Prevalence and progression of erosive tooth wear among children and adolescents in a Swedish county, as diagnosed by general practitioners during routine dental practice.

OBJECTIVES: To investigate the prevalence and four-year progression of erosive tooth wear (ETW) recorded in general dental practice, and to evaluate the usefulness of a simplified grading scale. METHODS: Four cohorts (aged 3, 7, 11 and 15 years at baseline; n = 735) were followed from 2008 to 2012 during their routine dental examinations. Grading of ETW was performed on permanent upper incisors and first molars, using the scales of Johansson et al. 1996 and Hasselkvist & Johansson 2010. RESULTS: Valid data were available for 641 individuals, 7-19-years of age, of whom 326 had data allowing analyses of progression. The prevalence of ETW increased with age, although at a lower level than in comparable studies. Progression was found in one-third of the subjects, with higher proportions and higher grades noted among the older cohorts. The simplified scale, that graded only four surfaces, resulted in just a few missed, mainly mild, cases of ETW. CONCLUSIONS: Clinically significant signs of ETW and patterns of progression can be reliably detected if the erosion index used includes a few selected surfaces of permanent teeth as part of the routine dental examination. Early signs of ETW, however, seem to be more difficult to detect and evaluate. CLINICAL SIGNIFICANCE: It is both possible and beneficial to introduce the diagnosing of ETW in routine dental examinations. To reduce the time involved in grading every patient, the simplified 4-surface application, seems to be a useful tool, but which is to be augmented with more extensive grading in individuals considered to be at risk.

A 4 year prospective longitudinal study of progression of dental erosion associated to lifestyle in 13-14 year-old Swedish adolescents.

OBJECTIVES: To evaluate the progression of dental erosion in 13-14 year-olds after 4 years, and its association with lifestyle and oral health. METHODS: 227 randomly selected 13-14 year-olds from a Public Dental Clinic, Örebro, Sweden, were investigated. A clinical examination was performed which included dental caries/gingival/plaque status, as well as grading of dental erosion at the tooth surface and participant levels in "marker teeth", including buccal/palatal surfaces of 6 maxillary anterior teeth (13-23), and occlusal surfaces of first molars. An interview and a questionnaire regarding drinking habits and other lifestyle factors were completed. All investigations were repeated at follow-up. The participants were divided into high and low progression erosion groups and logistic regression statistics were applied. RESULTS: 175 individuals participated at follow-up. Progression occurred in 35% of the 2566 tooth surfaces. 32% of the surfaces had deteriorated by one severity grade (n=51 individuals) and 3% by two grades (n=2 individuals). Boys showed more severe erosion than girls at the follow-up. Among the variables predicting greater progression, a lower severity of erosive wear at baseline had the highest OR (13.3), followed in descending order by a "retaining" drinking technique, more frequent intake of drinks between meals, low GBI and lesser sour milk intake, with reference to the baseline recording. Using these five variables, sensitivity and specificity were 87% and 67% respectively, for predicting progression of erosion. CONCLUSIONS: Progression of erosive lesions in Swedish adolescents aged 13-14 years followed up to age 17-18 years was common and related to certain lifestyle factors. CLINICAL SIGNIFICANCE: In permanent teeth, dental erosion may develop early in life and its progression is common. Dental health workers should be made aware of this fact and regular screenings for erosion and recording of associated lifestyle factors should be performed.

Association between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents.

OBJECTIVE: The aim was to investigate the relationship between soft drink consumption, oral health and some lifestyle factors in Swedish adolescents. MATERIALS AND METHODS: A clinical dental examination and a questionnaire concerning lifestyle factors, including drinking habits, oral hygiene, dietary consumption, physical activity and screen-viewing habits were completed. Three hundred and ninety-two individuals completed the study (13-14 years, n = 195; 18-19 years, n = 197). The material was divided into high and low carbonated soft drink consumption groups, corresponding to approximately the highest and the lowest one-third of subjects in each age group. Differences between the groups were tested by the Mann-Whitney U-test and logistic regression. RESULTS: Intake of certain dietary items, tooth brushing, sports activities, meal patterns, screen-viewing behaviors, BMI and parents born outside Sweden differed significantly between high and low consumers in one or both of the two age groups. Dental erosion (both age groups) and DMFT/DMFS (18-19 years group) were significantly higher in the high consumption groups. Logistic regression showed predictive variables for high consumption of carbonated soft drinks to be mainly gender (male), unhealthy dietary habits, lesser physical activity, higher BMI and longer time spent in front of TV/computer. CONCLUSION: High soft drink consumption was related to poorer oral health and an unhealthier lifestyle.

Dental erosion and soft drink consumption in Swedish children and adolescents and the development of a simplified erosion partial recording system.

The aims of this study were to investigate the prevalence of dental erosion among Swedish children and adolescents and to examine its relation to soft drink consumption. It was hypothesized that the prevalence of dental erosion would be higher in boys than girls,that it would show a correlation with soft drink consumption and that a further simplification ofa previously-used partial recording screening system for dental erosion would have an acceptable sensitivity and specificity. 801 individuals were invited to participate, of whom 609 (75%) accepted. 135 were 5-6 years, 227 were 13-14 years, and 247 were18-19 years old. A questionnaire survey of each individual's soft drink consumption habits, in addition to a clinical examination, were performed. Severe erosion extending into dentine on one or more maxillary anterior teeth/ molars was found to be 13.3% in the 5-6 group, 11.9% in 13-14 group and 22.3% in 18-19 group. The total prevalence for all age groups was 16.4%. The severity of erosion was highest among 18-19 year-old boys, 34.4 % of whom exhibited one or more teeth with severe erosive damage while none of the girls did so. Soft drink consumption was significantly correlated with severity of dental erosion in the 18-19 and 13-14 groups but not in the 5-6 years old group. A simplified erosion partial recording system (SEPRS) using 4 (permanent) or 6 (primary) surfaces as markers showed excellent sensitivity (100%/100%, respectively) and specificity (98%/100%, respectively) in relation to scoring of all maxillary canines/incisors and first permanent/all primary molars. In view of the high prevalence of dental erosion and soft drink consumption among Swedish children and adolescents reported here,there is clearly a need for a national epidemiological registration system as well as for community-based preventive programs to be implemented. The hypothesis that dental erosion would be higher in boys than girls and that it would show a correlation with soft drink intake was confirmed.