Radiographic study of the broadbeach aboriginal dentition

This study forms part of a larger anthropological investigation of the Ngaraangbal Aboriginal Tribe's ancestral burial ground at Broadbeach, Australia. It examines the dentition, records the associated pathology in a noninvasive manner, and relates this to the likely subsistence diet of the tribe. The Broadbeach osteological collection was returned for reburial in 1985; however, radiographic and photographic records of 36 adult males were available. These form the basis of our study. The pathology noted in the study sample was compared with a representative sample (n = 38) of pre-European Aboriginal remains from throughout Queensland for verification purposes only. Rates of dental pathology and injury were calculated from the radiographic and photographic records. There was a significant rate of tooth-wear related intra-bony pathology (4.0%), moderate to severe alveolar bone loss, and heavy dental attrition, of which the mandibular posterior teeth were the most severely affected. Caries prevalence (0.8%) was low for hunter-gatherer populations. A large number of molar pulp chambers had a distinctive cruciate morphology resulting from the formation of secondary dentine and pulp stones. Injuries and abnormalities included upper central incisor avulsion (58.3%) and taurodontism. These results support the proposal that the Ngaraangbal tribe was a hunter-gatherer population subsisting on an abrasive diet that included marine foods. (C) 1998 Wiley-Liss, Inc.

Dental erosion patterns from intrinsic acid regurgitation and vomiting

Background: The distribution of lesions from dental erosion due to intrinsic acid regurgitation and vomiting may be different from patterns of dental erosion due to extrinsic acids. To date studies have failed to validate this assumption. This study described the sites and nature of lesions from dental erosion in cases of intrinsic acid regurgitation, and compared them with the distribution of lesions occurring in age and sex matched controls, whose lesions are due to extrinsic acids. Methods: The University of Queensland tooth wear clinic patients were screened to select 30 cases, 21 self-identified bulimics and nine medically diagnosed chronic gastric acid regurgitators, and 30 controls. Epoxy resin models of the subjects' dentition were examined under stereoscopic light microscope at magnification 16 to 40. The patterns and sites of tooth wear were recorded for teeth representative of 20 tooth sites in every subject. Results: While the incisal edges of maxillary and mandibular anterior teeth of acid regurgitators were more frequently affected by erosion, incisal attrition was more common on controls' teeth. Cervical lesions were more commonly found in association with incisal attrition in the controls, and in association with incisal erosion in the cases. In 10 per cent of sites in case subjects, cervical lesions associated with incisal erosion were found on the lingual aspects of their mandibular incisors, canines and premolars. These lesions were almost exclusive to the case subjects. Conclusions: These results validate that lingual cervical lesions associated with incisal erosion on the mandibular anterior teeth are strong discriminators between tooth wear in patients with bulimia nervosa or chronic gastro-oesophageal reflux and those whose dental erosion is due to extrinsic acids.

Sites of dental erosion are saliva-dependent

Acid demineralization of teeth causes occlusal erosion and attrition and associated non-carious cervical lesions at sites relatively unprotected by saliva. Associations of occlusal pathology and cervical lesions were looked for in 450 patients with toothwear, and 174 subjects with cervical lesions were identified. Associations of occlusal attrition, or erosion, or no wear, with cervical lesions at 72 buccal and lingual sites were recorded from epoxy resin replicas of the subjects' dentitions (3241 teeth). Criteria used to discriminate occlusal erosion from attrition; and shallow from grooved and wedge-shaped cervical lesions were delineated by scanning electron microscopy (SEM). In the absence of occlusal pathology, cervical lesions were very rare (

Dental erosion in asthma: A case-control study from south east Queensland

Background: Asthma medication places patients at risk of dental erosion by reducing salivary protection against extrinsic or intrinsic acids. But patterns of lesions in asthmatics may differ from patterns in non-asthmatics, because gastro-oesophageal reflux (GOR) is found in 60 per cent of asthmatics. Methods: The lesions in 44 asthma cases were compared to those of age and sex match controls with no history of asthma or medications drawn from the dental records of 423 patients referred concerning excessive tooth wear. The subjects were 70 males age range 15 to 55 years and 18 females age range 18 to 45. Anamnestic clinical data were compared between the two groups. Models of all 88 subjects were examined by light microscopy, and wear patterns were recorded on permanent central incisor, canine, premolar and first molar teeth. Results: Clinical differences were a higher incidence of tooth hypersensitivity; xerostomia, salivary gland abnormalities, gastric complaints, and self induced vomiting in the cases. No differences were found between the cases and controls on citrus fruit and acid soft drink consumption. More occlusal erosion sites were found in cases, whereas more attrition sites were found in the controls. There were no significant differences in palatal erosion on maxillary anterior teeth found between cases and controls. Lingual erosion of the mandibular incisors, found only in GOR patients, was not observed. Conclusions: A higher incidence of erosion was found in asthmatics. Gastro-oesophageal reflux symptoms were not associated with the sign of lingual mandibular incisor erosion. The clinical significance is that asthmatics are at risk of dental erosion from extrinsic acid, but GOR does not appear to contribute in a site-specific manner.

Endodontic sequelae of dental erosion

Background. The incidence of, pulp involvement in patients with excessive wear has not been extensively documented. Methods: Clinical, records of 448 patients with excessive tooth wear were reviewed and 52 cases (11.6 per cent) with near or frank pulp exposures or root canal treatments were found and their numbers and sites were tabulated. Light microscopy of study models was used to determine aetiology at each site of exposure as. attrition, erosion or abrasion, scanning electron microscopy (SEM) was performed on some individual teeth. Results: Forty sites of near exposure and 57 sites of frank exposures or root canal treatments were found, some cases had both types of exposure. The commonest sites exposed by erosion were the palatal surfaces of maxillary, and the incisal surfaces of mandibular anterior teeth. Posterior teeth were not commonly affected. Toothbrush abrasion had exacerbated softie lesions as shown by SEM. Conclusions: Endodontic sequelae were found in 11 per cent of tooth wear patients as late stages of dental erosion. Near and frank exposures of the pulp thus constitute a small but significant, problem for,the Australian dental profession's concern in the of the tooth wear cases.

New insights into ancient environments using dental characters in Australian Cenozoic lungfish

Environmentally-related wear conditions and pathologies affecting the dentition of fossil lungfish from freshwater deposits in Australia have been analysed and compared with similar changes in the dentition of the living Australian lungfish, Neoceratodus forsteri. Fossil populations from the Namba, Etadunna, Wipajiri and Katipiri formations in central Australia, and the Carl Creek Limestone and the Camfield beds in northern Australia were assessed. Tooth plates from populations of living lungfish from the Brisbane River and Enoggera Reservoir in southeast Queensland were analysed for comparison. Tooth plates were measured to determine the numbers of different age groups in each population. They were assessed for abrasion, attrition, spur and step wear, erosion and caries, and for trauma and pathological conditions such as malocclusion, hyperplasia, abscesses, osteopenia and parasitic damage. All of these conditions are related to the environment where the fish lived, are found in living members of the group, and can be compared directly with those of fossil relatives. The results suggest that some of the fossil populations were at risk before climatic changes late in the Cainozoic destroyed their habitats. Some fossil lungfish populations, such as those of the Wipajiri Formation, exhibit active spawning and recruitment, good growth rates and a low incidence of disease and environmentally related damage to the tooth plates. Others, like those of the Katipiri and Namba Formations, include no young, and the adult fish were ageing and show environmentally-related damage to the dentition. Etadunna lungfish had active recruitment, but the tooth plates show a high incidence of attrition and caries. Riversleigh lungfish were actively spawning but did not grow large. Tooth plates from this latter deposit have a high incidence of pathological conditions. Fish from the Camfield Beds, where food was severely limiting, had little serious pathology but high levels of caries. Pathologies among living lungfish are common, but fossil fish were comparatively healthy, with few serious dental problems. Information from studies of fossil lungfish confirms that conservation of the few living species of lungfish depends on the maintenance of clean environments that provide adequate supplies of food and suitable sites for spawning and for the growth of young fish.

Health and safety issues in contemporary dental practice

Under current workplace health and safety legislation, the owners and managers of a dental practice have a legal responsibility to provide staff with a safe working environment. In this article, the emphasis will be on four common areas of risk: posture when seated, handling scalpel blades, flooring and lighting.

Integrating infection control into the dental curriculum

The dental profession has possessed traditional standards of cross-infection control but the recent expression of real concerns by both the public and the profession over the transmissibility of infectious diseases in the dental surgery has demanded a formalized and extended approach to teaching cross-infection control in the dental curriculum. Clear curriculum content must be formulated within contemporary Workplace Health and Safety Guidelines and the Strategic Plan of the Dental School or academic health centre. The full integration demands that the area is taught as a discrete entity but recognized as an intrinsic part of each clinical encounter. This paper discusses the structure and integration of cross-infection control into the curriculum at the University of Queensland Dental School.

The prevalence of Helicobacter pylori in practising dental staff and dental students

Recent studies suggest Helicobacter pylori is spread by faecal-oral or oral-oral transmission. Gastroenterologists who are exposed to gastric secretions and saliva have a high prevalence of H. pylori infection. Venous blood was obtained from 92 dentists, 40 dental nurses, 33 fifth year and 30 first year dental students. An ELISA assay was used to detect H. pylori IgG antibodies. Results were compared with an age and sex matched normal population. The prevalence of H. pylori infection in dentists, dental nurses, fifth year dental students and first year dental students were 23 per cent, 18 per cent, 18 per cent and 16 per cent, respectively. There were no significant differences when compared with the normal population controls. The prevalence of H. pylori antibody was not significantly increased with years of practice or patient contact time in dentists and dental nurses. Helicobacter pylori infection is uncommon in dental professionals working in the oral cavity.