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A nationwide survey of oral conditions, treatment needs, and attitudes toward dental health care in Dutch adults was carried out in 1986. One of the aims of the study was to assess the prevalence of signs and symptoms of temporomandibular disorder (TMD). A sample of 6577 persons (from 15 to 74 yr of age), stratified for gender, age, region, and socio-economic status, was contacted. Of this sample, 4496 persons participated in the behavioral part of the study, of whom 3526 were examined clinically. The TMD prevalence was based on (1) perceived signs and symptoms of TMD and (2) clinical examination of joint sounds, deviation, and pain on mandibular movements. A total of 21.5% of the Dutch adult population perceived some dysfunction, and 44.4% showed clinically assessed signs and symptoms of TMD. In nearly all age groups, the signs and symptoms of TMD appeared more in women than in men. Agreement between the results of the clinical examination and the anamnestic dysfunction index was significant (p < 0.0001); however, the Pearson's correlation coefficient was low (r = 0.29). The odds-value (risk-ratio) that subjects who perceived signs and symptoms of TMD would present with clinically assessed signs and symptoms of TMD was 2.3. The results of the survey were compared with results of a meta-analysis performed on 51 TMD prevalence studies. The analysis revealed (1) a perceived dysfunction rate of 30% and (2) a clinically assessed dysfunction of 44%, both based on compound samples of, respectively, over 15,000 (23 studies) and over 16,000 (22 studies) randomly selected subjects.

The purposes of the study were: (1) to assess the prevalence and distribution of smooth-bordered tooth wear in teenagers, and (2) to investigate the relationship between smooth-bordered tooth wear and social background, dietary pattern, drinking habits, oral hygiene practices and caries prevalence. In The Hague, The Netherlands, a sample of 345 10- to 13-year-olds and 400 15- and 16-year-olds was clinically examined. The criteria for the assessment of smooth-bordered tooth wear (‘smooth wear’) were in line with the diagnostic criteria for erosion developed by Lussi (1996). In the age group 10–13 years, the percentage of subjects with visible smooth wear (SW1 threshold) was 3% and in 1 subject (0.3%), deep smooth enamel wear was found. Due to the low prevalence, the results for this age group were not analysed further. In the age group 15–16 years, the proportion of subjects with visible smooth wear (SW1 threshold) was 30% and that with at least deep smooth enamel wear (SW2 threshold) 11%. Smooth wear into dentine was found in 1 subject. First molars and upper anterior teeth were affected predominantly. A significant effect on visible smooth wear (SW1 threshold) was found for gender and social background. At mouth level, no significant influence was found for dietary patterns, drinking habits or oral hygiene practices. The caries prevalence was similar in subjects with and without smooth wear.

To prevent erosive tooth wear, early diagnosis and identification of causative factors are essential. The aim of the present 3-year longitudinal study was to investigate the association between a broad collection of biological and behavioural factors and the incidence and progression of erosive tooth wear among adolescents. The study sample consisted of 656 attendees of a dental clinic with at baseline a mean age of 11.9 years (SD = 0.9). The criteria for the assessment of erosive wear were a modification of the erosion criteria developed by Lussi [Eur J Oral Sci 1996;104:191–198]. Information on biological and behavioural factors was gathered by clinical examinations (at baseline, after 1.5 and 3 years) and by self-reported questionnaires (completed semi-annually). Of the erosion-free children at baseline, 24.2% developed erosive wear. In children with erosion at baseline, 68.3% showed progression. Multivariate analyses showed significant associations between the incidence of erosive tooth wear and alcoholic mixed drinks (odds ratio, OR = 1.82), sour vegetables (OR = 1.16) and tooth grinding (OR = 4.03). The intake of yoghurt products was significantly negatively associated with the incidence of erosive wear (OR = 0.79). The interaction of acidic products and tooth grinding showed a significant extra risk (OR = 1.2). The intake of vitamins was positively associated with progression (OR = 2.03). Erosive wear was less likely to progress in subjects who consumed milk and yoghurt products (OR = 0.89 and 0.76, respectively). The present study showed that the aetiology of erosive tooth wear is complex. Possible aetiological factors include more than acidic drinks, and factors such as tooth grinding play a large role.

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