G.J. Truin

A longitudinal study of tooth erosion in adolescents.

Incidence studies on tooth erosion among adolescents are scarce. This longitudinal study aimed at estimating the prevalence, incidence, progression, and distribution of erosion in young adolescents over a 1.5-year period. Erosion at baseline was present in 32.2% of the 622 children (mean age, 11.9 ± 0.9 yrs) and increased to 42.8% over 1.5 yrs. The prevalence of deep enamel or dentin erosion increased from 1.8% to 13.3%. It was hypothesized that more boys will suffer from erosion than girls. At baseline, no difference was found (p = 0.139), whereas 1.5 yrs later, more boys showed erosion than girls (p = 0.026). Of the erosion-free children, 24.2% developed erosion. Progression of erosion in terms of lesion depth and/or in number of lesions was 61.0% and was found more frequently in boys than in girls (p = 0.034). The distribution of erosion showed a predominance of occlusal surfaces of molars, especially the mesiobuccal cusp top, and palatal surfaces of upper anterior teeth.

Dynamics of tooth erosion in adolescents: A 3-year longitudinal study

OBJECTIVESnThe aim of the present study was to estimate the prevalence, incidence and progression of tooth erosion on both mouth and tooth level over a 3-year period in a sample of adolescents. The study also aimed to investigate age, gender and socio-economic influences.nnnMETHODSnTooth erosion was recorded three times with 1.5 years intervals in a sample of 622 children, aged 10-12 years at baseline.nnnRESULTSnTooth erosion was present in 30.4% of the 11-year-olds, and 44.2% in 15-year-olds. Deep enamel or dentin was eroded in 1.8% of the 11-year-olds and in 23.8% of the 15-year-olds. Significantly more boys than girls showed tooth erosion as did children from a low socio-economic background compared with other children. The incidence of new tooth surfaces exhibiting erosion, in erosion-free children, decreased significantly with age, while the progression in children with erosion did not change. The incidence of tooth erosion in upper incisors and lower first molars decreased significantly with age. In upper incisors, a statistical significant relationship between SES and incidence was found, with lower incidences for higher SES. For first molars, only a relationship between gender and incidence was found, with a lower incidence for girls.nnnCONCLUSIONSnThe incidence of new tooth surfaces exhibiting erosion, in erosion-free children, decreased significantly with age. In children with tooth erosion the condition progressed steadily. On tooth level the incidence decreased significantly with age for upper incisors and lower first molars. There was a difference in influence of background variables on the incidence of tooth erosion between molars and upper incisors.

Multifactorial Analysis of Factors Associated with the Incidence and Progression of Erosive Tooth Wear

To prevent erosive tooth wear, early diagnosis and identification of causative factors are essential. The aim of the present 3-year longitudinal study was to investigate the association between a broad collection of biological and behavioural factors and the incidence and progression of erosive tooth wear among adolescents. The study sample consisted of 656 attendees of a dental clinic with at baseline a mean age of 11.9 years (SD = 0.9). The criteria for the assessment of erosive wear were a modification of the erosion criteria developed by Lussi [Eur J Oral Sci 1996;104:191–198]. Information on biological and behavioural factors was gathered by clinical examinations (at baseline, after 1.5 and 3 years) and by self-reported questionnaires (completed semi-annually). Of the erosion-free children at baseline, 24.2% developed erosive wear. In children with erosion at baseline, 68.3% showed progression. Multivariate analyses showed significant associations between the incidence of erosive tooth wear and alcoholic mixed drinks (odds ratio, OR = 1.82), sour vegetables (OR = 1.16) and tooth grinding (OR = 4.03). The intake of yoghurt products was significantly negatively associated with the incidence of erosive wear (OR = 0.79). The interaction of acidic products and tooth grinding showed a significant extra risk (OR = 1.2). The intake of vitamins was positively associated with progression (OR = 2.03). Erosive wear was less likely to progress in subjects who consumed milk and yoghurt products (OR = 0.89 and 0.76, respectively). The present study showed that the aetiology of erosive tooth wear is complex. Possible aetiological factors include more than acidic drinks, and factors such as tooth grinding play a large role.

Factors associated with the incidence of erosive wear in upper incisors and lower first molars: A multifactorial approach

OBJECTIVESnThe aim was to investigate associations between factors and the incidence of erosive wear in lower first molars and upper incisors, and to investigate whether these associations differ between these locations.nnnMETHODSnThe study sample of this 3-year longitudinal study consisted of 572 children (mean age 11.9 years, SD=0.9). The permanent dentition was examined for erosive wear according to a modified Lussi-index (1996). Information on biological and behavioural factors was gathered by clinical examinations (at baseline, after 1.5 and 3 years) and by questionnaires (every six months).nnnRESULTSnThe incidence of erosive wear in upper incisors over 3 years was 22.2%, for lower first molars the incidence was 14.8%. Multivariate logistic regression analysis showed that carbonated soft drink (OR=1.04) and tooth grinding (OR=2.93) were positively associated with the incidence of erosive wear in upper incisors and milk (OR=0.95) and yoghurt products (OR=0.88) were negatively associated. The incidence of erosive tooth wear in lower first molars was positively associated with alcoholic mixed drink (OR=1.45) and tooth grinding (OR=4.00) and was negatively associated with milk (OR=0.96) and yoghurt products (OR=0.84). The incidence of erosive wear in lower first molar was lower in girls than in boys (OR=0.51). t-Tests on the odds ratios of the factors showed that between the two incidence models only the odds ratios of anterior contact significantly differed.nnnCONCLUSIONSnIn the present study, except for anterior contact, no substantial differences in risk factors between the incidence of erosive wear in lower first molars and upper incisors were found. This indicates that the aetiology of erosive wear for the two locations is similar.

Long-term performance of resin based fissure sealants placed in a general dental practice

OBJECTIVESnThe aim of the present retrospective study was to evaluate the long-term performance of resin based fissure sealants applied in a general dental practice.nnnMETHODSnRegularly attending patients visiting the practice between July 2006 until November 2007 and who had received sealants before 1st of January 2000 were included in the study. Date of placement of a sealant in posterior non-discoloured permanent teeth and replacement by a restoration was recorded. In a clinical examination occlusal surfaces were scored for (partial) sealant loss and fissure discolouration. The restoration profile of the patient was assessed as low or high, based on the number of restorations placed per year since the first sealant. Sealants had been applied by four dentists and a dental hygienist.nnnRESULTSn1204 sealants were placed in 148 patients. After a mean follow-up time of 11.6 years, 41.3% of placed sealants were still fully retained and 11.4% were replaced by a restoration. Failure rates were significantly higher in high than in low restoration profile patients and in molars compared to premolars. In those fissures with lost or partially lost sealants, discolouration frequently occurred (40% of all surfaces) irrespective of restoration profile of the patient.nnnCONCLUSIONSnIn this retrospective practice based study, long-term performance of sealants depended on restoration profile of the individual patient and the tooth type (molar versus premolar).

The estimation of patients' views on organizational aspects of a general dental practice by general dental practitioners: a survey study

BackgroundConsidering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs) take patients views into account. The aim of the study was to compare patients views on organizational aspects of general dental practices with those of GDPs and with GDPs estimation of patients views.MethodsIn a survey study, patients and GDPs provided their views on organizational aspects of a general dental practice. In a second, separate survey, GDPs were invited to estimate patients views on 22 organizational aspects of a general dental practice.ResultsFor 4 of the 22 aspects, patients and GDPs had the same views, and GDPs estimated patients views reasonably well: Dutch-speaking GDP, guarantee on treatment, treatment by the same GDP, and reminder of routine oral examination. For 2 aspects (quality assessment and accessibility for disabled patients) patients and GDPs had the same standards, although the GDPs underestimated the patients standards. Patients had higher standards than GDPs for 7 aspects and lower standards than GDPs for 8 aspects.ConclusionOn most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDPs estimated only half of the patients views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients.

Views of patients and general dental practitioners on the organizational aspects of a general dental practice

Objectiveu2002 To examine the views of patients and general dental practitioners (GDPs) on the organizational aspects of a general dental practice and to see whether their views differ.

Organisational aspects of dental practices: do dental students think like patients or like general dental practitioners?

INTRODUCTIONnIn view of transparency in health care, the widespread desire for more patient-centred care, and in an attempt to facilitate educational programmes that effectively respond to these changes, two research questions are formulated: (i) How do dental students rate the importance of various organisational aspects of dental practices compared with dental patients and general dental practitioners (GDPs), and what prescripts, defined as specific operational responsibilities of GDPs in these matters, do dental students propose? and (ii) In doing so, do students resemble patients or GDPs?nnnMETHODSnIn two survey studies, dental students (n = 198), patients (n = 3127) and GDPs (n = 303) were asked to rate by questionnaire the importance of 41 organisational aspects of a general dental practice and proposed specific operational responsibilities (prescripts).nnnRESULTSnSeven of 41 aspects were rated as important by the majority of the students. Although in a different rank order, three aspects were predominantly selected by all three groups: continuing education, accessibility by telephone and Dutch-speaking GDP. For most aspects, significant differences were found between the prescripts proposed by students and those proposed by patients, and few differences were found between students and GDPs.nnnCONCLUSIONnThe findings do not permit the general conclusion that the views of dental students resemble those of patients or GPDs. Looking at the overall rank order, the three respondent groups showed a great resemblance although significant differences were found for specific aspects. With regard to the proposed prescripts, students showed realistic views and the majority wants to participate in continuing education and work with protocols and guidelines. In this, they tend to resemble GDPs more than they resemble patients.