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A study of the oral health of workers in flour mills was carried out. The examined group consisted of 40 males and 8 females currently employed at flour mills. As much as 93.75% of the workers showed evidence of dental abrasion, particularly of the front teeth. The authors concluded that the dental abrasions in the group are closely related to the work environment.
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OBJECTIVES: Professional tooth cleaning (PTC) may lead to loss of exposed dentin. The aim of the present study was to determine the absolute loss of dentin during PTC using various product combinations with an in vitro model. MATERIAL AND METHODS: Dentin specimens (72) were randomly assigned to nine groups. In four groups each, prophy brushes and prophy cups were used in combination with four different abrasives (calcium pyrophosphate, pumice, Hawe cleanic, Nupro coarse). In the ninth group, a rubber cup with embedded fluoride and abrasives was used (pasteless prophy cup). The treatment time was 37 s. Surface loss was determined by profilometry. RESULTS: The surface loss in the nine groups was as following: (1) brush/calcium pyrophosphate: 6.18 microm (a); (2) brush/pumice: 5.51 microm; (3) brush/Nupro coarse: 10.10 microm (b); (4) brush/Hawe cleanic: 1.88 (a, b); (5) prophy cup/calcium pyrophosphate 2.07 (c); (6) prophy cup/pumice: 6.07 microm; (7) prophy cup/Nupro coarse: 5.93 microm (c); (8) prophy cup/Hawe cleanic: 4.93 microm (c); (9) pasteless prophy cup: 11.86 microm (c). Groups with the same letter in parentheses are statistically significant different at p<0.05. In a pooled analysis, no statistically significant difference between brushes and prophy cups was found. CONCLUSION: In the present study, the surface loss of about eight PTC procedures was simulated. Hence, the dentin loss ranged between 0.24 and 1.48 microm per PTC. Therefore, PTC does not seem to be a main factor in dentin loss.
The aim of this study was to determine maximum attainable protection of enamel from erosion and erosion abrasion using a highly fluoridated gel with and without additional fluoride from toothpaste. Thirty-six bovine enamel specimens were subjected to six erosive attacks per day (1% citric acid with pH 2.3 for 30 s), while the rest of the day the specimens were in artificial saliva. There were four treatment groups (9 specimens in each group): fluoride-free toothpaste/saliva slurry twice daily (group T0), fluoride-containing toothpaste/saliva slurry twice daily using 1,250 ppm F toothpaste (group TF), fluoride-containing toothpaste/saliva slurry twice per day plus application of a highly fluoridated gel (12,500 ppm F) twice a day for 120 s (group 2F) and a group with gel application 8 times a day (group 8F). Additionally, half of each specimen in all groups was subjected to brushing abrasion during application of the toothpaste/saliva slurry. Brushing abrasion alone led to no observable enamel loss measured with profilometry. After 14 days of cycling of erosion without toothbrushing abrasion, high-fluoride gel application 2 or 8 times daily showed significantly less enamel loss (median 24/19 microm) than with toothpaste with or without fluoride (41/45 microm). After 14 days of cycling of erosion and toothbrushing abrasion, gel application 2 or 8 times daily (33/29 microm) showed significantly less enamel loss than toothpaste with or without fluoride (57/62 microm). We conclude that a highly fluoridated acidic gel is able to protect enamel from erosion and toothbrushing abrasion while fluoridated tooth paste provides little protection.
Dental staining, while always a significant problem, has become more important in recent years with the introduction and increased use of chlorhexidine-based mouthrinses. Not only do these rinses themselves cause staining, they also enhance staining from other sources, such as diet or tobacco use. An understanding of the etiologies of dental stains will help today's practitioners become more effective in managing dental stains in their practices. Important strategies for managing stain are patient education about the causes of staining, careful consideration of product recommendations for home use, and routine office visits for prophylaxis. Ideal products for patient use are those with effective stain-removal properties and low abrasivity, which minimizes tooth wear.
Dental staining, while always a significant problem, has become more important in recent years with the introduction and increased use of chlorhexidine-based mouthrinses. Not only do these rinses themselves cause staining, they also enhance staining from other sources, such as diet or tobacco use. An understanding of the etiologies of dental stains will help today's practitioners become more effective in managing dental stains in their practices. Important strategies for managing stain are patient education about the causes of staining, careful consideration of product recommendations for home use, and routine office visits for prophylaxis. Ideal products for patient use are those with effective stain-removal properties and low abrasivity, which minimizes tooth wear.
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It has been known for some time that tooth brushing can have unwanted effects on the gingiva and hard dental tissues. The aim of this study is to evaluate two factors that may be of influence on the incidence of gingival abrasion during tooth brushing. The first factor being the possible influence of feedback through oral sensory perception and the second the possible abrasive effects of dentifrice. From the sensory feedback experiment it became clear that a significantly greater number of abrasions occurred when the test subjects would brush their own teeth than when they would have their teeth brushed by a dental hygienist. From the dentifrice experiment it became clear that the use of dentifrice has no significant effect on the occurrence of gingival lesions.
On the abrasion resistance of dental materials. Part II: Reduction of the abrasion of tooth-colored plastics as achieved by the simultaneous use of dental ceramic materials In vitro experiments showed that dental plastics being in contact with dental ceramic materials are abraded to a lesser extent than dental plastics in contact with dental plastics.
Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification acts through a distinct process that is associated with unique clinical characteristics. Accurate prevalence data for each classification are not available since indices do not necessarily measure one specific etiology, or the study populations may be too diverse in age and characteristics. The treatment of teeth in each classification will depend on identifying the factors associated with each etiology. Some cases may require specific restorative procedures, while others will not require treatment. A review of the literature points to the interaction of the three entities in the initiation and progression of lesions that may act synchronously or sequentially, synergistically or additively, or in conjunction with other entities to mask the true nature of tooth wear, which appears to be multifactorial.
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OVERVIEW: The authors propose updated and revised nomenclature, definitions and classification for tooth surface lesions. Their objective is standardization, clarity and clinical utility for the dental practitioner. The article presents a schema of the pathodynamic mechanisms in the formation of tooth surface lesions--three basic physical and chemical mechanisms, their interactions and their dental manifestations. CONCLUSIONS AND CLINICAL IMPLICATIONS: The use of precise definitions will assist the practitioner in determining the etiology of various tooth surface lesions. Understanding the pathodynamic mechanisms and their many possible interactions, as set forth in the schema, will enable the practitioner to make an accurate differential diagnosis and to provide effective prevention and treatment. It also will assist dentists in communicating more effectively with their colleagues as well as with their patients. In addition, the schema helps identify areas in which future research is indicated.
Tooth wear is the result of three processes: abrasion (wear produced by interaction between teeth and other materials), attrition (wear through tooth-tooth contact) and erosion (dissolution of hard tissue by acidic substances). A further process (abfraction) might potentiate wear by abrasion and/or erosion. Both clinical and experimental observations show that individual wear mechanisms rarely act alone but interact with each other. The most important interaction is the potentiation of abrasion by erosive damage to the dental hard tissues. This interaction seems to be the major factor in occlusal and cervical wear. The available evidence seems insufficient to establish whether abfraction is an important contributor to tooth wear in vivo. Saliva can modulate erosive/abrasive tooth wear through formation of pellicle and by remineralisation but cannot prevent it.
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Hard tissue lasers and air abrasion units have a place in the modern dentist's armamentarium. Speed, comfort, ease of approach, public relations, and patient appeal are some of the advantages. The dentist's own comfort and satisfaction, knowing that he or she is doing the best dentistry without frightening the already fearful patient, should help the dentist decide which one of the modalities to incorporate into his or her practice.
Two types of interaction of erosive and abrasive forces with human enamel were analysed in an in vitro study. To simulate toothbrushing or chewing after an acidic challenge, enamel specimens were eroded in 0.3% citric acid (pH 3.2), then brushed with or without silica abrasive. To simulate simultaneous erosion and abrasion, as would occur during chewing of abrasive acidic food, enamel specimens were abraded in a toothbrushing machine, with and without silica abrasive, while immersed in citric acid. Enamel wear was measured by profilometry. In both experiments the combination of erosion and abrasion resulted in significantly greater wear than erosion alone, but no significant differences in wear after brushing with or without abrasive were found. Simultaneous erosion and abrasion resulted in about 50% more wear than alternating erosion and abrasion. It is concluded that softened enamel is highly unstable and potentially easily removed by short and relatively gentle physical action. Chewing of acidic foods with some abrasive properties might cause enhanced tooth wear.
A prerequisite for preventive measures is to diagnose erosive tooth wear and to evaluate the different etiological factors in order to identify persons at risk. No diagnostic device is available for the assessment of erosive defects. Thus, they can only be detected clinically. Consequently, erosion not diagnosed in the early stage may render timely preventive measures difficult. In order to assess the risk factors, patient should record their dietary intake for a distinct period of time. Then a dentist can determine the erosive potential of the diet. Particularly, patients with more than four dietary acid intakes have a higher risk for erosion when other risk factors (such as holding the drink in the mouth) are present. Regurgitation of gastric acids (reflux, vomiting, alcohol abuse, etc.) is a further important risk factor for the development of erosion which has to be taken into account. Based on these analyses, an individually tailored preventive program may be suggested to the patients. It may comprise dietary advice, optimization of fluoride regimes, stimulation of salivary flow rate, use of buffering medicaments and particular motivation for nondestructive toothbrushing habits with a low abrasive toothpaste. The frequent use of fluoride gel and fluoride solution in addition to fluoride toothpaste offers the opportunity to reduce somewhat abrasion of tooth substance. It is also advisable to avoid abrasive tooth cleaning and whitening products, since they may remove the pellicle and may render teeth more susceptible to erosion. Since erosion, attrition and abrasion often occur simultaneously all causative components must be taken into consideration when planning preventive strategies.