ORAL HEALTH

 Health Evidence Bulletins - Wales
Team Leader: Mr Tony Glenn

Date of completion: 9/7/1997

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

Inherited Dental Anomalies

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

The incidence of Amelogenesia Imperfecta is 1:4,000 - 1:14,000 births;
The incidence of Dentinogenesis Imperfecta is 1:5,000 - 1: 8,000 births;
Hypodontia is observed in 5.7% women and 3.1% meni.

i. Welsh Office: Oral Health. A technical document produced by the Health Gain Panel of Review. Cardiff: Welsh Office 1992, p 176. (Type IV evidence - statistical information)

 
The Statements The Evidence
8a. Genetic Counselling can be of value in order to prevent inherited dental anomalies, although alone they are not fatali.
(Health gain notation - 2 "likely to be 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)
8b. As the effects of inherited dental anomalies can be minimised by professional treatment, early diagnosis and regular dental attendance favourably influence the treatment outcomei.
(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)
8c. Treatment aims include prevention of caries and periodontal diseasei.
(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)
8d. In the treatment of Amelogenesis imperfecta the aim is to retain the maximum amount of dental hard tissue until the individual reaches an age at which the necessary advanced restorative work can be carried out to rehabilitate the teeth. This can be measured as the proportion of permanent teeth remaining at age 16i,ii.

(Health gain notation - 1 " beneficial")

 i. Witkop CJ, Rau S. Inherited defects in tooth structure. Baltimore: Williams and Wilkins, 1971
(Type V evidence - expert opinion);
ii. Roberts JF and Sherriff M. The fate and survival of amalgam and preformed molar stainless steel crowns placed in a specialist, paediatric dental practice. British Dental Journal 1990; 169: 237-244
(Type IV evidence - observational studies)
8e For Dentinogenesis imperfecta early diagnosis and treatment are required in order to prevent loss of vertical height i.
(Health gain notation - 1 " beneficial")		 i. Witkop CJ. Hereditary defects of dentin. Dental Clinics of North America 1975; 19(1): 25-45
(Type V evidence - expert opinion)

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8f. As the disorder dictates, the following treatments may be indicated i :
  • fluoride varnish
  • glass ionomer cements
  • composite veneers
  • enamel micro-abrasionn
  • preformed stainless steel crowns
  • overdentures

(Health gain notation - 2 "likely to be 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)
8g. Longterm care (throughout adulthood) requires prevention of decay and of periodontal disease, crowns, bridges, dentures, possibly implants i.
(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)
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Health Evidence Bulletins: Wales, Duthie Library, UWCM, Cardiff CF14 4XN. e-mail: weightmanal@cardiff.ac.uk