among the younger generations , as the Adult and Children ’ s Surveys indicate . As Poyser and colleagues ( 2005 ) so succinctly stated : ‘ The prevalence of tooth wear is likely to escalate as life expectancy continues to increase . As people expect to retain their teeth throughout life this has important implications on the type of preventative and restorative care that the profession will need to provide in the future . This also has an implication for training and funding for dental services . The management of TSL and the eventual failure of restorations placed to manage this problem are likely to be a significant issue in future years .’ 3
SIGNS AND SYMPTOMS For dentists , the signs and symptoms that indicate a patient may be suffering from tooth wear and that action is needed include :
• Sensitive teeth
• Discolouration , including yellowing and loss of shine ( where some of the outer enamel layer has been lost )
• Sharp or chipped anterior teeth
• Occlusal surfaces wearing flat and taking on a shiny , pitted appearance
• Altered occlusion as vertical height changes
• Restorations standing proud of the teeth
• Abfraction lesions developing cervically
• V-shaped notches or shallower cupping present cervically . When you do witness such damage , it is important to monitor the rate of wear objectively by taking clinical photographs and study casts for future reference .
Then , once the type of tooth wear has been diagnosed – always bearing in mind it is more common for patients to be suffering from more than one form – it is imperative that action is taken to prevent further damage , starting with patient education .
MEETING FUTURE CHALLENGES It is true that tooth wear is a natural part of life and it gets worse as we get older , and so it is fair to suggest that suffering some tooth wear is unavoidable . However , a number of causes of tooth wear are preventable – at least to some extent . Because of this , all dental professionals can make a difference to their patients ’ susceptibility to tooth wear .
Indeed , the European Federation of Conservative Dentistry ( EFCD ) has called for the dental community to increase its focus on erosive tooth wear and declared it a challenge requiring co-operation with other healthcare professionals . 4
Irrespective of age , patients need to be made aware that imprudent food and drink choices , medical conditions that may cause varying degrees of stomach acid regurgitation , stress-related bruxism , and over-zealous tooth brushing can all cause damage to the enamel and dentine .
Early diagnosis of tooth wear is essential so that simple treatment , including monitoring and prevention , may be provided to help patients achieve dentinal longevity . Left unaware and uneducated , patients will continue with their destructive habits , which will have serious implications on their oral health in years to come .
The London Tooth Wear Centre ® offers an evidence-based and comprehensive approach to managing tooth wear , using the latest clinical techniques and an holistic approach in a professional and friendly environment .
FOR FURTHER INFORMATION Please visit www . toothwear . co . uk , email info @ toothwear . co . uk or call 020 7486 7180 .
REFERENCES 1 . Adult Dental Health Survey 2009 . Report 2 : Disease and related disorders . Health and Social Care Information Centre 2011 2� �h�ld�e��� De���l �e�l�h S���e� 2013� �e���� 2 : De���l d��e��e ��d d����e �� �h�ld�e� : ���l��d� ��le� ��d ����he�� ��el��d� �e�l�h and Social Care Information Centre 2015 3� ����e� �� e� �l� The D�hl ����e�� : ����� ��e�e�� ��d f����e� BDJ 2005 ; 198 : 669-676 4� �����lh� TS e� �l ( 2015 ) ����e���� �e���� �f �he �����e�� �ede������ �f ����e������e De������� : e�����e ����h �e���d�������� ��d �����e�e��� Clin Oral Invest . DOI 10.1007 / s00784-015-1511-7
NOT WHITER THAN WHITE !
|
� Increasing interest is being shown in the UK in teeth whitening , where the legal position was established by the High Court case of GDC vs Jamous 2013 , that tooth whitening is the practice of dentistry and therefore can only be performed by registered dental care professionals . The High Court ruling came when it overturned a Magistrates ’ Court ’ s decision to acquit Ms Lorna Jamous of the offences of “ practising dentistry and unlawfully carrying on the business of dentistry when not regulated by the GDC ”. On 10 May 2013 judges at the High Court in London convicted Ms Jamous of the two offences . Since that time , the General Dental Council ( GDC ) has successfully prosecuted a number of illegal tooth whiteners .
This action has been recently reinforced by a statement by FEDCAR - the Federation of European Dental Competent Authorities and Regulators – issued in
|
November 2016 , which stated that “ in the interests of high standards of oral healthcare , and irrespective of the chemical products used , tooth whitening should only be provided under the supervision of a dental practitioner ”. This action by FEDCAR has now created a European position on the issue which , it is hoped will offer greater patient safety across Europe . Commenting upon this latest move , Victoria Sheppard-Jones , Interim Head of Illegal Practice at the GDC said : “ This is great news for the dental profession and patients . It endorses the UK legal position that tooth whitening is a complicated and potentially risky procedure and as such can only be undertaken by a qualified dental professional . As always , we encourage anybody who is considering tooth whitening to check the register to ensure that the individual is legally allowed to do so before proceeding .” |
EXAMPLES OF RECENT SUCCESSFUL PROSECUTIONS A Case in Salford Quays – 22 December 2016 Jordan Longbottom , who worked in Salford Quays in Manchester – appeared before Manchester and Salford Magistrates Court , where he was found guilty of one charge under the Dentists Act 1984 and was given an 18-month conditional discharge and was ordered to pay £ 3,000 costs to the GDC .
This related to an offence on 7 August 2015 , where Mr Longbottom offered to provide tooth whitening despite not being properly qualified or registered to do so . The GDC had contacted Mr Longbottom previously on 20 February and 31 March 2015 to warn him to stop his illegal practice . However , as this did not have any effect , the GDC took the decision to prosecute .
A Case in Colwyn Bay – 1 December 2016 A woman from Colwyn Bay , North Wales ,
|
u |
Dental Practice Magazine
65