Tooth wear and associated risk factors in a sample of Australian primary school children.

BACKGROUND: Anecdotally, tooth wear is increasing, perhaps attributable to diet. The irreversible surface loss may result in sensitivity and loss of form and function. Little data exist on the prevalence of tooth wear in Australian children. This study investigated consumption of potentially erosive foods and drinks, examining the prevalence, distribution of tooth wear and associations in a sample of children. METHODS: Parents of 350, 6-12-year-olds reported their child's oral hygiene, dietary intake, medical and dental histories; 154 children (subsample) were examined. Associations were studied with single and multivariable analyses. RESULTS: Tooth wear was parentally reported for 17% (59 children of the study population) and observed in 66% (102 of the subsample), particularly affecting primary teeth. Significant risk factors for parentally reported tooth wear were: consuming 2-4 cups soft drink/day (OR = 9.52), citrus flavoured sweets/gums ≥1/day (5.10), citrus fruits 1-2/wk (4.28); tooth grinding (5.32); medical condition present (2.48); male gender (2.80). Drinking 2-4 cups fruit juice/day was a significant risk factor for both parentally reported (3.23) and observed tooth wear (3.97). CONCLUSIONS: Tooth wear appeared under-reported as some parents were unaware their child's teeth were affected. Significant risk factors for tooth wear were identifiable from children's histories. Risk factors should be addressed early so that tooth wear in the primary dentition does not affect permanent teeth.

Contemporary fluid intake and dental caries in Australian children.

In Australia, caries experience of 6-year-old and 12-year-old children has increased since the mid to late 1990s. Previously, caries rates had declined, attributable to community water fluoridation. The recent caries increase has been attributed speculatively to changes in fluid intake, including increased consumption of sweet drinks and bottled waters. Increasing urbanization and globalization have altered children's diets worldwide, promoting availability and access to processed foods and sweet drinks. Studies in Australia and internationally have demonstrated significant associations between sweet drink intake and caries experience. Despite widespread fluoride availability in contemporary Australian society, the relationship between sugar consumption and caries development continues and restricting sugar intake remains key to caries prevention. Caries risk assessment should be included in treatment planning for all children; parents should be advised of their child's risk level and given information on oral health promotion. Readily-implemented caries risk assessment tools applicable to parents and clinicians are now available. Public health information should increase awareness that consuming sweet drinks can have deleterious effects on the dentition as well as the potential for promoting systemic disease. Restricting sales of sweet drinks and sweet foods and providing healthy food and drinks for purchase in schools is paramount.

Effect of casein phosphopeptide-amorphous calcium phosphate added to acidic beverages on enamel erosion in vitro.

BACKGROUND: To investigate, in vitro, the effect on enamel erosion of the addition of 0.2% w/v casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to four commercially-available soft drinks, two of which were carbonated. METHODS: Enamel specimens (n=27) were sectioned from sound extracted human third molar teeth and polished to a mirror finish. Exposed enamel windows of 1 mm2 were created by painting the surface with acid-resistant nail varnish. Four citric flavoured soft drinks (pH range 2.2 to 2.4) and distilled deionized water (DDW) were tested. Each drink was tested with and without 0.2% CPP-ACP w/v. The specimens were placed into 50 mL of solution at 37 °C for 30 minutes, rinsed and varnish removed. The samples were profiled with a white light profilometer and erosive depths recorded. RESULTS: All soft drinks tested caused enamel erosion but adding 0.2% w/v CPP-ACP significantly reduced (p<.05) erosive depth in all test solutions in comparison with the solutions without CPP-ACP. The erosive depths for all solutions with 0.2% CPP-ACP did not differ significantly from those of DDW. CONCLUSIONS: Adding CPP-ACP at 0.2% w/v significantly decreased the erosivity of all four soft drinks. The erosivity of the soft drinks with 0.2% CPP-ACP added did not differ significantly from that of distilled water.

Factors associated with dental admissions for children aged under 5 years in Western Australia.

OBJECTIVE: There is limited literature describing dental admissions in preschool children. This paper describes dental hospital admissions and associated factors in children aged under 5 years. DESIGN: This study uses total population data for Western Australia, which link midwives' information with birth defects, intellectual disability, hospital admissions and deaths. Children born 1980-1995 (n = 383,665) were followed until 5 years. Intellectual disability data were available for children born between 1983 and 1992. Admission data including length of stay were examined. OUTCOME MEASURES: Admissions for each relevant 9th Revision of the International Classification of Diseases, Clinical Modification (ICD-9) principal diagnosis category and factors associated with having had a dental admission (all categories) and ICD-9 521 (mostly caries) in particular were investigated. RESULTS: There were 11,523 dental admissions involving 10,493 children. Of all dental admissions, 76% were in ICD-9 category 521, which included admissions for dental caries. After adjusting for confounders, children with intellectual disability (odds ratio 1.92; 95% CI 1.63 to 2.27) and birth defect 1.85 (1.68 to 2.05) were more likely to have had a dental admission. Children living in a region without fluoridated water were also more likely to have had a dental admission 2.16 (1.94 to 2.40). Males were more likely to have had a dental admission 1.16 (1.08 to 1.25), as were children with an indigenous mother 1.17 (1.02 to 1.34). Investigation of ICD-9 521 admissions showed associations similar to those described above except for mother being indigenous, which was associated with reduced likelihood of admission. CONCLUSION: Given the burden of dental admissions in young children, these findings highlight the need for improved oral care for children.

Acidic diet and dental erosion among athletes.

BACKGROUND: The consumption of acidic foods and drinks is increasing in popularity. The purposes of the present study were to investigate the consumption patterns of acidic foods and drinks among several sport groups and to examine any relationships between consumption patterns and dental erosion. METHODS: A questionnaire of oral health habits, diet and dental health was developed. Thirty-two sports clubs (690 members) of the University of Melbourne participated in a survey. A total of 508 usable questionnaires were received (74.9 per cent response). Descriptive statistics were prepared and logistic regression was used to explore relationships between dental erosion (dependent variable) and the independent variables. RESULTS: Dental erosion was reported by 25.4 per cent of respondents, particularly among athletes of the Martial arts (affecting 37.4 per cent). The consumption of acidic foods and drinks was frequent among most athletes. No significant associations were identified between dental erosion and the frequency of drinking soft drinks or sports drinks. Statistically significant associations were found between dental erosion and age group (p=0.004), frequency of drinking juices (p=0.05), and tooth sensitivity (p=0.001). CONCLUSION: Athletes may be placing themselves unintentionally at risk of dental erosion and dentists could counsel athletes to control and reduce the effect of potentially erosive foods and drinks.

Teaching paediatric dentistry by multimedia: a three-year report.

Clinical cases can now be simulated utilising multimedia and used to teach case management to dental students. The modules developed should provide intellectual stimulation, user-interaction and immediate feedback, in addition to being intuitively navigated and user-helpful. Five paediatric dental case modules (early childhood caries, anterior trauma, anterior coronal fragment, anterior crossbite and dentigerous cyst) were created, installed in a multimedia presentation tool, PathFinder (from Westmead Hospital Dental Clinical School, New South Wales, Australia), and used to teach three classes of fourth year dental students at The University of Melbourne. Questionnaires, focus groups and a review were conducted by an external educational expert. Students responded anonymously to general learning questions and case specific questions using a five-point Likert scale (strongly agree to strongly disagree). Student responses indicated they were very enthusiastic about learning via multimedia, although a few students disliked this educational approach. Focus groups and external review indicated that the modules were navigated readily and were suitably interactive.