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Todorov J, Shmarina E, Johannsen A. Dental care staff's experience with risk assessment of dental erosion: a qualitative study. BMC Oral Health 2024; 24:933. [PMID: 39129015 PMCID: PMC11318332 DOI: 10.1186/s12903-024-04700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/02/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND The risk assessment of dental erosion among children and adolescents is an important aspect of dental care, as dental erosion constitutes a rapidly growing, global problem. Dental professionals rely solely on their own perception, as the current risk assessment process is not completely automatized, which affects the risk assessment reliability. AIM To explore dental professionals' experiences with risk assessment of dental erosion among children and adolescents. METHOD In-depth interview was used as data collection method. A total of 11 dental professionals were interviewed. The interviews were analyzed using qualitative content analysis. RESULTS The findings were summarized in the categories Professionals' responsibility, Systematic approach , and Collaboration and communication. Dental staff perceived that their basic knowledge regarding erosion should be improved, and skills development was desired to reduce the knowledge gaps around the risk assessment of dental erosion. They alleged that the systematic approach could be improved by reducing workplace stress, implementing a universal dental erosion index, improving the existing risk assessment software, and automating the risk assessment of the condition. Dental professionals also experienced a need to calibrate and collaborate with each other and with other healthcare professionals to improve patient care. CONCLUSION Dental professionals experienced their basic knowledge of dental erosion and their risk assessment as good, but a more advanced skill development was required. Furthermore, they experienced the risk assessment software as a good tool that should be improved to compile more objective risk assessment. A universal erosion index was also requested.
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Affiliation(s)
- Johannes Todorov
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
- Kronoberg County Council, Public Dental Service, Växjö, Sweden.
| | - Elena Shmarina
- Kalmar County Council, Public Dental Service, Oskarshamn, Sweden
| | - Annsofi Johannsen
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Wetselaar P, Lobbezoo F, de Vries R, Mehta SB, Opdam NJM, Loomans BAC. Developing diagnostic criteria for tooth wear, a preliminary beta version based on expert opinion, and a narrative literature review. J Oral Rehabil 2023; 50:1030-1042. [PMID: 37183351 DOI: 10.1111/joor.13499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/20/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Tooth wear is a multifactorial condition, leading to the irreversible loss of dental hard tissues. The availability of an unambiguous, universally applicable assessment protocol remains lacking. OBJECTIVES The goal of the authors is to develop a set of diagnostic criteria for the assessment of tooth wear (DC-TW). A two-step approach will be used to achieve this objective: (1) to develop a preliminary beta version of the DC-TW, based on the authors' clinical experience and their shared expertise and supported by a narrative review of the existing literature, and (2) to develop the final DC-TW, with input from a larger group of experts using an international Delphi process. This paper relates to the first step. METHODS The authors outlined the components that should be incorporated into the DC-TW. The literature search was performed to investigate if their concept was in line with the available literature. The search was conducted to identify eligible publications from inception to July 11, 2022. Two authors independently screened all publications, and differences in judgements were resolved through a consensus procedure. RESULTS The search yielded 5362 publications, resulting in the final inclusion of 383. These publications were divided into four main topics: (1) nomenclature/taxonomies; (2) self-report tools; (3) clinical assessment tools; and (4) clinical decision-making. CONCLUSIONS The information from the publications was used and fused with the clinical experience and shared expertise of the authors to contribute to the development of a preliminary beta version of the DC-TW.
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Affiliation(s)
- Peter Wetselaar
- Department of General Oral Health Care, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Shamir B Mehta
- Department of Conservative & MI Dentistry, Unit of Distance Learning, King's College London Faculty of Dentistry, Oral & Craniofacial Sciences, London, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
| | - Niek J M Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
| | - Bas A C Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
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Lieffers JRL, Vanzan AGT, Rover de Mello J, Cammer A. Nutrition Care Practices of Dietitians and Oral Health Professionals for Oral Health Conditions: A Scoping Review. Nutrients 2021; 13:3588. [PMID: 34684589 PMCID: PMC8539677 DOI: 10.3390/nu13103588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/02/2021] [Accepted: 10/02/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Oral health conditions, such as dental caries, pose a substantial burden worldwide. Although there are many risk factors for poor oral health, diet is often implicated as a cause of these issues. The purpose of this scoping review was to identify and map studies that have captured information on the "real-world" nutrition care practices of oral health professionals (OHPs) and dietitians to optimize oral health, and specifically the dentition and periodontium. METHODS A search of peer-reviewed articles was conducted using MEDLINE, CINAHL, and Embase. Articles that addressed the review objective and met the following criteria were included: English language, published since 2000, and study conducted in a high-income country. RESULTS Overall, 70 articles were included. Most articles reported on cross-sectional survey studies and provided self-reported data on OHP practices; few articles reported on dietitians. Most articles reported only general/unspecific information on assessment and intervention practices, such as dietary analysis, nutrition counselling, and diet advice, and lacked specific information about the care provided, such as the dietary assessment tools used, type of information provided, and time spent on these activities. Barriers to the provision of nutrition care by OHPs were common and included time and lack of remuneration. Few studies reported on collaboration between dietitians and OHPs. CONCLUSIONS Several studies have captured self-reported information on nutrition care practices of OHPs related to oral health; however, there is limited information available on the details of the care provided. Few studies have examined the practices of dietitians.
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Affiliation(s)
- Jessica R. L. Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada; (A.G.T.V.); (J.R.d.M.); (A.C.)
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Kangasmaa H, Tanner T, Laitala ML, Mulic A, Kopperud SE, Vähänikkilä H, Anttonen V, Alaraudanjoki V. Knowledge on and treatment practices of erosive tooth wear among Finnish dentists. Acta Odontol Scand 2021; 79:499-505. [PMID: 33689559 DOI: 10.1080/00016357.2021.1896031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate Finnish dentists' knowledge on and means of recording, detecting and diagnosing erosive tooth wear (ETW). Treatment options and possible differences in treatment decisions between general and specialized dentists were also evaluated. MATERIALS AND METHODS An electronic questionnaire was sent by e-mail to 3664 Finnish dentists. Respondents' gender, age, work experience, field of specialty, and practice location were requested. The questionnaire also included a patient case where the dentists were asked about their choice of treatment. Statistical analyses were performed using means, proportions, and cross tabulations. RESULTS Response rate was 24% (n = 866). Almost all respondents (98.0%) recorded ETW in patient files, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. Use of carbonated beverages (84.3%), energy drinks (57.0%), and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patient's dietary history while 1.9% evaluated saliva secretion rate. When asked about treatment decisions of ETW patients, the differences between general dentists and specialized dentists were not as obvious as hypothesized. CONCLUSIONS This study suggests that the Finnish dentists who participated in this survey are able to detect and/or diagnose erosive tooth wear, but there is variation in recording it. The differences in treatment decisions between general dentists and specialized dentists seem to be moderate. The treatment practices for ETW are not established and further research to create clinical guidelines seems to be needed.
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Affiliation(s)
- Hanna Kangasmaa
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Tarja Tanner
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marja-Liisa Laitala
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aida Mulic
- Nordic Institute of Dental Materials, NIOM, Oslo, Norway
| | | | - Hannu Vähänikkilä
- Faculty of Medicine, Infrastructure for Population Studies, University of Oulu, Oulu, Finland
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital and University of Oulu, Oulu, Finland
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Genetic Aspects of Dental Erosive Wear and Dental Caries. Int J Dent 2021; 2021:5566733. [PMID: 34335772 PMCID: PMC8292068 DOI: 10.1155/2021/5566733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives The present review aims to give an overview of the literature focusing on novel genetic aspects of dental erosion and dental caries. Once the tooth erupts into the oral cavity, the regenerative capability of enamel is fundamentally limited due to the loss of dental epithelium during eruption. The susceptibility or resistance to dental erosion and caries is presumably a result of environmental, phenotypic, and/or genetic influence. Even though it is evident that individuals frequently exposing their teeth to acid and sugar are at high risk of developing dental erosion and caries, the findings exclusively based on these factors are elusive. Data resources and study selection. The present review was based on data collected from the National Library of Medicine database with different combinations of the following terms: "tooth," "dental," "dentin," "enamel," "erosion," "erosive wear," "caries," "decay," "gene," and "genetic." A total of forty-six studies met the inclusion criteria. Data were extracted by one reviewer and verified by another. Conclusion The high prevalence of erosion and caries among certain groups, and observations that not all individuals appearing to be at risk develop these lesions, has sparked research on identifying genetic effects to these conditions. A connection of genome-wide and candidate gene studies has increased considerably in the literature. This review reveals largely varying success among studies, demonstrating the difficulties of developing the study with adequate sample sizes and durable phenotype definitions that permit enough statistical power to identify genetic contributors.
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Mortensen D, Mulic A, Pallesen U, Twetman S. Awareness, knowledge and treatment decisions for erosive tooth wear: A case-based questionnaire among Danish dentists. Clin Exp Dent Res 2021; 7:56-62. [PMID: 33124776 PMCID: PMC7853886 DOI: 10.1002/cre2.339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the knowledge and experience of erosive tooth wear (ETW) among Danish dental practitioners and, based on two cases, explore their treatment decisions. METHODS We sent a validated questionnaire electronically to all active members of The Danish Dental Association and The Association of Public Health Dentists in Denmark. The questionnaire had two parts; the first focused on scoring, recordkeeping, knowledge and experience of ETW. The second part presented two patients with different severity of erosive lesions to explore the dentists preventive and restorative treatment decisions. RESULTS We received 442 answers from 4,490 potentially eligible dentists in Denmark (response rate 9.8%). The majority (78%) was female and the median age was 44 years. Nearly all respondents (97%) registered ETW in the charts and 49% recorded "always" or "often" the patients' diet history, most commonly with aid of interviews. The respondents perceived the prevalence of ETW to be higher today than 10-15 years ago and male patients (15-25 years) appeared more affected than females. The majority (82%) thought that they usually found the probable cause of the condition with carbonated beverages being the most common factor. The treatment included dietary guidance, soft tooth brushing with non-abrasive fluoride toothpaste, topical fluoride applications and direct composite restorations. CONCLUSION The majority of Danish dentists taking part of this survey had adopted a minimally invasive approach for the management of erosive tooth wear in young adults. There was however room for improvements in diagnosis, scoring and case documentation.
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Affiliation(s)
- Diana Mortensen
- Department of Odontology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Aida Mulic
- Institute of Dental Materials (NIOM)OsloNorway
| | - Ulla Pallesen
- Department of Odontology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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Awareness and Treatment Decisions on Tooth Wear among Jordanian Dentists and Prosthodontists: A Cross-Sectional Survey Study. Int J Dent 2020; 2020:8861266. [PMID: 33299419 PMCID: PMC7701210 DOI: 10.1155/2020/8861266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/25/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To assess the awareness, knowledge, and treatment decisions by dentists in Jordan regarding tooth wear. Materials and Methods A questionnaire was disseminated to a random sample of 200 general dentists and 100 prosthodontists working in the Ministry of Health, academia, private practices, and military services. Chi square and independent t-tests were performed for statistical analysis. Results Hundred and seventy-nine dentists and prosthodontists responded (59.7% response rate), of which 71.5% was females. 83.8% of the dentists reported they see patients with tooth wear. 61.5% registered wear lesions in the patient file, and 68.2% reported they find a probable cause of tooth wear. 87.2% of the dentists reported that bruxism is the most common cause in Jordan. 63.3% dentists treated their patients. 46.4% reported they “always” record a dietary history. 77.7% did not think that tooth wear is linked to caries. Low confidence levels were demonstrated among general practitioners in diagnosing and treating tooth wear. Regarding treatment decisions, most dentists decided to restore worn teeth with composite and to construct a night guard. Minimally affected anterior teeth were mostly treated with fluoride. Restoration of posterior worn teeth with overlay was suggested by one-third of the dentists. Conclusion The dentists and prosthodontists in Jordan are aware of tooth wear. However, examination and documentation were given a little priority by general dentists. On the other hand, there was an agreement among the dentists and prosthodontists on applying the minimally invasive approach. Clinical Significance. It is challenging for dentists to make the best treatment decision for tooth wear especially as no standard treatment is available. Therefore, this study investigated the awareness and treatment decisions of a sample of dentists and prosthodontists in Jordan.
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