Tooth Wear:Prevalence and Risk in Isle of Man Schoolchildren

Objectives: to determine the prevalence and severity of tooth wear/erosion and caries experience (DMFT) in 13-14year-old children on the Isle of Man,(IoM),UK and to investigate the strength of association of dietary risk factors. Methods: tooth wear was assessed on a 4-point scale. Index teeth were incisors, canines and first molars, with all anterior and molar occlusal surfaces being examined. The dietary questionnaire, validated previously, measured frequency of consumption of common food and drinks relevant to oral disease. All examinations were conducted under BASCD guidelines. Results: a total of 629 children in six schools were examined, mean age=13.6 years. 320 (51%) of children had at least one surface with exposed dentine. Excluding incisal edges and canine tips, 124(20%) of children had exposed dentine labially, palatally or occlusally. More males had dentinal exposure on any surface N=169(56%) and on smooth surfaces N=72(58%) compared to females, p=0.01.The commonest surface with exposed dentine was the incisal edge (25%), palatal dentine was present in only 3% of children, whereas lower occlusal dentine was present in 18%. Odds ratios for a range of dietary factors were generally low eg fizzy drinks OR=1.6, 95% CI 1.05-2.03. The odds of toothwear in a male are 1.70 times the odds in a female. Brushing teeth twice a day increased the odds of toothwear by 2.1. Mean DMFT scores were not statistically different between children with smooth surface dentine exposed (1.37) compared to those without (1.58).The one private school had the lowest DMFT (0.5) and only 15% with smooth surface dentinal exposure. Conclusion: more males have exposed dentine than females. Most dentine exposure was on incisal edges. Few children had exposed palatal dentine (N=16, 3%) but occlusal dentine was evident in 114 children (18%). Odds ratios for a range of potentially erosive drinks were not high.