The Cheminar: Rebecca Moazzez
The Cheminar: Rebecca Moazzez
11:00 a.m. - 12:00 p.m.
Tuesday, Dec. 5 | 11 a.m. – 12 p.m.
Classroom Building 170
Acid attack: Where are we with Wear?
Erosive tooth wear is a multifactorial condition of growing concern to the clinician. The prevalence of tooth wear is growing. Changes in lifestyle, nutrition, disease patterns, as well as increased awareness, have been postulated for this rise. There have been debates and inconsistencies regarding the correct terminology for the condition, and recently the consensus by a group of experts in the field is that the term, “Erosive Tooth Wear” is most encompassing. Erosive Tooth Wear (ETW) indicates that acid is the primary etiological factor, however, recognizes the multifactorial nature of the condition, and that attrition and abrasion also play a contributory role in the oral cavity. The prevalence of ETW has been reported to be between 20- 45% globally, with around 3-10% being severe. At present, it is not known whether the progression of ETW is continuous or episodic. What is known is that ETW affects patients’ quality of life, most commonly due to esthetic concerns, but also sensitivity, and poor function. Treatment of ETW is complicated and costly, as it involves many teeth. It is imperative to understand the etiology, risk factors and predictive factors, in order to prevent the condition from progressing.
The presentation will discuss research on the nature, timing, frequency, and method of consumption of acidic foods and drinks. The efficacy of providing preventive advice in the reduction of consumption of acidic foods and drinks, and progression of ETW will be reported. Gastroesophageal Disease (GERD) will be reviewed in detail, including pathophysiology, current and future developments in diagnosis, and lifestyle changes for minimally invasive management of the disease and its relationship to ETW. The role of saliva and acquired enamel pellicle (AEP) in ETW will also be discussed. Research on differences between AEP in patients with dietary ETW, as well as ETW as a result of GERD will be presented. Erosive Tooth Wear and caries will be compared vis a vis the role of bacteria. Despite ETW being a common disease of the oral cavity, which harbors the body’s second largest microbiome, there has been a long-standing belief of its lack of bacterial involvement, distinguishing it from dental caries. Despite the plethora of microbiome analyses in dental caries, there have been limited investigations into the role of microbial dysbiosis in ETW. There are significantly reduced amounts of pellicle proteins in individuals with ETW compared to healthy controls, in particular a reduction in statherin, which suggests the presence of proteases affecting the AEP. As with the microbiome analysis of people who suffer from ETW, there has been limited investigation of the metabolomics in ETW. Since oral bacteria can degrade salivary proteins by protease and peptidase activity, and produce organic acids from amino acid fermentation, their role in ETW will be reported in a first novel study of this type. The study has shown significant changes in two AEP-associated salivary proteins and increased free amino acids in saliva, suggesting microbial proteolytic activity. The study is also the first to report altered diversity in the salivary microbiome of individuals with ETW. The presentation will be concluded with a summary of practical suggestions for prevention of ETW and the importance of detailed assessments of diet and GERD symptoms. This will be complemented by a review of the role of saliva.
About the Speaker
Rebecca Moazzez, BDS, MSc, PhD, FDSRCS (Eng.), FDSRCS (Rest.), MRD, joined the Dugoni School of Dentistry as the chair of the Department of Preventive and Restorative Dentistry in 2021. Previously, she was professor of Prosthodontics and Oral Clinical Research at King’s College London school of Dentistry in the UK, where she began teaching in 1998, focusing on predoctoral and specialty prosthodontics. In 2013, she also served as the college’s founding director of the Oral Clinical Research Unit, which has attracted over $7M of funding since its conception. Rebecca received her BDS in 1986 from University of London and subsequently engaged in postgraduate specialty training, earning the gold medal and prize for the fellowship examination of the Royal College of Surgeons of England, a master’s degree in prosthodontics and a PhD with work in the field of dental erosion and gastroesophageal reflux disease, as well as several other specialty qualifications from the Royal College of Surgeon’s of England. She is a specialist in prosthodontics with special interest in dental erosion, TMJ dysfunction and minimally invasive dentistry. She is one of 16 global experts in the field of dental erosion and erosive tooth wear. She has supervised 10 PhD and 15 MSc projects. She has to her credit over 60 publications in refereed journals and several book chapters, as well as grants totaling $7.8 million from commercial and non-commercial organizations to help fund her research. Rebecca, in collaboration with colleagues from UOP and Stanford University has recently been awarded an NIH/NUDCR award to the value of $3.8M. She serves on several national and international organizations including International Association of Dental Research and acts as examiner for the Royal College of Surgeons of England and University of Malaya for their Prosthodontics specialty programs and examinations.