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Study examines knowledge and experience of erosive tooth wear among Danish dentists

From diagnosis to therapy: Danish dentists were recently surveyed on their management of erosive tooth wear in patients. (Image: Tolikoff Photography/Shutterstock)

Fri. 27. November 2020

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COPENHAGEN, Denmark: Erosive tooth wear (ETW) is of growing concern to dental professionals and therefore the subject of extensive research. A survey has now investigated how knowledgeable Danish dental professionals are about the problem and how they would potentially treat such cases.

In order to conduct the survey, a team at the University of Copenhagen sent validated questionnaires electronically to all active members of the Danish Dental Association and the Association of Public Health Dentists in Denmark. The first part of the questionnaire concerned scoring and record-keeping, and knowledge and experience of ETW. The second part presented two patients with different severity of erosive lesions in order to explore the dentist’s preventive and restorative treatment decisions. 

In an interview with Dental Tribune International, Dr Diana Mortensen, senior clinical instructor at the University of Copenhagen, explained the incentive behind the research: “In light of the increasing awareness of ETW, we wanted to evaluate general knowledge, opinions and clinical decision‐making among dentists. Similar studies from Iceland and Norway indicated that dentists generally are well educated with respect to diagnosis and treatment and we were interested to see whether this was also the case with Danish dentists.”

According to Mortensen, it was very difficult to get a sufficient response rate and that the EU General Data Protection Regulation posed a great challenge. “It was not possible to send the questionnaire directly to all dentists in Denmark. Consequently, the majority of the dentists might not have noticed the questionnaire link in a regular newsletter via the domestic dental associations, and reminders could not be personalised to non‐responders.”

Out of 4,490 potentially eligible dentists in Denmark, 442 participated in the survey. Nearly all the respondents (97%) registered ETW in the charts and 49% recorded the patients’ diet history “always” or “often”, most commonly with the aid of interviews. The respondents perceived the prevalence of ETW to be higher today than ten to 15 years ago and male patients (15–25 years of age) appeared more affected than females. The majority (82%) thought that they usually identified the probable cause of the condition, and the consumption of carbonated beverages was considered the most common contributing factor. The treatment included dietary guidance, soft toothbrushing with non‐abrasive fluoride toothpaste, topical fluoride applications and direct composite restorations.

“If more dentists use scoring systems […] it will be easier to measure the progress of the ETW”

The results showed that, whereas the majority of Danish dentists adopted a minimally invasive approach for the management of ETW, there was room for improvement in diagnosis, clinical scoring and case documentation.

Finally, Mortensen explained why clinical scoring is important and how dentists can achieve this. “If more dentists use scoring systems on tooth level supplemented with clinical photos, cast study models or digital scanning systems, it will be easier to measure the progress of the ETW and thereby evaluate, for example, the individual effect of prophylactic treatment advice,” she said.

The study, titled “Awareness, knowledge and treatment decisions for erosive tooth wear: A case‐based questionnaire among Danish dentists”, was published online on 30 October 2020 in Clinical and Experimental Dental Research, ahead of inclusion in an issue.

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