Erosive Tooth Wear, Presence of Parafunctional Habits and Tooth Injuries-Occurrence in a Group of Children and Adolescents Exposed to Domestic Violence.

OBJECTIVES: To compare the prevalence of parafunctional habits, erosive tooth wear and occurrence of tooth injuries among children being under the care of Social Welfare Centre and children treated in the Department of Children's Dentistry of the Medical University of Warsaw. STUDY DESIGN: The study contains environmental and medical interviews, record-based analysis and clinical examination. Parafunctional habits were rated on the base of dental interviews and clinical examinations. The occlusal surfaces were evaluated by visual examination using modified tooth wear index (TWI). Tooth injuries were reported from a medical interview labeled using Andreasen classification. The consent of the bioethics committee and guardians of children participated in the study was obtained. RESULTS: The study involved 782 patients, including 404 children from dysfunctional families (average age 11,4 ± 3,7) and 378 from ordinary families-control group (8,53 ± 3,92). In the study group we observed higher prevalence of erosive tooth wear (44,66% vs 18,02% p=0,000), dental trauma (9,4% vs 3,44% p=0,001) and a presence of parafunctional habits (67,8% vs 20,4 % p=0,000). CONCLUSION: The occurrence of parafunctional habits, erosive tooth wear and tooth injuries may be an indicator of domestic violence and a component of maltreated child syndrome.

Assessment of Antagonist Enamel Wear and Clinical Performance of Full-Contour Monolithic Zirconia Crowns: One-Year Results of a Prospective Study.

PURPOSE: To assess the clinical performance and survival of full-contour monolithic zirconia (MZ) crowns and enamel wear produced over a 1-year period. MATERIALS AND METHODS: 60 patients requiring full-coverage restorations for endodontically treated posterior teeth opposed by healthy unrestored antagonistic teeth were selected. MZ crowns were fabricated. Vinyl polysiloxane impressions of the antagonist teeth were made, and the stone casts were digitized using a 3D laser scanner. Wear of the opposing natural teeth was evaluated at baseline (1 week), 6 months, and 1 year after crown cementation. Superimposition of the follow-up scans on the baseline scans were performed to evaluate wear. Survival and function of the restorations were evaluated by the modified USPHS rating criteria at the same timeframes. RESULTS: Comparison of the baseline and the follow-up wear values was statistically tested using the paired t-test. Statistical significance was noted between the wear values at 6 months (15.5 µm) and at 12 months (16.3 µm) (p < 0.05). The Wilcoxon signed rank sum test was performed to evaluate each parameter of the modified USPHS criteria and to analyze the change in the follow-up scores of the restorations. The survival rate for the crowns was 100%. Results were classified as "excellent" over a 1-year follow up. CONCLUSIONS: MZ crowns showed promising results related to antagonist enamel wear and survival/clinical performance.

Tooth wear risk assessment and care-planning in general dental practice.

Objective To assess charting, risk assessment and treatment-planning of tooth wear between recently qualified and experienced dentists in general dental practice.Design Service evaluation.Setting Multi-setting evaluation of three mixed NHS/Private general dental practices in North-East London.Methods The clinical notes of new patient examinations on dentate adults presenting from the 1 October 2016 to 31 December 2016 were audited collecting data on tooth wear charting, risk assessment and treatment planning. Data were analysed using descriptives, chi square and logistic regressions in SPSS. Significance was inferred at p <0.05.Results Foundation dentists and experienced dentists performed 85 and 200 new patient examinations, respectively, during the evaluation period. Tooth wear was charted for 48% of those attending foundation dentists and 5% of those attending experienced dentists. Diet was assessed in 50.6% of patients examined by foundation dentists and 1.0% of patients examined by experienced dentists. Foundation dentists were more likely to chart tooth wear, risk assess and preventively manage tooth wear compared to experienced dentists (p <0.001).Conclusion This service evaluation highlights that improvements are required in recording, risk assessing and preventive treatment planning of erosive tooth wear. Experienced dentists were less likely to risk assess tooth wear and less likely to provide preventive treatment. Experienced GDPs may benefit from re-training in this area.

The Influence of Behavioural and Sociodemographic Risk Indicators on Erosive Tooth Wear in Flemish Adolescents, Belgium.

Although Belgium has recently been ranked as the second highest consumer of soft drinks in Europe, no data on erosive tooth wear (ETW) are currently available. Therefore, the aim of this cross-sectional study was to determine the prevalence and associated risk indicators of ETW in adolescents residing in the region of Flanders, Belgium. Convenience sampling was used to recruit participants from different types of Belgian schools: general and vocational/technical education. Three calibrated dentists performed the dental examinations and a self-reported questionnaire was applied to evaluate risk indicators related with ETW. ETW was classified using the Basic Erosive Wear Examination (BEWE) index, and the overall prevalence was calculated using BEWE sum >0. The Kruskal-Wallis test, the Mann-Whitney U test, and logistic regression analysis were performed to evaluate frequencies and risk associations. From a total of 613 recruited adolescents (mean age: 15.1 years, SD: 0.8), 48.6% presented at least one affected tooth surface by ETW (BEWE sum >0), 14.4% (n = 88) scored BEWE sum >2, and the highest score obtained was BEWE sum = 8. Two predictive variables were found to have an association with ETW: vocational/technical type of education (OR: 1.49; 95% CI: 1.03-2.13) and frequent consumption of soft drinks (OR: 2.08; 95% CI: 1.38-3.14). In conclusion, ETW is a common condition presented with low severity among Flemish adolescents. Additionally, the frequent consumption of soft drinks and being part of a vocational/technical education appear to be risk indicators for ETW in this population. The latter indicates the need for specific orientated oral health promotion programmes for the prevention of ETW in Flemish adolescents.

Risk Assessment for Tooth Wear.

Tooth wear has an increasing prevalence in the UK population. The aetiology is commonly multifactorial, and the aetiopathology is through a combination of erosion, attrition, abrasion and abfraction. Erosion is associated with intrinsic or extrinsic acids, and therefore subjects with reflux disease and eating disorders are at increased risk. Fruit juice, fruits and carbonated drink consumption, frequency of consumption and specific habits are also risk factors. Attrition is more prevalent in bruxists. Other habits need to be considered when defining the risk of tooth wear. Abrasion is usually associated with toothbrushing and toothpastes, especially in an already acidic environment. Patients with extensive lesions that affect dentin may be at higher risk, as well as those presenting with unstained lesions. Monitoring of the progress of tooth wear is recommended to identify those with active tooth wear. Indices for tooth wear are a helpful aid.

Usefulness assessment indices of non-carious dental defects with consideration of aetiological factors and the quality criterion.

Much attention is being paid in the current literature to the necessity of raising awareness of the problem of tooth wear. The aim of this paper is to discuss advantages, disadvantages and modifications of currently used tooth wear indices with particular attention drawn to the advantages of their use both in everyday practice and epidemiological research, as well as an attempt to make the choice of a wear index easier and better adjusted for the needs of a single patient or a group of patients. The paper compares index assessment attempts available in the current literature in the context of validity of criteria choices and reliability results. The role of supporting methods is stressed as they facilitate both diagnosis and storing of data on tooth wear, as well as usefulness of indices which comprise therapeutic recommendations.

Current concepts on the management of tooth wear: part 1. Assessment, treatment planning and strategies for the prevention and the passive management of tooth wear.

The aim of this series of four articles on tooth wear management is to provide the reader with the necessary information in order to be able to successfully manage cases of tooth wear, regardless of the cause, severity and location of the wear pattern seen. The content will largely focus on contemporary clinical techniques, illustrated where possible by case examples. Emphasis will be placed on 'additive adhesive techniques' utilising fixed prosthodontic protocols; however, cases of tooth wear amongst partially dentate patients involving the use of removable prostheses will also be described. The importance of patient consent and contingency planning will also be discussed. Paper 1 will describe the assessment of the wear patient, including the rationale for the planning of dental care. Also discussed will be the administration of preventative and passive management strategies for cases displaying tooth wear.

Risk indicators for tooth wear in Sri Lankan adolescents.

The aim of the study was to determine the risk indicators for tooth wear in Sri Lankan adolescents. A total of 1,200 17-year-olds were selected using a two-stage cluster sampling technique from schools in the Colombo district. The data were collected by means of a self-administered questionnaire and a clinical examination. A modified version of Smith and Knight's index of tooth wear was used to record tooth wear on occlusal/incisal, buccal and lingual/palatal surfaces of teeth excluding the third molars. Tooth wear was present in 22% of the adolescents, while nearly 9% had at least 1 wear lesion extending up to the dentine. In the multivariate logistic regression analysis, the consumption of Coca Cola(R) (OR: 2.60; 95% CI: 1.41-4.78), apples (OR: 1.63; 95% CI: 1.04-2.58), the father's occupation (OR: 2.20; 95% CI: 1.29-3.74) and chewing vitamin C tablets (OR: 1.68; 95% CI: 1.03-2.75) were significantly associated with dentinal wear, while tooth wear was associated with the consumption of oranges (OR: 1.60; 95% CI: 1.09-2.37) and apples (OR: 1.38; 95% CI: 1.06-1.80), the father's occupation (OR: 1.81; 95% CI: 1.22-2.68) and chewing vitamin C tablets (OR: 1.44; 95% CI: 1.04-2.00). As the father's occupation could be considered as a proxy measure of socioeconomic status, the findings suggest that tooth wear in Sri Lankan adolescents is a disorder of affluence.