Measuring the progress of toothwear

Key Points

• Tooth wear was a slow process in this group of patients.

• Study casts are a convenient way to monitor the longitudinal progress of tooth wear.

• Restorations are not always indicated to control tooth wear, monitoring is equally important.

• If preventing further tooth wear is more important to the patient than their appearance, monitoring is an acceptable treatment since progression is often slow.

• Treatment for tooth wear can be aggressive implementation of prevention and monitoring with study casts.

• Tooth wear in this group of patients was monitored with study casts and the progression assessed by comparing changes on the models.

Abstract

Objective Tooth wear is recognised as a common feature of European dentitions. However, little is known about its progression in susceptible patients. The aim of this study was to assess the degree and progression of tooth wear in patients by examining study casts taken of their teeth on two separate occasions.

Design Over 500 sets of study casts taken during an 18-year period from patients referred for a variety of restorative procedures, were examined at Guy's Dental Hospital. Of these, 34 cases were found to have consecutive models taken at two time intervals and these were used to assess the progression of tooth wear. Study models from 19 females and 16 males, with an average age of 26 years (range 18-60) at the time of their first presentation and were all examined by a single operator. The Smith and Knight tooth wear index was used to assess the degree of tooth wear at presentation and then at another time which was a median of 26 months (interquartile range 14 –50 months) later.

Results The most common initial TWI score per surface was 1, with 54% of surfaces affected at the first assessment and 57% at the second. Score 2 was less common (14% at both assessments) and the scores for 3 and 4 combined were relatively uncommon with 5% of surfaces effected. Minimal progression of tooth wear was observed on study casts with only 7.3% of surfaces involved.

Conclusion In this sample, tooth wear was a slow, minimally progressive process.

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