King's College London

As part of a series of special editions, leading expert on erosive tooth wear Professor David Bartlett from King’s College London was appointed as guest editor of the British Dental Journal for this edition.  As Head of Prosthodontics at King’s, Professor Bartlett has been involved in research on erosive tooth wear for the last 30 years.

Bringing together expertise from across the King’s College London’s Dental Institute and colleagues from across the world, the special edition features articles on prevention, epidemiology, the role of diet in tooth wear, risk assessment, the role of gastric juices, and the role of composites.

Contributors from King’s include Drs Rupert Austin, Subir Banerji, Shamir Mehta, Rebecca Moazzez, Saoirse O’Toole and Sachin Varma.

“It is incredibly important to shine a spotlight onto the issue of erosive tooth wear,” explains Professor Bartlett.

“Detecting erosive tooth wear in the early stages is quite difficult.  There are very subtle changes to the enamel and eventually the loss of tissue due to tooth wear can have a profound impact on the patient’s appearance if not caught early enough.”

“At King’s we have identified the risk factors, investigated the epidemiology and have published audits on outcome. We have a world renowned laboratory capable of measuring very small changes and associated them with risk factors. Very few researchers have the facilities we have,” he adds.

See the Erosive Tooth Wear special edition of the British Dental Journal at https://www.nature.com/articles/sj.bdj.2018.175, published 9 March 2018.

 

 

Articles from King’s College London academics:

The role of the diet in tooth wear by Saoirse O’Toole (corresponding author) and Francesca Mullan, PhD Student (published online 23 Feb 2018, can be viewed here: https://www.nature.com/articles/sj.bdj.2018.127)

An investigation by scientists at King’s College London into why some people suffer tooth erosion while others don’t has found that it’s not just what they eat and drink, but how they eat and drink, that increases their chances of developing the condition.

The research, reviewed in the British Dental Journal, identifies the risk factors and damaging habits associated with the consumption of acidic foods that result in the loss of tooth enamel and dentine, known as erosive tooth wear.

 

Medical Conditions and Erosive Tooth Wear by Dr Rebecca Moazzez and Dr Rupert Austin (published online 2 March 2018)https://www.nature.com/articles/sj.bdj.2018.166

Dentists can play a key role in the detection of health conditions including anorexia nervosa, bulimia and Gastro-Oesophageal Reflux Disease (GORD), according to research from King’s College London.

The data, published in the British Dental Journal, found that many of the medical conditions that result in the erosion of tooth enamel, known as erosive tooth wear (ETW), can have serious and even possibly fatal consequences if left undiagnosed or untreated.

 

Tooth Wear Risk Assessment and Care-Planning in General Dental Practice by Saoirse O’Toole. Other authors: Khan M, Patel A, Patel NJ, Shah N, Bartlett D, Movahedi S.

 Tooth wear is being under diagnosed and under recorded in some general dental practises in London by more experienced dentists. In a study that looked at 285 patient examinations in a three month period in 2016, it was shown that recently qualified dentists were statistically more likely to record tooth wear and ask patients about their diet and history; key factors that indicate whether or not they were at risk of getting tooth wear.

 

 The Restorative Management of Tooth Wear involving the Aesthetic zone by Shamir Mehta & Subir Banerji

The loss of tooth tissue can have a profound impact on the patient’s oral / facial appearance, and is increasingly encountered condition. Sometimes, the resulting aesthetic impairment can lead to feelings of self-consciousness and embarrassment, and may ultimately prompt a patient to seek care. Undertaking the rehabilitation of these patients can prove to be very demanding, as occasionally, there can be a mismatch in the perception of beauty and aesthetics between that of the patient and the clinician. This article provides a pragmatic approach to the assessment of the aesthetic zone/ smile zone, and describes the way by which rehabilitation can be approached to give a predictable outcome for sufferers.

 

 

The management of tooth wear with crowns and indirect restorations by Sachin Varma, Alon Preiskel, David Bartlett

The purpose of this article is to discuss the use of crowns as a restorative treatment option for tooth wear. It provides the profession an understanding of challenges associated with restoring dentitions affected by tooth wear, gives an insight into the options available.

The article also discusses the challenges with the use of composites as they can repeatedly fail and in these situations the indications for crowns4 for treatment of tooth wear is worthy of consideration.