Rate
Background:
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Regarding erosion, there is ‘evidence that the presence of this condition is growing steadily’. [1]
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Many adults are mainly seen with moderate tooth surface loss where values have risen from 11% in 1998 to 15% in 2009. [2][3]
To prevent or reduce non-carious tooth wear, it is important to recognise, grade, diagnose and monitor the severity, cause and progression of tooth wear. [4]
BEWE:
Basic Erosive Wear Examination (BEWE) is a recently developed screening tool for general dental practitioners to assess and record the severity of tooth wear [5].
Objectives:
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Identify risk assessment, charting and use of a screening tool for erosive tooth wear in general practice
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The most common risk assessment performed by associate dentists and experienced practice owners was TMD assessment (8% of associate dentists or experienced dentists assessed TMD) and least common was assessing for intrinsic sources of acid (0.5%).
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Foundation dentists were statistically significantly more likely to assess dietary sources of acid, intrinsic sources of acid, TMD and soft tissue signs of parafunction (p<0.001).
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A higher percentage of risk assessments were carried out by foundation dentists compared to educational supervisors and associate dentists.
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A high percentage of educational supervisors and associates did not record tooth wear on the dental charts.
- Overall there is little or no use of a screening tool such as the BEWE.
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Erosive tooth wear screening and a comprehensive risk assessment is not routinely performed in audited dental practices.
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Foundation dentists are more likely to perform risk assessments but an increase in sample size and statistical analysis is required to confirm this.
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Intrinsic sources of erosive toothwear include: gastro-oesophageal reflux disease (GORD), hiatus hernia, rumination, morning sickness, eating disorders anorexia, bulimia, orthorexia. [6].
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Conditions that induce reduced salivary flow and therefore reduced buffering capacity against acid - Sjogrens syndrome and other autoimmune diseases, medications e.g. anti-depressants can show increased risk of toothwear [6].
- GI cancer is becoming increasingly prevalent. In 2012, more than 12,000 people died of gastro-intestinal cancers –more than twice the combined total for breast and prostate cancers. [7].