ORAL HEALTH

Health Evidence Bulletins - Wales
Team Leader: Mr Tony Glenn

Date of completion: 5/2/1998

The contents of this bulletin are likely to be valid for approximately one year, by which time significantly new research evidence may become available


6. Tooth Wear and Hypersensitivity

(Users are advised to consult the supporting evidence for a consideration of all the implications of a recommendation)

The Statements The Evidence
6a. The prevalence of tooth wear (loss of enamel with or without exposure of dentine) is widespread in childreni,ii.

 

 

i. Milosevic A, Young PJ, Lennon MA. The prevalence of tooth wear in 14-year-old school children in Liverpool. Community Dental Health 1994; 11: 83-86
(Type IV evidence - observational studies);
ii. O’Brien M. Children’s dental health in the United Kingdom 1993. London: HMSO,1995 pp. 75-76
(Type IV evidence - observational studies);
6b. Tooth wear may be caused by acidic drinks i,ii,iii,iv,v.

(Health gain notation - 6 "likely to be harmful")

The sale of unconcentrated soft drinks in the United Kingdom has more than doubled between 1985 and 1995 (from 251 to 514 ml per person per week)vi

i. Eccles JD. Dental erosion of non-industrial origin. A clinical survey and classification. Journal of Prosthetic Dentistry 1979; 42: 649-653
(Type IV evidence - observational studies);
ii. Eccles JD. Erosion affecting the palatal surfaces of upper anterior teeth in young people. British Dental Journal 1982; 152: 375-378
(Type IV evidence - observational studies);
iii. Smith AJ, Shaw L. Baby fruit juices and tooth erosion. British Dental Journal 1987; 162: 65-67
(Type IV evidence - observational studies);
iv. Millward A, Shaw L, Smith AJ, Rippin JW, Harrington E. The distribution and severity of tooth wear and the relationship between erosion and dietary constituents in a group of children.
International Journal of Paediatric Dentistry 1994; 4: 151-157
(Type IV evidence - observational studies);
v. Milosevic A, Lennon MA, Fear SC. Risk factors associated with tooth wear in teenagers: a case control study. Community Dental Health 1997; 14: 143-147
(Type IV evidence - observational studies);
vi. Ministry of Agriculture, Fisheries and Food. National Food Survey 1995. London: Stationery Office, 1995. p.12
(Type IV evidence - statistical information)

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6c. Tooth wear and dentine hypersensitivity may be prevented by
  • correct toothbrushing
  • the application of fluoride varnish

(Health gain notation - 1 "beneficial")

Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6d. Dentine Hypersensitivity may be reduced by
  • a reduction in gingival trauma

(Health gain notation - 1 "beneficial")

  • a reduction in periodontal disease

(Health gain notation - 2 " likely to be beneficial")

Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6e. In the diagnosis and assessment of tooth wear, a dietary and medical history should be taken into account and referral made to medical personnel if appropriate.
(Health gain notation - 1 "beneficial")
Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6f. In the diagnosis and assessment of dentine hypersensitivity, it is important to eliminate other causes. History-taking, gentle tactile examination and cold air are useful diagnostic aids .
(Health gain notation - 1 "beneficial")
Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)

6g. Individuals suffering from dentine hypersensitivity should be advised on its aetiology.

(Health gain notation - 1 "beneficial")

Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6h. Tooth wear related to parafunction, may be controlled by the use of
  • muscle relaxants or antidepressants
  • bite raising appliances
  • stress counselling

(Health gain notation - 2 " likely to be beneficial")

Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)

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6i. The aim of treatment of dentine hypersensitivity is to block dental tubules or to block nerve transmissions at the pulpal surfacei.
(Health gain notation - 1 "beneficial")
i. Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6j. Therapeutic toothpaste or glass ionomer cement can be used to treat dentine hypersensitivityi.
(Health gain notation - 2 " likely to be beneficial")
Further research is recommended on treatments for dentine hypersensitivity.
i. Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)
6k. Adhesive resin retained veneers and onlays can effectively restore lost tissue and remain retentivei,ii.

(Health gain notation - 2 "likely to be beneficial")

i. Nohl FSA, King PA, Harley KE, Ibbetson RJ. Retrospective survey of resin-retained cast-metal palatal veneers for the treatment of anterior palatal tooth wear. Quintessence International 1997; 28: 7-14
(Type IV evidence - observational studies);
ii. Hunter L, Stone D. Supraoccluding cobalt-chrome onlays in the management of ameliogenesis imperfecta in children: a 2 year case report. Quintessence International 1997; 28(1): 15-19
(Type IV evidence - observational studies)
6l. Veneers, fillings and/or crowns can replace lost tooth tissuei.
(Health gain notation - 1 "beneficial")
Further research is recommended to evaluate restorative treatment for toothwear.
i. Oral Health. Protocol for Investment in Health Gain. Welsh Health Planning Forum. Cardiff: Welsh Office NHS Directorate, November 1992
(Type V evidence - expert opinion)

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Health Evidence Bulletins: Wales, Duthie Library, UWCM, Cardiff CF14 4XN. e-mail: weightmanal@cardiff.ac.uk