Tooth Wear
Conditions
Brief summary
This is a questionnaire based study investigating the relationship between the timing of dietary acid intake toothbrushing and erosive tooth wear. Data will be collected on the timing, nature, frequency and duration of dietary acid intakes and timing and frequency of the participants toothbrushing. Signs of the participants erosive tooth wear will then be recorded
Detailed description
The study group will consist of two cohorts, those presenting with tooth wear and a control group. Participants will be recruited from the care planning clinic of the Dental Institute King's College London. Suitable participants meeting the inclusion criteria will be approached on the clinic, given the patient information sheet and asked to consider participating. Written consent will be obtained from those accepting the request. An interviewer-led, previously validated questionnaire will question their frequency and timing of dietary acid intake, tooth brushing and any habits associated with dietary acid intake. This will be followed by a Basic Erosive Wear Examination. The process will take 7-8 minutes and the participant is free to withdraw at any time
Interventions
None listed
Sponsors
King's College London
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Severe tooth wear with a BEWE score of 12 and at least one score of 3 in three quadrants 2. Adult 18 years or older 3. No missing anterior teeth 4. minimum of at 10 teeth in the upper and 10 teeth in the lower jaw 5. No anterior crowns/ bridges or implants 6. Written consent to the study
Exclusion criteria
1. Pregnancy 2. Participation in other research within 30 days 3. Unable to speak or understand English 4. Presence of periodontal disease or caries on more than one tooth
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Basic Erosive Wear Examination | Single reading of wear of the teeth at the appointment date. Examination of wear takes 5 minutes | Each tooth will be graded by the extent of the surface which the acid has damaged. The Basic Erosive Wear Examination (BEWE) index will grade tooth wear on the buccal, occlusal and palatal/lingual surfaces of each tooth excluding third molars. This ordinal scale graded tooth wear from 0 to 3 (0 = no wear, 1 = early surface loss, 2 = surface loss \< 50% or specific defect, 3 = surface loss \> 50%). The worst score in each sextant will be taken to be the sextant score. A cumulative score will be calculated for the mouth by adding each sextant score, which can range from 0-18. A higher score indicates a higher level of erosive tooth wear (worse outcome) |
Countries
United Kingdom
Participant flow
Recruitment details
Participants (n = 600) aged 18 years or older, were recruited between May 2014 and March 2016 following referral by their general dental practitioners (GDP) for erosive tooth wear (cases, n = 300) or general treatment (controls, n = 300) to the restorative clinics at King's College London Dental Institute.
Participants by arm
| Arm | Count |
|---|---|
| Severe Erosive Tooth Wear BEWE score of 12 or higher and at least one score of 3 in a sextant whereas | 300 |
| Mild/Moderate Erosive Tooth Wear BEWE score of 10 or lower and no score of 3 on any surface of any tooth | 300 |
| Total | 600 |
Baseline characteristics
| Characteristic | Severe Erosive Tooth Wear | Mild/Moderate Erosive Tooth Wear | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 15 Participants | 15 Participants | 30 Participants |
| Age, Categorical Between 18 and 65 years | 285 Participants | 285 Participants | 570 Participants |
| Region of Enrollment United Kingdom | 300 Participants | 300 Participants | 600 Participants |
| Sex: Female, Male Female | 138 Participants | 175 Participants | 313 Participants |
| Sex: Female, Male Male | 162 Participants | 125 Participants | 287 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Basic Erosive Wear Examination
Each tooth will be graded by the extent of the surface which the acid has damaged. The Basic Erosive Wear Examination (BEWE) index will grade tooth wear on the buccal, occlusal and palatal/lingual surfaces of each tooth excluding third molars. This ordinal scale graded tooth wear from 0 to 3 (0 = no wear, 1 = early surface loss, 2 = surface loss \< 50% or specific defect, 3 = surface loss \> 50%). The worst score in each sextant will be taken to be the sextant score. A cumulative score will be calculated for the mouth by adding each sextant score, which can range from 0-18. A higher score indicates a higher level of erosive tooth wear (worse outcome)
Time frame: Single reading of wear of the teeth at the appointment date. Examination of wear takes 5 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Severe Erosive Tooth Wear | Basic Erosive Wear Examination | 15.01 Units on a scale | Standard Deviation 2.3 |
| Mild/Moderate Erosive Tooth Wear | Basic Erosive Wear Examination | 6.27 Units on a scale | Standard Deviation 2.79 |
Comparison: A minimum sample size of 490 participants (245 in each group) was needed. This calculation assumed the proportion of adults with high dietary acid intake (3+ times/day) was 55% among cases and 40% among controls (expected odds ratio of 2.25), case- control ratio of 1-to-1, 90% statistical power and 95% significance level.p-value: <0.05Regression, Logistic