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Award Winning Project on Erosive Tooth Wear (ETW) Among Young Soldiers in Singapore
It was during his time as a Prosthodontics resident that Dr Nicholas Lim became aware of the costs and complexity of rehabilitating patients with generalised severe ETW. Many of these tooth wear conditions could have been picked out earlier and easily prevented early in life.
Dr Lim also discovered that there was a lack of epidemiological data on ETW in Singapore. He then decided to start a project that formed the baseline to spur future studies on the wear progression in the Singapore population.
ETW is the irreversible chemo-mechanical loss of dental hard tissues not caused by plaque or bacteria. This condition is increasingly affecting both primary and adult dentition globally.
Dr Lim was inspired by his colleague in the Singapore Armed Forces (SAF) Dr Tay Koong Jiunn who encouraged him to conduct his research within the SAF as it has a ready population of wide-ranging demographics. This helped to reduce sample biases and facilitated easy recruitment for his study. The study aimed to determine the prevalence of ETW and the associated risk factors among young military personnel enlisted in the military.
Dr Lim hopes to spur future studies on wear progression.
Supported by a team of Dental Officers from the Dental Officer Posting Exercise (DOPEX DOs), Dr Lim conducted his study on over 1,300 military personnel between the age of 18 and 25 years old from various SAF Dental Centres. Through the team’s efforts, Dr Lim discovered that over 21.8 per cent of participants suffered from ETW, with 61.4 per cent of these young participants exhibiting a mild to moderate risk of ETW. The study also identified some of the significant risk factors associated with ETW.
“While the relationship may not be causal, the etiology can be explained logically and scientifically. Common causes of ETW include gastric esophageal reflux disease (GERD), acidic diet (food and drinks), presence of Temporomandibular Disorder (TMD) symptoms, caries susceptibility, and the use of hard bristles toothbrush,” explained Dr Lim.
Even though a majority of the study’s participants were at risk of ETW, the positive aspect was that the severity of the wear lesions of these risk-susceptible individuals was not high.
“It is fortunate that we are able to provide timely dental education and increase awareness to this population to limit the rate of wear which will ultimately affect them in later life. If you can prevent it early, why not?” added Dr Lim.
With the study’s results, Dr Lim was encouraged by Prosthodontic Society Singapore (PSS) Executive Council member, Dr Kelvin Khng to submit his project to several international competitions including the AAP 2022: Korean Academy of Prosthodontics Award.
“I was pleasantly surprised by this achievement as I was down with COVID-19 and lost my voice completely just four days before the competition date. Miraculously, I somehow managed to get my voice back in time for the presentation and the Q&A session,” shared Dr Lim.
Even as he celebrates his win, Dr Lim remains grateful for the support given to him throughout his project.
“I would like to thank the DOPEX DOs who allocated clinical time to help with the data collection – many of whom are my undergraduate classmates who have already left the scheme. Next, I am grateful to my comrades, Dr Sonia Lee (who participated in this competition with me) and Dr Kelvin Khng, both of whom supported me during the Q&A session. Also, special thanks to Associate Professor Keson Tan, Prosthetic Dentist from the National Dental Centre Singapore Dr Ken Tan and Dr Tay Koong Jiunn, for supervising and guiding me throughout this study,” said Dr Lim.
Dr Lim plans to expand on his research to study ETW among Singapore’s general population as well as the effects of ETW on psychosocial factors like self-confidence and quality of life.