Knowledge of and Treatment Practices for Erosive Tooth Wear Among Finnish Dentists


 

TAKE-HOME MESSAGE

  • Erosive tooth wear (ETW) is a chemical loss of mineralized tooth substance caused by the exposure to acids mainly from foods or from the GI system. The prevalence and severity of ETW among children and adolescents is increasing with limited measures to improve awareness among patients and oral healthcare providers. This study interviewed 866 dentists from Finland regarding the approach to evaluate and treat ETW based on a clinical case shared by email. A great majority of the respondents (98.0%) recorded ETW in the patient pictures, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. The consumption of carbonated beverages (84.3%) and energy drinks (57.0%) and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patients' dietary history while 1.9% evaluated the saliva secretion rate. 

  • Finnish dentists successfully detected and/or diagnosed ETW wear, but there is variation in recording it due to a lack of adoption of a precise scoring system. The authors suggested the Basic Erosive Wear Examination (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2238785/) to improve diagnosis and management. 
– Luiz  Meirelles, DDS, MS, PhD

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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