The frequency and quantity of drinking flavoured waters or water with added syrup/juice, sweetened carbonated, and non-carbonated drinks were associated with the occurrence of erosive tooth wear for all children studied. Conclusions: The group of studied children presents inappropriate drinking behaviours regarding the frequency and amount of beverages consumed, which, especially in a group of children with disabilities, may contribute to the formation of erosive cavities.

Case Report: Case report: Rapidly progressing tooth wear dominated by intrinsic and extrinsic erosion.

Tooth wear is multi-factorial presenting as a combination of abrasion, attrition, and erosion. This case report represents a case of combined tooth wear in a 46-year-old Indo-Trinidadian male, with a predominant erosive component with both the clinical signs and features of intrinsic and extrinsic erosion. This patient case is unique since the wear predominated by dental erosion has occurred rapidly evidenced by the physical clinical appearance of a lack of compensation and the upper left premolars and molars relatively unaffected by the overall effects of tooth wear. This lack of compensation, where opposing teeth have not supra-erupted to maintain inter-arch stability, and the maintenance of occlusal vertical dimension on the left due to the non-worn posterior maxillary teeth, provides the benefit of simplifying subsequent restorative management. The medical and diet history corroborates the diagnoses of intrinsic and extrinsic erosion respectively. Complications noted with rapid tooth wear, such as dentine sensitivity and pulpal necrosis are known sequelae of tooth wear however the patient presented in this case report shows a concomitant high caries experience and poor oral hygiene. Cases such as the one presented here require not only comprehensive dental management, utilizing a restorative approach but also medical referral for confirmation of a diagnosis and management of gastroesophageal reflux disease. Inherent to the management of this patient should be a multidisciplinary medical and dental approach, with confirmation and management of the cause of the intrinsic erosion as well as restorative dental management, together with dietary counseling to mitigate the effect of intrinsic and extrinsic sources of acid on dental hard tissue. A key lesson learned from this case is the importance of history and targeted questioning when trying to determine the cause of tooth wear dominated by intrinsic and extrinsic erosion.

Prevalence and association of gastroesophageal reflux disease and dental erosion: An overview of reviews.

OBJECTIVES: The aim of this overview of reviews was to retrieve and evaluate the available evidence concerning the prevalence and association between gastroesophageal reflux disease (GERD) and erosive tooth wear (ETW). DATA: A literature search was conducted in electronic databases and relative systematic reviews with or without meta-analyses were located. Updated supplemental search was also undertaken to identify additional primary studies. SOURCES: Medline (via Pubmed), Embase, Scopus, Cochrane Register of Systematic Reviews, PROSPERO and Epistemonikos.org database were searched. Additional search of the gray literature, abstracts of conferences and meetings as well as manual search of the reference lists of retrieved studies, was also performed. STUDY SELECTION: The search retrieved 116 systematic reviews of which 10 were considered eligible and eight additional primary studies. CONCLUSIONS: GERD constitutes a risk factor for ETW and there is a positive association between the two conditions. In the present overview, despite the heterogeneity between studies and the low level of evidence, it was clearly supported that individuals with GERD have an increased probability of also presenting with signs of ETW. In special groups of population, a high association was found between GERD and ETW. The geographic location may affect the association between GERD and ETW, while regarding the effect of flow rate, buffering capacity of saliva and oral microbial changes caused by GERD, the results were controversial. CLINICAL SIGNIFICANCE: Appropriate preventive dental care should be considered for individuals with GERD and a multidisciplinary medical and dental approach for the management of individuals with ETW is advised. The results of this study can be used by dentists dealing with typical and atypical GERD signs and symptoms in the oral environment, but also by the physicians and gastroenterologists who need to motivate their patients for oral examination.

Dental erosion and salivary flow rate in cerebral palsy individuals with gastroesophageal reflux.

BACKGROUND: A high prevalence of gastroesophageal reflux (GERD) has been observed in individuals with cerebral palsy (CP). One of the main risks for dental erosion is GERD. This study aimed to evaluate the presence of GERD, variables related to dental erosion and associated with GERD (diet consumption, gastrointestinal symptoms, bruxism), and salivary flow rate, in a group of 46 non-institutionalized CP individuals aged from 3 to 13 years. METHODS: Twenty CP individuals with gastroesophageal reflux (GERDG) and 26 without gastroesophageal reflux (CG) were examined according to dental erosion criteria, drinking habits, presence of bruxism, and salivary flow rate. A face-to-face detailed questionnaire with the consumption and frequency of acid drinks, gastrointestinal symptoms (regurgitation and heart burn), and the presence of bruxism were answered by the caregivers of both groups. Unstimulated whole saliva was collected under slight suction, and salivary flow rate (ml/min) was calculated. RESULTS: The GERDG presented higher percentages of younger quadriplegics individuals compared to CG. The presence of regurgitation, heart burn, and tooth erosion (Grade 1) was significantly more prevalent in GERDG. It was observed difference in the salivary flow rate between the studied groups. On logistic multivariate regression analysis, the unique variable independently associated with the presence of GERD was dental erosion (P = 0.012, OR 86.64). CONCLUSION: The presence of GERD contributes significantly to dental erosion in the most compromised individuals with quadriplegics cerebral palsy individuals, increasing the risk of oral disease in this population.

The erosion and abrasion-inhibiting effect of TiF(4) and NaF varnishes and solutions on enamel in vitro.

OBJECTIVE. Previous in vitro study has shown that TiF(4) varnish might reduce enamel erosion. No data regarding the effect of this experimental varnish on enamel erosion plus abrasion, however, are available so far. Thus, this in vitro study aimed to analyse the effect of TiF(4) compared with NaF varnishes and solutions, to protect against enamel erosion with or without abrasion. METHODS. Enamel specimens were pre-treated with experimental-TiF(4) (2.45% F), experimental-NaF (2.45% F), NaF-Duraphat (2.26% F), and placebo varnishes; NaF (2.26% F) and TiF(4) (2.45% F) solutions. Controls remained untreated. The erosive challenge was performed using a soft drink (pH 2.6) 4 × 90 s/day (ERO) and the toothbrushing abrasion (ERO+ABR) 2 × 10 s/day, for 5 days. Between the challenges, the specimens were exposed to artificial saliva. Enamel loss was measured profilometrically (µm). RESULTS. Kruskal-Wallis/Dunn tests showed that all fluoridated varnishes (TiF(4) -ERO:0.53 ± 0.20, ERO+ABR:0.65 ± 0.19/NaF-ERO:0.94 ± 0.18, ERO+ABR:1.74 ± 0.37/Duraphat-ERO:1.00 ± 0.37, ERO+ABR:1.72 ± 0.58) were able to significantly reduce enamel loss when compared with placebo varnish (ERO:3.45 ± 0.41/ERO+ABR:3.20 ± 0.66) (P < 0.0001). Placebo varnish, control (ERO:2.68 ± 0.53/ERO+ABR:3.01 ± 0.34), and fluoridated (NaF-ERO:2.84 ± 0.09/ERO+ABR:2.40 ± 0.21/TiF(4) -ERO:3.55 ± 0.59/ERO+ABR:4.10 ± 0.38) solutions did not significantly differ from each other. CONCLUSION. Based on the results, it can be concluded that the TiF(4) varnish seems to be a promising treatment to reduce enamel loss under mild erosive and abrasive conditions in vitro.

Oral rehabilitation of severely worn dentition using an overlay for immediate re-establishment of occlusal vertical dimension.

The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.

[Prosthetic rehabilitation of a traumatic occlusion due to bulimia nervosa. Case report]. / Prothetische Rehabilitation eines durch Bulimia nervosa beeinträchtigten Erosionsgebisses. Ein Fallbericht.

Because of the typical localisation of erosions in anorectic/bulimic patients, the dentist is frequently the first medical person to discern this general illness (anorexia and bulimia nervosa). From the dental viewpoint, the aim should be to preserve sound dental tissue and to prevent further toothwear. A restorative treatment is to be carried out only after causal therapy and after resolving the basic disease. By means of this procedure a good long-term prognosis can be expected. Considering the patient's young age, dentistry should be preservative using the adhesive technique. This case report documents the systematic procedure of the functional and esthetic rehabilitation of an eroded dentition and shows factors essential to the treatment.

Association between gastric reflux, obesity and erosive tooth wear among psychiatric patients.

ABSTRACT: The prevalence of erosive tooth wear and obesity are high in psychiatric patients and soft drink consumption is a common risk factor associated with both diseases. This study aimed to assess the association between soft drink consumption, gastric reflux, erosive tooth wear, and obesity among resident patients at the Psychiatric Hospital, Taif, Saudi Arabia.This descriptive, cross-sectional study included 223 adult psychiatric inpatients (126 male, 97 female) with a mean age of 42.3 years (± 2.2). Dental erosion detection was performed according to World Health Organization criteria. The medical evaluation included assessment of the body mass index (BMI). With appropriate sample weighting, relationships between erosive tooth wear, gastric reflux, and obesity were assessed using multivariable logistic regression.Ninety eight patients (43.9%) presented with erosive tooth wear. The mean BMI for the entire study population was 27.7 ±â€Š6.3 kg/m2. Regression analysis showed a strong association between erosive tooth wear and chronic vomiting or bulimia (adjusted odds ratio = 2.11; 95% confidence interval [CI] = 1.98-5.07, P < .001), gastric reflux (adjusted odds ratio = 2.13; 95% CI = 1.34-6.23, P < .001), consumption of soft drinks (adjusted odds ratio = 2.14; 95% CI = 1.03-6.08, P < .001), and schizophrenia and delusional disorders (adjusted odds ratio = 2.07; 95% CI = 1.98-5.08, P < .001).This study demonstrates a significant association between erosive tooth wear prevalence and chronic vomiting or bulimia, consumption of soft drinks, and gastric reflux among resident patients at psychiatric hospital.

Cervical wear and occlusal wear from a periodontal perspective.

The aim of this study was to investigate whether cervical wear was associated with occlusal wear and clinical periodontal parameters in relatively older adults. A total of 30 patients, with multiple non-carious cervical lesions (NCCLs) and without a disease or condition that could cause heavy tooth wear, were included in the study. The periodontal parameters including plaque index, probing pocket depth, gingival recession (GR) and tooth mobility were obtained from 641 teeth of which 475 (74·1%) displayed NCCLs. The levels of cervical wear and occlusal wear were determined according to a tooth wear index. Premolars were more likely to develop cervical wear than canines, molars and incisors. Cervical wear was significantly associated with less plaque accumulation and the presence of shallow pockets. The teeth with advanced GR and without increased mobility were 2·583 and 1·715 times more likely to develop deeper cervical lesions, respectively. Age and the level of occlusal wear were not linked to the bucco-lingual depth of cervical wear. In conclusion, the significant association of advanced cervical wear with the relatively healthy periodontal status suggested the role of abrasion and its possible combined action with erosion in the aetiology of NCCLs. The rate of GR and the lack of tooth mobility could constitute predisposing factors for the progression of cervical wear because the exposed root surfaces could be more susceptible to abrasion and/or erosion, and the non-mobile teeth resisting strongly against frictional forces, thus abrasive effects, could possibly develop cervical wear.