Prevalence of dental erosion in children: a national survey.

OBJECTIVES: To measure the prevalence of dental erosion in permanent teeth in Iceland as part of the National Oral Health Survey. METHODS: A representative, nationwide sample of 2251 Icelandic children, 20% of those aged 6, 12 and 15 year, was examined. Dental erosion was recorded for all erupted permanent teeth and graded using the modified scale of Lussi. RESULTS: Erosion was not seen in the permanent teeth of six-year-olds, but was present in 15.7% of 12-year-olds, more frequently in boys than girls (19.9% boys, 11.0% girls; P < 0.001). Among 15-year-olds, dental erosion was seen among 30.7% of subjects (38.3% boys, 22.7% girls; P < 0.001). Severity of erosion was mostly scored as grade I, with only 5.5% of 15-year-olds scored as grade II, mostly on tooth 46 (4.3%) and 36 (4.2%). For 12-year-olds, 0.9% had erosion scores of grade II mostly on tooth 46 (0.8%) and 36 (0.7%). No subjects had erosion of grade III. The most common clinical manifestation of erosion was the appearance of cup-like lesions on the cusps of lower first molars. CONCLUSIONS: Dental erosion was frequently present by the age of 12; the prevalence doubled by age 15 and was seen almost twice as often among boys than girls. Teeth most frequently showing signs of erosion were the lower first molars. The rapidly growing prevalence of erosion demonstrated by this nationwide survey emphasizes the need for further research into the aetiology of erosion and possible methods of preventing and treating this emerging dental problem.

Caries prevalence of permanent teeth: a national survey of children in Iceland using ICDAS.

OBJECTIVES: The Icelandic Oral Health Survey aimed to obtain new national data on the oral health of Icelandic children and teenagers. METHODS: A representative stratified random cluster sample of 2251 Icelandic children in first, seventh and 10th grade, aged approximately 6-, 12- and 15-years old was examined for caries prevalence using the ICDAS criteria. Bite-wing digital radiographs were obtained for the children in 7th and 10th grade. RESULTS: D(3)MFT scores by visual examination of 6-, 12- and 15-year olds were 0.12, 1.43 and 2.78 respectively but when including radiographs, the D(3)MFT rose to 2.11 at 12 years and 4.25 at 15 years. The Significant Caries Index, SiC, by visual examination for 12 and 15 y was 3.7 and 6.7 respectively but was 4.7 for 12 y and 8.9 for 15 y with radiographs. In all age groups and at most disease levels, caries was active in the majority of the lesions (58-100%). The percentage of children with no visually detectable caries at D(3)/D(1) level was 93%/74% for 6 years, 48%/22% for 12 years and 35%/16% for 15 years. When radiographs were included the percentage reduced to 34%/15% for 12 years and 20%/6% for 15 years. Approximately 80% of 12- and 15-year-olds had at least one of their first molars sealed, with the mean number of sealed first molars being 2.2 among 12 y and 2.0 among 15 y. CONCLUSIONS: Caries levels were higher than expected in this national survey and further away from the goals of the National Health Plan for 2010 than anticipated. Caries distribution was skewed with more than half of the children having low caries scores but a wide distribution of caries experience was seen among the remaining population.

Loss of teeth and coronary heart disease.

PURPOSE: This study examined the possible association of three dental factors with total mortality and death from coronary heart disease. MATERIALS AND METHODS: Samples from two studies were combined, for a total of 2,613 individuals aged 25 to 79 years; a total of 353 deaths occurred, of which 82 were from coronary heart disease. The hazard ratio was calculated for total and coronary heart disease mortality by regression for the dental components; conventional risk factors were controlled for in a stepwise manner. RESULTS: For total and coronary heart disease mortality, associations with both edentulousness and number of years of edentulism were statistically significant until smoking was added into the analysis; then, all significance was lost. When the effect of the oral parameters was studied in relation to total and coronary heart disease mortality, after adjusting for age and gender, there was a significant hazard ratio for total mortality, but only for edentulousness. When examined by stepwise regression of the coronary heart disease risk factors, all significance of risk from the three oral parameters was lost, smoking having the largest effect of all risk factors. CONCLUSION: Number of remaining teeth, edentulousness, and number of years of edentulism were not independent risk factors for total or coronary heart disease mortality, but they were surrogate markers for the risk from smoking.