A study to investigate habits with tooth wear assessments among UK and non-UK dental practitioners

Managing tooth wear with respect to quality of life: an evidence-based decision on when to intervene

Patients with more severe forms of tooth wear may require restorative rehabilitation. The decision to commence treatment must be taken carefully and there are a multitude of factors to consider. Alongside the clinical signs and symptoms typically associated with tooth wear, there is also the need to assess the impact of the condition on the patient's oral health-related quality of life. As part of the discussions relating to the attainment of informed consent for the restoration of the worn dentition, not only is it relevant to appropriately appraise the risks, benefits, costs, reasonable alternatives and likely prognosis of the proposed treatments, but to also elaborate on the expected impact of the intervention on the patient's oral health-related quality of life. The aim of this article is to review the evidence relating to the impact of the quality of life with the management of tooth wear, with the introduction of the concept of an evidence-based approach to decision-making when planning care.

The opinions of GDPs on the challenges of managing tooth wear in primary dental care

As patients access most of their dental care within the primary care setting, it is relevant to consider how the experience and opinions of general dental practitioners (GDPs) influence the diagnosis, monitoring and treatment of their patients with tooth wear. This paper records the agreed outcomes of semi-structured discussions with three experienced GDPs. The aim is to continue the broader debate about how patients with tooth wear currently are and ideally could be managed within the primary care settings in England. The outcomes are also likely to be applicable to other countries, regardless of the local funding models for routine patient care.

Questionnaire surveys - sources of error and implications for design, reporting and appraisal

Questionnaire surveys of dentists are a commonly used research method which can yield important results. Nevertheless, in order to give reliable information, surveys must be carefully designed to avoid bias. The challenge of planning, designing and implementing a questionnaire study is often underestimated. While headline response rate is commonly used as an indication of survey quality, there are four potential areas of survey error. These are coverage, sampling, measurement and response. These four areas of error are discussed, with examples from the current literature, to assist readers in critically appraising questionnaire studies. We make 12 key recommendations to researchers to help avoid bias in their research; approaches to response enhancement are also considered. Reporting guidelines for questionnaire studies are suggested which improve transparency and assist in understanding of research methodologies and results. We have termed these guidelines: Reporting Items for Surveys and Questionnaires (RISQ). In conclusion, there is no single solution that can guarantee a successful study. Conversely, failure to pay careful attention to any one of many crucial aspects of survey design can be the downfall of an otherwise robust study.

Objective assessment of simulated non-carious cervical lesion by tridimensional digital scanning

OBJECTIVE

To explore the use of 3D intraoral scanner/image analysis for the detection and monitoring of simulated non-carious cervical lesions (NCCLs) in vitro.

MATERIALS AND METHODS

A total of 288 NCCLs of different severities and simulated using a laboratorial model associating toothbrush stiffness (soft, medium, and hard) and toothpaste abrasivity (low, medium, high, and negative control) were analyzed. Dental impressions were taken from specimens before and after 35K and 65K brushing strokes, and then scanned with a CEREC Omnicam scanner. 3D models were analyzed for volumetric tooth loss. 3D optical profilometry was considered as the gold standard. Data were analyzed using ANOVA and Fisher's PLSD tests (alpha = 0.05), and agreement between methods by using intraclass correlation coefficient.

RESULTS

Toothbrushes of hard and mid stiffness caused higher tooth loss than soft when associated with the highest abrasive, at 35K and 65K strokes (p < 0.001). Variation in slurry abrasivity led to differences in tooth loss (with control < low < medium < high, p < 0.0001) after both 35K and 65K strokes, regardless of the type of toothbrush used, except at 35K, wherein control = low (p = 0.55). 35K strokes caused less tooth loss than 65K for all abrasive slurries (p < 0.0001) except controls. The intraclass correlation coefficient for agreement between the test and gold standard methods was 0.85.

CONCLUSIONS

Analysis of 3D images from intraoral scanner could detect and monitor NCCL progression, although this ability was limited on incipient lesions. Overall good agreement was found between the test method and optical profilometry.

CLINICAL RELEVANCE

The suggested method may be applicable to detect and monitor NCCLs clinically.