Contemporary diagnosis and management of dental erosion.

OBJECTIVE: This article is aimed at providing an overview of the topic of erosive tooth wear (ETW), highlighting the clinical signs, diagnosis, and management of dental erosion. OVERVIEW: With the increased prevalence of ETW, it is important that oral health professionals are able to recognize the early signs. Early clinical signs of dental erosion are characterized by loss of enamel texture, a silky glossy appearance, and sometimes a dulling of the surface gloss, referred to as the "whipped clay effect, cupping, and restorations 'standing proud'." The progression of ETW should be monitored by means of diagnostic models or clinical photographs. ETW can be as a result of acid attack of extrinsic or intrinsic origin. CONCLUSION: There is an increase of ETW that is being recognized by the profession. The first step in diagnosing and management is to recognize as early as possible that the process is occurring. At that point a determination of whether the primary etiology is either intrinsic or extrinsic should be made. If these findings are confirmed, appropriate prevention, and management strategies can be adopted followed by appropriate restorative therapy. CLINICAL SIGNIFICANCE: The prevalence of ETW continues to increase. It is therefore important that oral health care providers have a better understanding of the etiology, pathophysiology, and management of this condition. This review aims to provide the guidelines for diagnosis and management of dental erosion.

Clinical performance of a modified Resin-Bonded fixed partial denture (Carolina bridge): A retrospective study.

OBJECTIVES: This research aims to retrospectively evaluate the clinical performance of Carolina bridge (CB) placed at a dental school. MATERIALS AND METHODS: Data were collected from the electronic patient record system. A follow-up letter was sent to the subjects' mailing address explaining the research purpose along with a questionnaire to assess their satisfaction with the treatment. A phone interview was performed to assess patient satisfaction, function, and choice of permanent restoration. Finally, a clinical exam was conducted for patients that agreed to come for a follow-up and still had their CBs. RESULTS: Twenty-three patients with 26 resin-bonded CBs met the inclusion criteria. All patients who did the phone interview reported to be very satisfied with the treatment. Most chose to keep the CB as definitive treatment and not to move forward with implant therapy. According to the number of rebonding needed to maintain the CB, the types of survival were analyzed as 42.3% complete survival (no rebonding needed), 26.9% functional survival (rebonded once), 23.1% survival with multiple rebondings, 7.6% failure. CONCLUSION: The performance of CBs revealed highly acceptable performance with high-patient satisfaction. CLINICAL SIGNIFICANCE: Carolina ridge is an esthetic and conservative interim treatment option that can be utilized in favorable clinical situations.

The Canadian Core Cariology Curriculum: Outcomes of a national symposium.

Despite the efforts that have been made in dental education and clinical practice to adopt the evidence-informed, risk-based, nonsurgical caries management approach, the surgical treatment approach continues to prevail. There is an urgent need to understand resistance to such a paradigm shift and establish a coordinated evidence-based Cariology teaching approach in Canadian dental schools so trainees are equipped to implement caries management in their practice. To work towards this goal, a two-day interinstitutional symposium was organized in Montreal, QC, bringing together clinical and research experts in cariology and dental education from all 10 Canadian dental schools to develop a consensus on an evidence-informed Core Cariology Curriculum, and strategies for its implementation. Through consensus, participants produced the Core Cariology Curriculum for Canadian dental schools and articulated the challenges and solutions for its implementation. Future work will include working collaboratively on the curriculum integration and evaluation.

The erosive potential of additive artificial flavoring in bottled water.

Acidic beverage consumption is a well-recognized contributor to extrinsic dental erosion. Although the pH values of some commercially available bottled waters are below neutral pH, water is still considered to be a safe and healthy choice. Artificial flavoring liquids or powders, known as water enhancers (WEs), have been introduced to the market to modify the taste of water. The purposes of the present study were to measure the pH and titratable acidity of WEs and to perform gravimetric analysis of teeth immersed in solutions of WEs mixed with different brands of bottled water in order to determine the erosive potential in vitro. The pH and titratable acidity using 0.1M sodium hydroxide were calculated for 7 brands of WEs added to 3 brands of bottled water, which had different initial pH values. Extracted human molar teeth were submerged in each combination of solutions for gravimetric analysis. Distilled water was used as the positive control and citric acid as the negative control. Data were analyzed with 2-way analysis of variance and post hoc Tukey-Kramer testing (P = 0.05). The pH value (2.9-3.0) and titratable acidity (32.2-35.3 mmol/L hydroxide) of all of the experimental solutions were considered acidic, regardless of the WE brand. Average tooth structure loss after 1 month of immersion in the solutions was 4%, and surface changes were consistent with erosive dissolution. The results showed that adding a WE to water significantly increases the potential for dental erosion. The high content of citric acid in WEs is believed to be the cause. Patients should be advised to use WEs with caution.