Age effect on presence, susceptibility and treatment of erosive tooth wear

Abstract

Erosive tooth wear (ETW) is a growing dental condition often associated with aging. This in-vitro project comprised three studies aiming to investigate the impact of tooth age on ETW susceptibility and prevention. In the first study, un-identified extracted premolars were collected and had their ages estimated using validated dental forensic methods. The premolars were examined to investigate the relationship between age and presence and severity of ETW, as well as other main dental-hard tissues conditions. ETW, dental caries, fluorosis, extrinsic staining and tooth color were evaluated using established clinical indices. In the second study, the tooth age impact on ETW susceptibility and response to preventive treatments (Sn+F, NaF, and de-ionized water control) were evaluated using representative samples from the initial study. Enamel and dentin specimens were prepared and subjected to daily erosion-treatmentremineralization cycling procedure. Surface loss (SL) was determined during and after the cycling, by optical profilometry. Similar protocol was adopted in the third study with the addition of toothbrushing abrasion to the model, in order to explore the interplay between age and toothpaste abrasivity on erosion-abrasion development. SL was measured during and after the erosion-toothbrushing-remineralization cycling. The relationships between age and the investigated variables were assessed using linear regression models. In conclusion: 1. The presence and severity of ETW, dental caries, and extrinsic staining increased with age, while of enamel fluorosis decreased. Tooth also showed to be darker with age. 2. Susceptibility of enamel and dentin to demineralization increased with age. Sn+F showed the highest anti-erosive efficacy, and was not affected by age. NaF showed lower efficacy on dentin, which increased with age. 3. Enamel and dentin SL increased with toothpaste abrasivity level. Dentin SL also increased with age. Age effect on enamel SL was observed only with low abrasive toothpaste. Age-related changes on enamel and dentin affected ETW development.