The aim of the study was to introduce an individual tooth wear index and to use this index to investigate factors correlated to occlusal wear. The material consisted of 585 randomly selected dentate individuals from the community of Jönköping, Sweden, who in 1983 reached the age of 20, 30, 40, 50, 60, 70, or 80 years. The degree of incisal and occlusal wear was evaluated for each single tooth in accordance with criteria presented earlier. An individual tooth wear index, which made it possible to rank individuals in accordance with incisal and occlusal wear, was used as dependent variable to investigate factors related to incisal and occlusal wear. Of all factors analyzed, the following were found to correlate significantly with increased incisal and occlusal wear: number of existing teeth, age, sex, occurrence of bruxism, use of snuff, and saliva buffer capacity. Stepwise multiple regression analysis gave a total explanation factor of R2 = 0.41. It was also possible to distinguish well between groups of individuals with and without tooth wear by means of these factors.
The aim of this study was to assess the number of, and time intervals between, bitewing examinations performed on a group of Swedish patients between 3 up to and including 18 yr of age and to relate them to the accumulated posterior approximal caries experience of the patients as found in the last bitewing examination before age 19. The patients showed a marked variability in approximal caries experience. 25% accounted for about 1% of the total number of carious lesions and restorations accumulated up to age 19 while 25% accounted for 60%. From age 9 up to age 18 more than 75% of the patients were subjected to at least one bitewing examination annually. Between 10 and 15 yr of age more than 90% received annual radiographic examinations. Mean number of bitewing examinations was 10.4 and the average time interval between bitewing examinations was 11.5 months. 11% of the variation in the number of bitewing examinations and 8% of the variation in average time intervals between bitewing examinations could be explained by the number of lesions and restorations in the approximal surfaces of the patients accumulated up to age 19.
Cavitation of enamel lesions probably represents a significant step regarding further progression of the caries process. The primary objective of this study was to examine in adolescents the macroscopical appearance of approximal surfaces with radiographic lesions and relate this to the caries activity of the individual. A second objective was to establish the clinical feasibility of a modified technique for inspection of approximal contact surfaces. The material consisted of 46 enamel lesions selected on the basis of routine bite-wing radiographs of 140 patients aged 17-18 years, available from the Public Dental Service of Lillehammer, a non-fluoridated town. Lesions close to or approaching the AD junction were classified as D2 lesions, whereas those demonstrating a shadow not more than 1 mm into the dentine were designated D3 lesions. Based on recorded treatment during the last 3 years, patients were dichotomised as caries-active (CA) if they had more than 6 new lesions involving the dentine. The remainder with little or no activity were designated modestly active (MA). A small orthodontic rubber ring was placed around the contact point of the approximal surface of interest 1 day before an impression was taken. A separation of 0.5 mm facilitated cleansing and injection of low viscosity impression material (Xantopren(R) L, Blue, Bayer Dental). Discontinuity in the approximal enamel surface, determined by visual inspection of stone dyes, prepared from the impressions, was classified as cavitation. The results demonstrated that in MA patients D2 lesions seldom had cavities while in CA patients cavitation was usually found both in D2 and D3 lesions. The feasibility of the impression/inspection method seems established. It is easily performed and should be considered as a diagnostic tool in borderline cases.
OBJECTIVES: Demarcated opacities in permanent first molars are common developmental tooth defects, characterized by areas with insufficient mineralization of the enamel. The defects present clinically as a continuum from creamy-white demarcated opacities, yellowish-brown demarcated opacities to macroscopic loss of tooth substance. The etiology is sparsely elucidated, but asthma drugs have been suspected to increase the prevalence. The aim of this study was to examine the prevalence of demarcated opacities in permanent first molars among 6-to-8-year-old children with prescriptions and without prescriptions for asthma drugs. METHODS: In a cross-sectional study in two Danish municipalities, all children aged 6-8 years (n = 891) were included. A total of 745 (83.6%) went through a dental examination during which demarcated opacities and tooth substance loss due to these were recorded. The analyses were restricted to 647 children in whom all four permanent first molars had erupted. Data on use of asthma drugs from birth until the time of the dental examination were obtained from a population-based pharmaco-epidemiological prescription database. RESULTS: Among 47 children with prescriptions for both inhaled beta(2)-agonists and inhaled corticosteroids before the age of 3 years, 15 (31.9%) had demarcated opacities of any type, and six children (12.8%) had opacity-related loss of tooth substance. Among 264 children with no prescriptions for either inhaled or oral asthma drugs from birth until the date of the dental examination, 96 (36.4%) had demarcated opacities of any type, and 13 (4.9%) had opacity-related loss of tooth substance. The odds ratio (OR) of any demarcated opacity, and of opacity-related loss of tooth substance in children with prescriptions for both inhaled beta(2)-agonists and inhaled corticosteroids before the age of 3 years was 0.82 (95% CI: 0.39-1.65), and 2.42 (95% CI: 0.70-7.43). CONCLUSIONS: Children with prescriptions for inhaled asthma drugs before the age of 3 years did not have an overall increased risk of demarcated opacities in first permanent molar but they seemed to have an increased risk of the severe demarcated opacities, i.e. opacities resulting in macroscopic loss of tooth substance, and possibly a need for restorative care.
The aim of the present study was to describe awareness and attitudes related to dental erosive wear among 18-yr-old adolescents in Oslo and to explore attitudinal differences between participants with and without the condition. All 18-yr-old subjects scheduled for their routine examination at the Public Dental Service clinics during 2008 (n = 3,206) were invited, and 1,456 agreed to participate (a response rate of 45%). The data were collected using structured questionnaires and by clinical examination of the participants. Dental erosive wear was assessed using a pictorial manual - the Visual Erosion Dental Examination scoring system - as a guide. Overall, 88% of participants had heard about dental erosive wear; however, of participants with erosive lesions only 56% were aware of, and only 47% could recall their dentist mentioning, the condition. Participants with erosive wear were more likely to have low or moderate positive attitudes towards acidic drink consumption and to be reluctant to change. In multivariate analyses controlling for gender and behavioural variables, weak or moderate positive awareness of acidic drinks remained significantly associated with higher erosion risk. This study emphasizes the importance of assessment and understanding of awareness and attitudinal aspects in relation to dental erosive wear.
This prospective, in vivo study compared bond failure and enamel decalcification with a cyanoacrylate bracket bonding system (SmartBond, Gestenco International, Gothenburg, Sweden) and a traditional light-cured composite system (Light Bond, Reliance Orthodontic Products, Itasca, Ill). A total of 327 teeth were evaluated after a period of 12 to 14 months; 163 experimental teeth were bonded with the cyanoacrylate bonding system, and 164 control teeth were bonded with the light-cured composite resin. All teeth were evaluated for breakage (bond failure). The average percentage of bracket failures with cyanoacrylate was 55.6% compared with 11.3% with composite resin (P
OBJECTIVES: The purpose of this study was to assess the caries status of 5-year-olds in a low caries area, and study associations between dental caries and parent-related factors: parents' education, national origin, oral health behaviours and attitudes. METHODS: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. RESULTS: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non-western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child's tooth brushing (OR = 2.8), parents' brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). CONCLUSION: Caries prevalence in 5-year-olds was strongly associated with parent-related factors signifying that information on parents' socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non-western children whose parents have low education.
This study assesses the prevalence of caries and some background factors in 4-year-old children in the city of Umeå, northern Sweden, and compares this with data from earlier studies to reveal changes over time.
Children from the catchment areas of three Public Dental Health Service clinics in Umeå (n = 224) born during the third quarter of 2008 were invited to undergo a clinical dental examination. Decayed surfaces (including both dentine and enamel, except for enamel lesions on buccal and lingual surfaces), missing and filled surfaces (dmfs) were recorded using the same methods and criteria as in a series of earlier studies performed between 1980-2007. Background data were collected in a case-history and a questionnaire. Results. The proportion of children with caries significantly decreased from 2007 (38%) to 2012 (22%) (p 0.05). An immigrant background was associated with a lower frequency of tooth brushing and a higher intake of ice cream, sweets and chocolate drinks (p
The aim was to study any variability in approximal and occlusal caries diagnoses and restorative treatment decisions among Swedish dentists. The material consisted of a pre-coded questionnaire sent to a random sample of 923 dentists with 4 items concerning approximal and occlusal caries diagnosis and restorative treatment decisions. Responses were received from 651 (70.5%) dentists. In an adolescent with low caries activity and good oral hygiene, more than 90% of the dentists stated that they would not automatically restore a primary approximal caries lesion if its radiographic appearance did not show obvious progression in the outer 1/3 to 1/2 of the dentin. Moreover, 67% of the dentists would only consider immediate restorative treatment of an occlusal surface if obvious cavitation and/or radiographic signs of dentin caries could be observed. When diagnosing questionable occlusal caries, the dentists largely relied on the radiographic appearance. Concerning both approximal and occlusal caries, the threshold for restorative treatment differed between the metropolitan regions in Sweden, and younger more often than older dentists would postpone restorative treatment of approximal caries until the lesion had reached a relatively advanced stage of progression. The responses also showed that dentists in private practice would restore approximal caries at an earlier stage of progression than the dentists in the Public Dental Health Service.
Collecting data for dental caries studies is costly. In countries where uniform patient records are available for virtually the whole population, it is tempting to use them as a data source. Our aim was to compare data collected from patient records to those obtained by trained examiners. In 1992 and 1995, dentists who were specially trained and calibrated examined random samples of 12- and 15-year-olds living in two towns in Finland. The dental record of each child was obtained from public dental clinics, the dental status was entered into a computer file, and the DMFS value was calculated. Data were available for 824 children. In the two data sets, 1.3% of the tooth surfaces were recorded differently (DMF vs. sound) with the related kappa value being 0.70. In two thirds of the discrepancies, the reason was that a filling was marked in only one of them, which confirms the known difficulty in discerning a white filling. For 48% of the subjects, the DMFS values calculated from the two sets of data were equal. The difference was 1 and 2 surfaces for 28 and 11%, respectively. Public health dentists had almost equally often registered more and less DMF surfaces compared to trained examiners. The results suggest that data collected from public health records are not decisively inferior to those obtained from examinations by trained examiners. In large enough settings, data obtained from patient records could possibly be used as a replacement for separate surveys.