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PubMed1992

Prevalence of dental caries and enamel defects in the primary dentition of Antiguan pre-school children aged 3-4 years including an assessment of their habits.

In 1989 a national survey was carried out on children aged 3 to 4 years attending nursery schools, to investigate the prevalence of caries experience, nursing bottle caries and enamel defects in the primary dentition, and these children's dentally related habits. In the first part of the study, examination of 482 Antiguan children showed that the dmft and dmfs values were 0.80 and 1.26 respectively, and that 77 per cent of the children were caries free; 4.6 per cent of children had nursing bottle caries; and enamel defects occurred in 24 per cent of children. No significant difference was found in oral health between urban and rural samples. In the second part, which was an interview survey, habits such as thumb sucking (13 per cent), not brushing their teeth (3 per cent), and swallowing fluoride toothpaste (13 per cent) were found among 369 children. In the third (a questionnaire) survey, a response rate of 63 per cent was obtained. Significantly more of the children with nursing bottle caries (78.6 per cent) had the habit of sleeping with a feeding bottle than occurred in caries free children (25.6 per cent), but there was no difference in the infant feeding pattern. The children with enamel defects were breast fed for a shorter period and had an earlier introduction to bottle feeding, compared with children without enamel defects. In the final part of the survey, an assessment of snack eating habits at school, a 58 per cent response rate was achieved. The majority of children often brought healthier snacks, together with daily sugar-rich drinks. Significantly more caries free children brought sugary snacks less frequently than children with caries experience.

Age Factors↗
PubMedDate not supplied

The etch-bleach-seal technique for managing stained enamel defects in young permanent incisors.

Hypomineralized enamel defects frequently are manifest as a mottled-white appearance and can be associated with variable degrees of discrete yellow-brown intrinsic staining. Numerous treatment approaches have been proposed, ranging from bleaching to enamel reduction to restorative techniques. Bleaching of hypomineralized enamel lesions, using 1 to 2 applications (10 to 15 minutes each) of 5% sodium hypochlorite, has been applied clinically. Treatment using this approach has proven successful in removing yellow-brown discolorations from lesions in young permanent teeth. Young permanent incisors with yellow-brown intrinsic discolorations can often be treated by a simple and conservative bleaching protocol using sodium hypochlorite.

Acid Etching, Dental↗
PubMed1989

The prevalence and distribution of enamel defects in 11-12 year old Malaysian schoolchildren.

The prevalence and symmetrical distribution of enamel defects were studied in 218 Malaysian school children aged 11-12 years old. The tooth prevalence of enamel defect was 40.3 per cent. The first permanent molars were the most severely affected, whereas the lower incisors were the least severely affected. Overall there was no sex difference. Distribution of symmetry was assessed between the right and left tooth pairs as well as for upper and lower teeth. A higher proportion of symmetry was observed for the right and left tooth pairs and the lingual surfaces showed a greater percentage of bilateral distribution.

Child↗
PubMed1999

Patterns of dental enamel defects at ancient Mendes, Egypt.

The dental remains of 88 individuals from Old Kingdom, First Intermediate, and Greco-Roman periods at the ancient Egyptian site of Mendes (Tell er-Rub(c)a) were examined for dental enamel hypoplasia, and the results reported here provide some of the first comparative data on enamel defects in ancient Egypt. Overall, 48% of the individuals in the sample have one or more teeth with hypoplasia, with 17% of permanent teeth and 8% of deciduous teeth affected. The permanent teeth account for 87% of the total number of affected teeth, a prevalence over deciduous teeth that is significant at alpha = 0.05. Permanent and deciduous teeth display different patterns of hypoplasia, with the former exhibiting both discrete pitting and linear furrowing, and the latter exhibiting only pits. Teeth with linear defects significantly outnumber those with pits by a factor of more than three to one. Only permanent canines display more than one lesion on a tooth, with a mean of 1.4 defects per affected tooth. Although calculation of the age of insult from lesion position is imprecise, it appears that stress episodes occurred most commonly between approximately 3-5 years of age. The presence of pits in the deciduous dentition, however, suggests that physiological stresses began in utero. There is no statistically significant difference in the frequency of enamel defects between males and females. An observed decrease in the frequency of defects from the Old Kingdom period to the subsequent First Intermediate and Greco-Roman periods is not significant at alpha = 0.05, although such a decrease is expected given epigraphic and other data that refer to prolonged drought and malnutrition in the late Old Kingdom. The calculated chi(2) value of 3.83 is significant at the 0.10 level, however, and since our sample is rather small and the magnitude of the chi-square statistic is a function of sample size, we recommend that future research investigate further the relationship between the frequency of enamel defects and the time period in which they occur.

Dental Enamel↗
PubMed1990

Enamel defects in the primary dentition of children born weighing less than 2000 g.

The findings for enamel defects in the primary dentition of a group of low birthweight (LBW) children were related to their perinatal medical histories. Examination of 110 LBW children and 93 control children aged 5 years showed that significantly more of the LBW children (71%) had hypoplasia than controls (15%), but there was no difference in opacities alone (LBW 25%, control 26%). In the LBW group, defects were seen more often in children classified as ill during the perinatal period, who received ventilator support or intravenous alimentation and in those children born at less than 32 weeks gestation, compared to the LBW children without these perinatal problems. It is speculated that the high incidence and the cause of enamel defects in sick preterm infants may be due to oxygen deprivation and mineral substitute depletion.

Analysis of Variance↗
PubMedDate not supplied

Macroscopic enamel defects of primary anterior teeth--types, prevalence, and distribution.

A total of 40.7% of 509 exfoliated primary anterior teeth from children who were healthy products of uneventful pregnancies exhibited at least one macroscopic enamel defect. Twenty percent of the teeth exhibited hypoplastic defects (HD), 12.4% exhibited white-cream opacities (WCO), and 9.8% exhibited yellow-brown opacities (YBO). Slightly more than a third (33.6%) of the teeth had defects we considered to be developmental enamel defects (DED). The occurrence of DED did not vary with gender, side of mouth, individual tooth types, or racial background. DED occurred with increased frequency on maxillary teeth, facial surfaces, and the middle third of affected surfaces. These locations have thicker enamel than other sites and may be more susceptible to insult if vulnerability is a function of metabolic demand of the rapidly secreting ameloblasts. Twenty-five per cent of the maxillary incisors and 10.1% of the mandibular incisors exhibited HD whose locations coincided with enamel forming at birth. A third (33.3%) of the canines exhibited HD, which occurred most commonly in the middle third of the facial surfaces. These defects are believed to occur approximately six months postnatally and may be primarily due to mechanical trauma. YBO most commonly occurred on the middle third of the facial surfaces, while WCO on the gingival third. Neither YBO nor WCO followed a chronologic pattern.

Child↗
PubMed1980

Tetracycline discoloration, enamel defects, and dental caries in patients with cystic fibrosis.

The prevalence, distribution, and interrelationship between tetracycline discoloration, enamel defects, and dental caries was determined in 86 patients with cystic fibrosis (age 3 to 24 years). The dental caries experience was compared to control subjects matched for sex, race, exposure to optimally fluoridated water, chronologic age, and dental age. The findings indicate a high prevalence of tetracycline discolorations and enamel defects but a significantly reduced dental caries experience in these patients. However, interrelationships between these three factors were not strikingly evident. The presence of an altered oral health status in cystic fibrosis patients and the increased prevalence of this disease due to recent therapeutic and diagnostic advances in its management suggest the need for further familiarization with the dental manifestations of cystic fibrosis.

Adolescent↗
PubMed2005

Enamel defects in children with coeliac disease.

AIM: This was to investigate the prevalence of enamel developmental defects in a group of children with a history of coeliac disease. METHODS: A study group of children attending the Dept. Paediatrics (Leeds General Infirmary), born between 1985 and 1986 and subsequently diagnosed and treated for coeliac disease (CD) were recruited. A group of age/sex-matched children attending the Paediatric Dentistry department were used as a control group (Cont). Examinations were carried out for enamel defects and opacities (DDE index), dmf, dmfs, DMF and DMFS (BASCD method), and a full medical and dental history were obtained. RESULTS: Significantly more children in the CD group had a greater number of enamel defects than controls for both primary (p=<0.02) and permanent (p=<0.001) dentitions. Opacities in both primary and permanent teeth were statistically significantly greater in the CD group than controls (p=<0.04 and p=<0.001 respectively). Dental caries in both primary and permanent dentitions was less in the CD group compared with the control group of children. CONCLUSION: Coeliac disease was associated with an increased prevalence of developmental enamel defects.

Case-Control Studies↗
PubMed2002

Type and extent of enamel defects in juvenile idiopathic arthritis (JIA).

AIM: To establish whether there is an increased prevalence and extent of enamel defects associated with Juvenile Idiopathic Arthritis (JIA) in patients in the North of England. STUDY DESIGN: clinical examination of subjects and age and sex matched controls. METHODS: The labial surfaces of all erupted permanent teeth in subjects, as well as age and sex matched controls, were examined. They were classified for type and extent of defects according to the Modified DDE index. The records of 146 subjects and 142 controls were available for analysis. STATISTICS: defects were expressed as the percentage of subjects or controls with or without any defects or specific types of defect. Fisher's exact test was used to compare the prevalence of disease in the two groups with significance being accepted at the 5% level. In addition, 95% confidence intervals for the relative risk of disease in the two groups were derived. RESULTS: There was no significant difference between subjects and controls for the presence of any type of defect (p=0.48), demarcated opacities (p=0.39), diffuse opacities (p=0.71), or hypoplasias (p=0.19). There was no significant increase in severity of defects in subjects compared with controls. There was also no significant difference when comparing the group diagnosed before the age of 4 (0-3) and the group diagnosed after the age of 4 (>4) years. CONCLUSION: There was no greater overall prevalence of enamel defects or specific type of defects and no greater extent of them in subjects with JIA compared with age and sex matched controls.

Journal Article↗
PubMed1996

Dental enamel defects and screening for coeliac disease.

Specific dental enamel defects (DEDs) in permanent teeth are frequently observed in coeliac patients. We examined the permanent teeth in 6949 secondary school children living in Trieste (78% of 8724 children born between 1978 and 1982). Children with DEDs were tested for serum antigliadin antibodies (AGAs) and antiendomysium antibodies (AEAs), and those positive for serum AGAs and/or AEAs underwent intestinal biopsy. Specific DEDs were observed in 52 children (0.59% of the total population examined). Serum AGAs and/or AEAs were positive in 10 cases. Nine patients underwent intestinal biopsy (one refused) and in four cases a flat mucosa was documented (one with short stature, three completely asymptomatic). The known incidence of CD in the study area was 1:1000 before the study programme and 1:670 (an increase of 44%) after it. Dental enamel inspection may be utilized for detecting undiagnosed coeliac disease in symptom-free schoolchildren. This clinical test is probably less sensitive than serum AGA screening test, but deserves some consideration because it is cheap, easy to perform and well accepted by the population.

Adolescent↗
PubMed1999

Cross-polarized photography in the study of enamel defects in dental paediatrics.

An investigative trial was set up to determine the efficacy and practicality of using cross-polarized photography in the assessment of enamel defects. Twenty patients were photographed using this technique. The photography was assessed by ten clinicians, each of whom completed a questionnaire. Two calibrated examiners using the DDE Epidemiology and Screening Indices also undertook assessment. The results show overwhelming evidence to support the use of cross-polarization, with significant increase in agreement between the assessors, than that which could be obtained by conventional photography. It also enhanced the visual detail of enamel defects enabling changes in the appearance to be assessed by the DDE Indices.

Child↗
PubMed1996

RVG-S, VIXA, and Ektaspeed film in detection of proximal enamel defects under orthodontic bands.

An in vitro investigation was carried out to compare CCD-based intraoral radiographic systems with E-speed film for the detection of proximal enamel defects beneath orthodontic bands, with and without added niobium filtration to attenuate the x-ray beam. Twenty caries-free extracted teeth were randomly divided into five groups. Fifteen of 30 contacting proximal surfaces remained lesion free; the other 15 received a small, medium large mechanically induced enamel defect. Images were made with and without the addition of 30 microns niobium filtration, and with and without orthodontic bands. Six dentists were viewers. Receiver operating characteristic (ROC) curves were developed for each modality under each test situation. The area under the curve (Az) was used as an index of diagnostic accuracy, and the critical ratio was used for statistical comparisons. In the absence of orthodontic bands, the Az values for E-speed film and for nonenhanced RVG-S were greater than for all other modalities tested, indicating that they have the greatest diagnostic accuracy. With orthodontic bands, the RVG-S with steep gradient enhancement (X-function) had a higher Az value than all other modalities. Addition of niobium had no significant effect on defect detection. CCD-based devices hold no diagnostic advantage over conventional film for detecting changes in the density of enamel not covered by orthodontic bands. Contrast enhancement of digital images (RVG-S X-function) holds promise for the detection of such changes beneath orthodontic bands.

Bicuspid↗
PubMed1977

Clinical and histologic observations of opalescent dentin associated with enamel defects.

The rare variant of opalescent dentin associated with enamel defect was found in a 1 1/2-year-old boy. The pulp chambers and root canals of the affected deciduous teeth were very large, with no sign of obliteration. The enamel layer of those teeth was markedly reduced in thickness, and the enamel prisms were not recognized even by scanning electron microscopy. The mantle dentin was abnormal, as were other portions of dentin.

Amelogenesis Imperfecta↗
PubMed1990

Dental enamel defects in celiac disease.

The teeth of 40 adults aged 19 to 67 yr with celiac disease (CD) were examined for dental enamel defects (ED). A total of 33 of the 40 adults with CD (83%) had systematic ED in contrast to only 5 of the 112 clinical controls (4%). Unspecific enamel lesions were found in both groups, but they were more common in the control group (80% vs. 18%). Altogether 69% of the permanent teeth in adults with CD were found to be defected, in clinical controls only 19%. In adults with CD the ED were in contrast to those in controls symmetrically and chronologically distributed in all four sections of dentition. The present study clearly shows that symmetrically and chronologically distributed enamel defects are strongly associated with CD. Therefore in the absence of symptoms and signs of malabsorption dentists could easily select the right patients possibly suffering from CD for gastroenterologic consultations.

Adult↗
PubMed1989

A modified DDE Index for use in epidemiological studies of enamel defects.

The aim of this study was to investigate possible modifications to the DDE Index to make it simpler to use and to make the data collected more meaningful and amenable to analyses and interpretation. After the use of the DDE Index in a National Study in Ireland, initial alterations to the Index were tested on a group of children with enamel defects, in Ireland and New Zealand. The DDE Index was then modified to allow for the measurement of demarcated, diffuse, and hypoplastic defects and their severity. With the Modified Index, the prevalence of defects both on index teeth and all permanent tooth surfaces of 8- and 15-year-old children in fluoridated Cork City and non-fluoridated areas of Cork County and Manchester, U.K., was measured. The prevalence of enamel defects on one or more index teeth of children in the three areas ranged from 30 to 42% in 8-year-olds and from 31 to 38% in 15-year-olds. The percentage of children affected as seen by full-mouth examination was somewhat higher, ranging from 38 to 51% for 8-year-olds and 58 to 63% for 15-year-olds. The percentage of index teeth affected (7 to 14%) was generally higher than for all teeth (5 to 9%). Demarcated opacities were the most common defect seen. Diffuse opacities were found to be the discriminating factor between the fluoridated and non-fluoridated areas. In all areas, the vast majority of diffuse opacities extended over less than 1/3 of the surface area of the teeth affected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗