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Pathological tooth wear (also known as tooth surface loss) is on the increase, as indicated by the most recent Adult and Children’s Dental Health Surveys.1,2
Recognising that tooth wear has the potential to be a serious issue in the UK in the future if preventive action is not fully embraced, its incidence and significance was recorded in the Adult Dental Health Survey (ADHS) for the first time in 1998, and this exercise was repeated in the latest offering. Comparison of the two surveys shows that in just 11 years the incidence of tooth wear in England has increased by 10%.1
As for the Children’s Dental Health Survey, it tells us, for example, that 33% of 5-year-olds
demonstrated tooth surface loss (TSL) on one or more of the buccal surfaces of the primary upper incisors, while a quarter of 12-year-olds were reported to have TSL on the molars and the buccal surface of the incisors. In addition, 15-year-olds were shown to be more adversely affected than the 12-year-olds when TSL on the occlusal surface of molars was measured (31% compared to 25%).2
So, what does this mean in reality for dental professionals and patients looking to the future? As Poyser and colleagues (20015) so succinctly stated: ‘The prevalence of tooth wear is likely to escalate as life expectancy continues to increase. As people expect to retain their teeth throughout life this has important implications on the type of preventative and restorative care that the profession will need to provide in the future. This also has an implication for training and funding for dental services. The management of TSL and the eventual failure of restorations placed to manage this problem are likely to be a significant issue in future years.’3
Commenting on this worrying trend, Prof. Andrew Eder, said: ‘Irrespective of age and circumstance, patients need to be aware that, amongst other issues, poor drink and food choices, eating disorders, stress-related bruxism and traumatic oral hygiene measures can all cause considerable tooth wear.
‘Once the first signs of tooth wear are recognised, a partnership approach offers the most effective way in which to prevent further damage. Left in the dark, patients – especially those in the younger age groups – are likely to continue in ignorance with their destructive habits, which will have nationwide dental health repercussions for many years to come if the figures published in the most recent surveys are anything to go by.
‘So, if we are to have any chance of subverting the oral health outcome that the statistics indicate, it is incumbent upon all dental professionals to meet this challenge head-on.’
The London Tooth Wear Centre® offers an evidence-based and comprehensive approach to managing tooth wear, using the latest clinical techniques and an holistic approach in a professional and friendly environment.
1. Adult Dental Health Survey 2009. Report 2: Disease and related disorders. Health and Social Care Information Centre 2011
2. Children’s Dental Health Survey 2013. Report 2: Dental disease and damage in children: England, Wales and Northern Ireland. Health and Social Care Information Centre 2015
3. Poyser NJ et al. The Dahl Concept: past, present and future. BDJ 2005; 198: 669-676
Professor Andrew Eder is a Specialist in Restorative Dentistry and Prosthodontics and Clinical Director of the London Tooth Wear Centre®, a specialist referral practice in central London. He is also Professor/Honorary Consultant at the UCL Eastman Dental Institute and Pro-Vice-Provost and Director of Life Learning at UCL.