Epidemiology, aetiology and prevention of tooth wear.

Tooth wear is a commonly reported finding globally; however, many patients are unaware of having tooth wear. Identifying early signs of erosion, abrasion or attrition and determining the risk factors contributing to a patient's tooth wear may help to prevent further loss of enamel and dentine in the future. Appropriate prevention should be instigated, or appropriate referral made to other health professionals, when conditions such as gastroesophageal reflux or eating disorders are suspected. This paper presents the epidemiology and aetiological factors for tooth wear, as well as identifying the common clinical presentations of tooth wear. Patient perspectives on tooth wear and preventive techniques that can be utilised are also discussed.

Factors related to the presence of dental erosion and abrasion in peruvian adults / Factores relacionados con la presencia de erosión y abrasión dental en adultos peruanos

Introduction: Non-carious lesions are an oral health problem in adults, consequently it is necessary to create mechanisms for their diagnosis and prevention. Objective: To determine the frequency of erosion, abrasion and related factors in patients treated at a university dental clinic. Material and Methods: A cross-sectional study was conducted in a sample of 153 adults treated at a university clinic in Lima, Peru, in 2018. Personal aspects (age, sex, characteristics of saliva), dietary factors, health condition, oral habits, and tooth brushing were identified. The presence of abrasion was determined according to clinical criteria through direct observation. Erosion was identified using the Basic Erosive Wear index. Generalized linear models with Poisson distribution with robust variances were used. Results: The frequency of dental abrasion (70.6%) is higher than erosion (26.1%). The presence of erosion is associated with asthma (PR= 2.11), abrasion is related to age and poor dental hygiene habits (PR= 1.67 and 1.30, respectively). Conclusion: The presence of dental abrasion is greater than dental erosion. Age and poor dental habits are factors associated with tooth abrasion. The characteristics of saliva regarding pH and salivary flow were within normal p-values.

Introducción: Las lesiones no cariosas son un problema de salud bucal en adultos siendo necesario establecer mecanismos para su diagnóstico y prevención. Objetivo: Determinar la frecuencia de erosión, abrasión y factores relacionados, en pacientes que acudieron a una clínica odontológica docente universitaria. Material y Métodos: Estudio transversal en una muestra de 153 adultos asistentes a una clínica docente asistencial de Lima en el 2018. Se identificaron factores personales (edad, sexo, características de la saliva), factores dietéticos, condición de salud, hábitos orales y cepillado dental. A través de la observación directa se identificó la presencia de abrasión de acuerdo a criterios clínicos, y de erosión utilizando el índice Basic Erosive Wear. Se utilizaron modelos lineales generalizados con distribución de Poisson con varianzas robustas. Resultados: La frecuencia de abrasión dentaria (70,6%) es mayor que la erosión (26,1%). La presencia de erosión está asociada al asma (RP= 2,11), la abrasión está relacionada con la edad y los malos hábitos de la higiene dental (RP= 1,67 y 1,30 respectivamente). Conclusion: La presencia de la abrasión dental es mayor que la erosión dental. La edad y los hábitos dentales inadecuados son factores asociados con la abrasión dentaria. Las características de la saliva en pH y flujo salival estuvieron dentro de los valores normales.

Evaluation of tooth wear and associated risk factors: A matched case-Control study.

AIM: The aim of this case-control study was to compare the associated risk factors between adults with tooth wear (TW) and age- and sex-matched controls without TW. METHODS: Fifty participants with TW and 50 age- and sex-matched controls participated in this study. A questionnaire was prepared to assess oral healthcare and consumption of erosive food and drinks. All participants completed the diet analysis forms. Saliva characteristics were evaluated with GC Saliva-Check BUFFER test. Examiners measured the TW of case patients, using the TW index. Data were statistically analyzed using Chi-square and Mann-Whitney U-tests (P < 0.05). RESULTS: Individuals in the case group brush their teeth more often (P < 0.05). The difference in erosive food consumption between the case and control groups was significant (P < 0.05). There was no erosive effect of acidic food when consumed as a main meal or a snack (P > 0.05). Although there was no difference between stimulated saliva flow rate and buffering capacity between groups, the difference between the resting saliva flow rates and pH values was significant (P < 0.05). Although some wear was seen on buccal/labial surfaces of teeth, cervical and occlusal/incisal surfaces were scored higher. No TW was observed on palatal/lingual surfaces. The cervical surfaces of mandibular premolars and incisal surfaces of anterior teeth were most affected. CONCLUSION: Of the factors investigated, TW in the case group was correlated with consumption of acidic foods, lower salivary flow rate, and pH.

Lesiones cervicales no cariosas en pacientes del área de salud Eléctrico, municipio Arroyo Naranjo, 2015 / Non carious cervical lesions in patient of the area of health Electric, Arroyo Naranjo municipality, 2015

Introducción: las lesiones cervicales no cariosas son la pérdida patológica de la estructura dentaria localizada en el límite amelo-cementario, que no responden a un agente causal bacteriano. Teniendo en cuenta la incidencia de esta afección en la salud bucal, resulta una necesidad su estudio más detallado, que permita conocer mejor su comportamiento clínico-epidemiológico para favorecer su prevención y tratamiento de una forma más eficaz. Objetivo: determinar la distribución y características de lesiones cervicales no cariosas en pacientes pertenecientes al área de salud Eléctrico del municipio Arroyo Naranjo de la provincia La Habana. Métodos: se realizó una investigación descriptiva transversal en un total de 153 pacientes con lesiones cervicales no cariosas. Fue considerada una lesión cervical no cariosa cuando el paciente presentara alguna de las variantes erosión, abrasión y/o abfracción, o la combinación de estas. Se asumieron para la investigación otras variables como: sexo, edad, grupo de diente, localización y factores de riesgo. Se utilizó la prueba estadística de chi cuadrado para la asociación de variable. Resultados: predominaron el sexo masculino con 52,9 por ciento y el grupo de edad de 37 a 47 años con el 30,7 por ciento. Los premolares resultaron el grupo dentario más afectado con el 38,9 por ciento; se destacó al bruxismo y al cepillado traumático con el 43,8 por ciento y 35,3 por ciento respectivamente. Conclusiones: las lesiones cervicales no cariosas se manifestaron entre los 37 a 47 años, específicamente en los hombres, y afectaron fundamentalmente a los premolares superiores con un promedio de 4 dientes por paciente. El bruxismo y el cepillado traumático constituyeron los factores de riesgo que más se correspondieron con el desarrollo de este tipo de lesión no cariosa a nivel cervical del diente(AU)

Introduction: non-carious cervical lesions are the pathological loss of dental structure located in the amelocementum junction, which do not result from a bacterial causative agent. Given the incidence of this condition in the oral health, it is necessary to study it in detail in order to better know its clinical and epidemiological behavior and to prevent it and treat it more effectively.Objective: to determine the distribution and the characteristics of non-carious cervical lesions in patients from the Electrico health area in Arroyo Naranjo municipality in Havana province. Methods: a cross-sectional descriptive study was conducted on a sample of 153 patients with non-carious cervical lesions. The classification of a non-carious cervical lesion was considered when a patient presents with some of the variants called erosion, abrasion and/or abfraction, or their combination. Other variables were also taken for this study, that is, sex, age, tooth group, location and risk factors. The Chi square test was used for the association of variables. Results: in the study, males with 52.9 percent of the total number and the 37-47 year age group with 30.7 percent predominated. Premolars represented the most affected dental group with 38.9 percent; bruxism and harmful brushing were present in 43.8 percent and 35.3 percent of cases, respectively.Conclusions: non carious cervical lesions occur in the 37-47 age group, mainly in men and fundamentally affect upper premolars and 4 teeth per patient as average. Bruxism and harmful brushing were the most related risk factors to this type of non-carious lesion(AU)

Lesiones cervicales no cariosas en pacientes del área de salud Eléctrico, municipio Arroyo Naranjo, 2015 / Non carious cervical lesions in patient of the area of health Electric, Arroyo Naranjo municipality, 2015

Introducción: las lesiones cervicales no cariosas son la pérdida patológica de la estructura dentaria localizada en el límite amelo-cementario, que no responden a un agente causal bacteriano. Teniendo en cuenta la incidencia de esta afección en la salud bucal, resulta una necesidad su estudio más detallado, que permita conocer mejor su comportamiento clínico-epidemiológico para favorecer su prevención y tratamiento de una forma más eficaz. Objetivo: determinar la distribución y características de lesiones cervicales no cariosas en pacientes pertenecientes al área de salud Eléctrico del municipio Arroyo Naranjo de la provincia La Habana. Métodos: se realizó una investigación descriptiva transversal en un total de 153 pacientes con lesiones cervicales no cariosas. Fue considerada una lesión cervical no cariosa cuando el paciente presentara alguna de las variantes erosión, abrasión y/o abfracción, o la combinación de estas. Se asumieron para la investigación otras variables como: sexo, edad, grupo de diente, localización y factores de riesgo. Se utilizó la prueba estadística de chi cuadrado para la asociación de variable. Resultados: predominaron el sexo masculino con 52,9 por ciento y el grupo de edad de 37 a 47 años con el 30,7 por ciento. Los premolares resultaron el grupo dentario más afectado con el 38,9 por ciento; se destacó al bruxismo y al cepillado traumático con el 43,8 por ciento y 35,3 por ciento respectivamente. Conclusiones: las lesiones cervicales no cariosas se manifestaron entre los 37 a 47 años, específicamente en los hombres, y afectaron fundamentalmente a los premolares superiores con un promedio de 4 dientes por paciente. El bruxismo y el cepillado traumático constituyeron los factores de riesgo que más se correspondieron con el desarrollo de este tipo de lesión no cariosa a nivel cervical del diente(AU)

Introduction: non-carious cervical lesions are the pathological loss of dental structure located in the amelocementum junction, which do not result from a bacterial causative agent. Given the incidence of this condition in the oral health, it is necessary to study it in detail in order to better know its clinical and epidemiological behavior and to prevent it and treat it more effectively. Objective: to determine the distribution and the characteristics of non-carious cervical lesions in patients from the Electrico health area in Arroyo Naranjo municipality in Havana province. Methods: a cross-sectional descriptive study was conducted on a sample of 153 patients with non-carious cervical lesions. The classification of a non-carious cervical lesion was considered when a patient presents with some of the variants called erosion, abrasion and/or abfraction, or their combination. Other variables were also taken for this study, that is, sex, age, tooth group, location and risk factors. The Chi square test was used for the association of variables. Results: in the study, males with 52.9 percent of the total number and the 37-47 year age group with 30.7 percent predominated. Premolars represented the most affected dental group with 38.9 percent; bruxism and harmful brushing were present in 43.8 percent and 35.3 percent of cases, respectively. Conclusions: non carious cervical lesions occur in the 37-47 age group, mainly in men and fundamentally affect upper premolars and 4 teeth per patient as average. Bruxism and harmful brushing were the most related risk factors to this type of non-carious lesion(AU)

The Prevalence of Tooth Wear in the Dutch Adult Population.

This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of 's-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one.

Meta-analysis of the prevalence of tooth wear in primary dentition.

AIM: To conduct a meta-analysis of all the studies published in literature over the past three decades on the prevalence of dental erosion in preschool children. MATERIALS AND METHODS: The Pubmed data base revealed only one systematic review on the prevalence of tooth wear in children up to 5 years old. The search included works published from January 1982 to September 2012, using the following combinations of keywords: 1) "dental erosion" AND "children"; 2) "dental erosion in primary dentition"; 3) "dental" AND "attrition" AND "prevalence". The inclusion criteria for papers on tooth wear were the deciduous dentition observed only on the palatal and buccal sides with the distinction of erosion, attrition and abrasion. We took into consideration only randomized control trials. We excluded articles not written in English, case reports, historical and forensic studies, in vitro and in vivo studies. In case of doubt and/or when an abstract was not available, the full text copy of the article was examined. The first search on Pubmed revealed 29 articles, the same found in the study of Kreulen [2010], however we selected only multicentric studies focused on children of age below 5 years old, in which only the primary dentition (D) and only anterior teeth (incisors) were considered. RESULTS: Both forest plot and scatter plot showed the prevalence of dental erosion in primary dentition, and that older children had a more severe dental erosion. CONCLUSION: Dental erosion should be considered a paediatric dentistry pathological entity as well as dental caries, and it can be related to more severe systemic diseases such as Gastroesophageal reflux disease. In addition, taking care of these little patients is important because they might suffer persentiveness, and also pulpal pathology caused by the typical structure of deciduous teeth, where the pulp cavity is wide and close to the dentine and the enamel.

Tooth wear in aging people: an investigation of the prevalence and the influential factors of incisal/occlusal tooth wear in northwest China.

BACKGROUND: The aim of this study was to estimate the prevalence of tooth wear in the aging population of northwest China and to investigate the factors associated with such tooth wear. METHODS: Cross-sectional analytic clinical and questionnaire study was performed in 704 participants who had a mean age of 46.5 ± 0.2 SD and of which 367(52.13%) were males and 337(47.87%) female. These participants were invited when they attended the hospital which located in northwest China for routine oral examination. RESULTS: In the maxilla of the examined patients, the rate of tooth wear varied from 85.51% for molar group, 89.77% for premolar group, 100.0% for canine group to 87.22% for incisor group. In the mandible, the rates were 86.36%, 88.92%, 100.0% and 91.19% for the four groups respectively. Moreover, both the incisor and canine groups of these patients showed median scores of 3, the premolar group showed a median score of 1, and the molar group had a median score of 2. Additionally, multiple factors were considered to contribute to these patterns of tooth wear, especially the habitual consumption of a hard or sour diet (P < 0.05,odds ratio 1.21, 95% confidence intervals 1.04-1.49). CONCLUSIONS: Tooth wear is a common disease in which the anterior teeth exhibit greater wear than posterior teeth. The data support an association between tooth wear and dietary patterns.

[Optimization of treatment of wedge-shaped tooth defects with hyperesthesia].

Development of tooth wedge-shaped defect leads to a gradual loss of hard tissue and is characterized by pain. Most often patients complain of pain and aesthetic defect that adversely affects the emotional status and quality of life. Search for adequate means and methods of treatment providing increased resistance of dental hard tissues and reducing hyperesthesia is challenging for dentists. Wedge-shaped defect and hyperesthesia as concomitant symptom was found in the city of Ufa in the 5.65 and 63.0% of dental patients, respectively. Analysis of the questionnaires revealed a relationship between the sociological parameters (gender, age, profession) and the patient's quality of life. Improvement of all clinical manifestations was observed in the result of complex treatment.

Alliance of oral hygiene practices and abrasion among urban and rural residents of Central India.

OBJECTIVES: To attain alliance between the oral hygiene practices with prevalence of tooth abrasion among urban and rural adult population of Central India. To plan dental care services in inaccessible areas and to suggest appropriate remedial measures to prevent this avertable and self-inflicted injury of teeth in this cross-sectional study. MATERIALS AND METHODS: A sum of 1045 adult residents both from Urban (529) and rural (516) parts of Bhopal district (Central India) was selected on a random basis. The multistage sampling technique was adopted to ascertain the sample size. In urban area the study population consisted of 240 males, 289 females and 201 males and 315 females in rural area respectively. All residents above 18 years of age from the Bhopal district were included in cross-sectional study. Assessment form comprises of questionnaire and general information on oral hygiene practices, dietary habits and medical history. Abrasion was assessed using diagnostic criteria recommended by Smith and Knight (modified). Chi- square test was used to test associations between categorical variables at 5% level of significance. Regression analysis attempted to define for risk factors causing abrasion. Literature on the prevalence of abrasion is very sparse, so attempt is made to correlate the etiological factors and recommend to prevent tooth wear. RESULTS: Investigation of this cross-sectional study was aggregate of 1045 residences. Result shows high prevalence of abrasion 70.2%. Higher prevalence concomitant with diffident habits related to oral hygiene maintenance was recorded more among rural (76.9%) when compared to urban dwellers (63.7%). Presence of abrasion verifies statistical significance in relation to age, rural urban difference and variations in habit of oral hygiene care. Stated in the present study, avertable and self-inflicted is tooth abrasion, recurrently resulted by the reprehensible brushing method and common use of indigenous material for the maintenance of oral hygiene. CONCLUSION: Shows significant liaisons with the presence of abrasions in relation to Urban and rural dwelling, age, material used and mode of brushing and duration of brushing. Indigenous and course material causes high amount of enamel wear and with the advancement in age abrasion tend to increase. Prevalence of abrasion does not show any gender predilection. Cultural believes, lifestyle and transition reflects in deviating presence of abrasion in populations.

[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.

Systematic review of the prevalence of tooth wear in children and adolescents.

Data on the prevalence of tooth wear among children and adolescents are inconsistent. Given the impact of extensive tooth wear for over a lifetime, evidence on the extent is required. The aim was to systematically review the literature on the prevalence of tooth wear in children and adolescents. A PubMed literature search (1980-2008) used the keywords 'tooth' AND 'wear'; 'dental' AND 'attrition' AND 'prevalence'; 'dental' AND 'wear' AND 'prevalence'; 'erosion AND prevalence' AND 'abrasion AND prevalence'. Following exclusion criteria, 29 papers were reviewed using established review methods. There was a total of 45,186 subjects (smallest study 80 and largest study 17,047 subjects) examined from thirteen multiple random clusters, eight multiple convenience clusters and eight convenience clusters. Nine different tooth wear indices were used, but the common denominator among studies was dentin exposure as an indicator of severe wear. Forest plots indicated substantial heterogeneity of the included studies. Prevalence of wear involving dentin ranged from 0 to 82% for deciduous teeth in children up to 7 years; regression analysis showed age and wear to be significantly related. Most of the studies in the permanent dentition showed low dentin exposure, a few reported high prevalence (range 0-54%); age and wear were not related (regression analysis). The results of this systematic review indicate that the prevalence of tooth wear leading to dentin exposure in deciduous teeth increases with age. Increase in wear of permanent teeth with age in adolescents up to 18 years old was not substantiated.

[Clinical study on the distribution of tooth wear of the adult population]. / Studiu clinic asupra distributiei leziunilor dentare necariogene la populatia adulta.

UNLABELLED: Tooth wear is becoming increasingly significant in the developed societies, because the etiological factors are frequently present in the daily life. The aim of this study was to assess the distribution of the tooth wear of the adult population in a private practice of dentistry. MATERIAL AND METHOD: The group of study had 614 patients, structured on the following subgroups of age: 18- 30 years, 31-40, 41-50, 51-65 and more than 65 years old. Each patient had a clinical exam and a questionnaire for the diet and the lifestyle, spotlighting the etiology of tooth wear. RESULTS: attrition was the most frequent (55.7%), followed by abrasion (32.7%), erosion affected 7.5% of the patients and abfractions are the least frequent (4.1%). Erosions (9.7%) and attritions (59.9%) are more frequent at the feminine gender, and abrasions (40.4%) at the masculine gender. More than half of the abfractions (56%) were found at the youth patients (18-30 years old). Erosions were found in the 31-40 years subgroup at almost 40% of the patients; in the 41-50 years subgroup, abrasion and erosion were found in equal proportions. Abrasion prevails at the 51-65 years subgroup (30.8%). 72% of the consumers of acidic fruits had dental erosions. CONCLUSION: Tooth wear is under the influence of the diet and the age factor.

The prevalence of cervical tooth wear in patients with bruxism and other causes of wear.

PURPOSE: The aim of this study was to investigate the prevalence of cervical wear lesions in three groups of patients: bruxists, combined tooth wear, and controls. The hypothesis was that those subjects presenting with bruxism were more likely to develop cervical wear lesions. MATERIALS AND METHODS: Of 119 subjects, 31 were bruxists with a mean age 48.7 years [standard deviation (SD): 11.6]; 22 had combined wear, aged 43.5 years (14.2); and 66 controls aged 44.9 years (17.0). The clinical appearance of the tooth wear was used to recruit subjects to the bruxist and combined tooth wear groups. Control subjects were randomly selected from those attending for routine dental examination at two general dental practices. A tooth wear index (TWI) was used by two trained examiners to record the severity of wear in each group. RESULTS: There was a statistically significant difference between the controls and both the bruxist and combined tooth wear groups for wear on all surfaces (p < or = 0.001). There was no significant difference between the bruxist and the combined tooth wear group for wear on any surface. There was a statistically significant difference between the control group and both the bruxist and the combined tooth wear group for the severity of cervical wear (p < or = 0.005), but no difference between the bruxist and combined tooth wear groups. There was also no statistical difference in the number of cervical lesions between the groups. CONCLUSIONS: In this study, the likely cause of cervical tooth wear was multifactorial.

Prevalence of tooth wear in adults.

PURPOSE: The aim of this study was to investigate data on the prevalence of tooth wear in adults and assess possible correlations using a systematic review. MATERIALS AND METHODS: A search of the literature, using PubMed and the Cochrane Library, from January 1980 to July 2007 was made using keywords "tooth + wear"; "dental + attrition + prevalence"; "dental + wear + prevalence"; "erosion + prevalence"; and "abrasion + prevalence". References were independently screened for inclusion and exclusion by two investigators and Cohen Kappa was used as the measure of agreement. Data were collected and converted into the Smith and Knight Tooth Wear Index. RESULTS: One hundred eighty-six references were initially selected and subjected to the systematic review procedure; 13 survived the inclusion procedure. Four articles were suitable for regression analysis at tooth level (R2 = .593) and 3 at subject level (R2 = .736), using "age and age squared" and "age squared" as variables, respectively. Six studies reported males having significantly more tooth wear than females. CONCLUSION: The predicted percentage of adults presenting with severe tooth wear increases from 3% at the age of 20 years to 17% at the age of 70 years. Increasing levels of tooth wear are significantly associated with age.

Oral findings in adults with osteogenesis imperfecta.

This paper describes oral findings in an adult population with osteogenesis imperfecta (OI) in Norway (n=94). All participants underwent a structured interview and an oral examination. Panoramic radiographs were analyzed. The findings were compared with data from other Nordic epidemiological studies. Seventeen individuals (19%) had clinical signs of dentinogenesis imperfecta (DI). Persons with OI had twice as many missing teeth as the general population, and the number of endodontically treated teeth was higher than in the general population. All persons in the study had an acceptable state of tooth tissue loss. Almost all (97%) of the participants in the study group visited a dentist or a dental hygienist regularly. The results of the study indicated a low prevalence of clinical DI compared with previous reported studies. Oral health was not as good in the population with OI when compared with the general population, although daily oral health habits were good and dental visits were regular.

Anterior tooth wear and retention type until 5 years after orthodontic treatment.

OBJECTIVES: To study occlusal wear of anterior teeth in orthodontic patients retained with different retainers until 5 years post-treatment, and to investigate whether type of retention influences occlusal wear. MATERIAL AND METHODS: Orthodontic patients (n=222), aged 15 years maximally at the start of treatment, were followed until 5 years post-treatment. In the maxilla, a retainer bonded on all six teeth or a removable retainer was used; in the mandible, a lingual retainer was bonded on all anterior teeth or on canines only. Dental casts were analyzed before treatment (T(0)), after treatment (T(1)), and 5 years post-treatment (T(5)). Incisal and canine wear were scored by applying a grading scale. Intercanine width, overjet, and overbite were measured with an electronic caliper. Statistics used were: Paired samples t-test for differences over time; Pearson correlation coefficients for associations between wear and retention type; and backward linear regression for influence of retention type on wear. RESULTS: There was an increase in wear during all time periods and for all teeth. From T(0) to T(5) an increase in maxillary intercanine width and maxillary retention had an effect on changes in canine wear. Incisal wear was associated with an increase in upper intercanine width (T(1)-T(5)). For both arches, an increase in maxillary intercanine width during treatment was associated with less progression of canine and incisal wear, but the explained variance was low, 13.4% and 19.3%, respectively. CONCLUSIONS: Retention type and, occasionally, an increase in intercanine width influence anterior teeth wear post-treatment. However, the clinical significance and impact of the examined retention methods on occlusal wear are small.

Prevalence of dental wear among 12-year-old Brazilian adolescents using a modification of the tooth wear index.

OBJECTIVE: This study investigated the prevalence of dental wear in 12-year-old adolescents using a modification of the tooth wear index (TWI). The modifications were proposed in order to fit with the World Health Organization standard, thus allowing application of the index in broad epidemiological surveys. STUDY DESIGN: An epidemiological cross-sectional survey was performed by trained, calibrated examiners, using a modified version of the TWI. METHODS: Urban elementary schools were chosen because they provide a fair representation of the city's population in terms of socio-economic status. The sample included 295 adolescents, selected randomly and systematically. Dental wear was assessed by calibrated examiners (kappa>0.85), using a modified version of the TWI. This modified version includes a code for teeth restored due to wear, and another code for teeth that cannot be assessed. In addition, it does not differentiate the depth of dentine involvement. Proportions and confidence intervals were used to describe the prevalence of dental wear. Mann-Whitney test was used to detect differences in the degree of dental wear between males and females. The level of statistical significance was set at 5%. RESULTS: In total, 24,780 dental surfaces were evaluated. Among these surfaces, 73.10% did not present dental wear, 24.10% had incipient lesions, 2.46% had moderate lesions and 0.34% had been restored. No severe lesions were detected. Tooth wear was mainly seen on the occlusal/incisal surfaces (26.55%), involving enamel or enamel-dentine, but not the secondary dentine or pulp. The prevalence of dental wear was 26.90%. Considering the different teeth, wear was present in 53.22% of incisors, 50.51% of canines, 10.17% of premolars and 10.85% of molars. The prevalence of the different degrees of dental wear was similar in males and females (P>0.05). CONCLUSION: The modified TWI seems to be an effective tool for use in broad epidemiological surveys, due to easier calibration and high reproducibility rates.

Irregular tooth wear and longevity in captive wild ruminants: a pilot survey of necropsy reports.

Tooth wear is often suggested as an important factor limiting the life span of free-ranging wildlife. Given the frequent occurrence of poor dental health in captive animals reported in the literature, one would expect tooth health to be a limiting factor in captivity as well. Additionally, it could be assumed that brachydont (browsing) animals are more susceptible to dental health problems than are hypsodont (grazing) animals, given current indications for systematic increased tooth wear in some browsing species. A pilot survey of necropsy reports of adult captive wild ruminants (n = 294, 12 species) in one facility was performed in order to test these hypotheses and to calculate the incidence of irregular tooth wear. The overall incidence of irregular tooth wear was 20%, with a very high proportion of reports that did not mention the teeth at all. In contrast to this study's hypotheses, animals with irregular tooth wear were older than animals that died from other causes, indicating that reaching above-average age was a prerequisite for the development of reported abnormalities in this data set. A grazing species (blackbuck, Antilope cervicapra) was most affected, whereas two browsing species were not affected. Affected species had been regularly fed on sandy soil, whereas browsers had received feeds from racks, indicating that husbandry practices are most important for dental health. There was a high proportion of reported serous fat atrophy in animals with irregular tooth wear, indicating the clinical relevance of the problem. On average, adult individuals of the species investigated reached 41% of the maximum reported life span. Although this number appears low, the lack of comparative data from other facilities does not allow for conclusions on the adequacy of the husbandry practices used.