[Assessment of tooth wear depending on Smith and Knight index]. / Evaluarea leziunilor dentare necariogene în functie de indicii Smith si Knight.

UNLABELLED: For the clinical diagnosis of tooth wear Smith and Knight have been suggested the index with the same name, the criteria for the quantification of the hard tissue loss being the size of the area affected and the depth of the defect. The aim of this study was to assess tooth wear depending on Smith and Knight index, on a group of 614 patients. MATERIAL AND METHOD: The criteria for the selection of the patients were the age more than 18 years old and the Smith and Knight index >0. RESULTS: The biggest proportion of tooth wear (47.3%) presented the value 2 of the Smith and Knight index. Most of the tooth wear with Smith and Knight index 3 (54.4%) are abrasions, 71.4% of the tooth wear with Smith and Knight index 1 are attritions, and 20.3% of the tooth wear with Smith and Knight index 3 are erosions. High alcohol consumption is associated with deep tooth wear, exposing dentine (value 2 and 3 of the Smith and Knight index). Currently, various indices are used, making the comparison of the results of prevalence studies difficult.

Treatment received, treatment demand, and treatment need for temporomandibular disorders in 35-year-old subjects.

An epidemiological sample of 114 subjects was followed longitudinally from the age of 15 to 35 years with regard to treatment received, treatment demand, and treatment need for temporomandibular disorders (TMD). Some kind of TMD treatment had been provided to 18% of the subjects during the 20-year follow-up period. Eighty-five percent of those who had received previous TMD treatment reported that the treatment had had a positive effect on their symptoms. The estimated present need for treatment was 11%, but, in line with several other investigations, the active demand for such treatment was much less (3%). From age 15 to 25 years, a small but gradual increase of clinical signs of dysfunction was found. From the age of 25 to 35 years, however, a significant reduction of such signs was noted. One explanation for this reduction of clinical signs and symptoms of TMD might be the stomatognathic treatment received. It was concluded that 18% of the subjects had received some TMD treatment during the 20-year follow-up period. Only 3% still had a demand for such treatment at age 35.

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.

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.

Major clinical findings from a dental survey of elderly people in three different English communities.

A random sample of 2280 subjects aged 60 years or over from three areas of England were examined clinically in order to assess their dental health and needs. Between 33% (south of England) and 57% (north of England) were edentulous. Twenty per cent of all dentate subjects were edentulous in one arch and thus still required a complete denture. Amongst the dentate subjects geographical differences were small, but social class and behavioural differences were large. Dental non-attenders were the group who stood out as having much poorer oral health, averaging six fewer natural teeth than attenders. Nearly 50% of all teeth either had coronal fillings or needed them. Root caries was common, 20-22% of vulnerable teeth were affected and there was an age related increase in disease risk. The mean number of teeth with decayed roots per subject (0.8) was similar to the mean number with decayed coronal surfaces (0.9). Moderate tooth wear and moderate periodontal disease were both widespread. A minority of subjects had a functional dentition of 21 or more teeth. Major changes in the dental status of older adults have taken place in the last 30 years and these will continue, resulting in lower levels of edentulousness but a large need for maintenance of existing restorations.

Assessment of tooth wear in an ageing population.

A random sample of 2222 adults aged 45 years and over was taken from the age/sex registers of two general medical practices in Newcastle upon Tyne, and asked to take part in a dental health survey. A total of 1002 individuals agreed to take part and were visited in their homes. Five hundred and eighty-six subjects were dentate and able to undergo an assessment of tooth wear using the Tooth Wear Index (TWI). Increasing wear with increasing age was observed for all cervical and occlusal/incisal tooth surfaces. Occlusal/incisal surfaces displayed some of the highest mean wear scores, especially in the older age cohorts. With the exception of lingual surfaces of maxillary anterior teeth, no significant variation in tooth wear with age was noted for buccal or lingual surfaces. Greater mean wear scores were observed among males than females, but there was little variation between subjects of different social class backgrounds. The threshold levels of wear suggested for use with the TWI may require modification for use among elderly populations.

CPITN, DMFT, and treatment requirements in a Nicaraguan population.

WHO basic methods were used to assess CPITN, DMFT, and treatment requirements in a population of 178 persons aged 12-64 yr living in urban and rural areas of Nicaragua. Two groups were examined: individuals presenting for dental treatment at health clinics (30%) and subjects chosen randomly at other locations (70%). Mean ages of both groups were similar although females were found in higher percentages among those presenting for dental care. With the exception of one young individual, all subjects had calculus in at least one sextant. About 26% of the subjects who presented for treatment had a > or = 6 millimeter pocket compared to about 14% of the remainder of subjects. The mean DMFT for health clinic subjects was 16.1 compared to 10.3 for subjects from other locations. Subjects presenting for treatment had twice as many missing teeth and a mean of 0.5 filled teeth compared to 2.4 filled teeth for other subjects. Subjects at the clinics were in greater need of restorative care and extractions, while subjects from other locations were found to have more teeth that did not require any treatment. Health clinic subjects reported more visits to the dentist in the last year than other subjects. Only 80% of those presenting for treatment owned a toothbrush compared to 97% of those examined in other locations, and the latter group reported brushing their teeth more frequently. Attrition was a commonly encountered tooth disorder with 53% of all subjects exhibiting this condition.

Wear of teeth in a mentally retarded population.

The study includes an evaluation of dental wear in 69 individuals, 44 men and 25 women, of mean age 35 years and range 18-59 years, living in a home for mentally retarded persons. Wear was evaluated with a newly developed index based on Ryges' system, where the need for treatment is the key issue. The index consisted of three categories representing clinical situations from no wear to moderate, age dependent wear without problems for the patient, and two categories in which treatment was found to be necessary either to prevent future problems or to improve the present situation. A relatively large number of teeth showed considerable wear in the 20-29 year age group. Wear was observed predominantly in incisors and canines. Only 1% of cases were considered to require treatment. Wear increased with age, and more than 5% of teeth were diagnosed as needing treatment in the 30-39 year and 40-49 year age groups. Wear in the studied population was found to be more severe than that observed in an urban population from the same area in a parallel study.