Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study

Prevalence of erosive tooth wear in risk group patients: systematic review

OBJECTIVE

This systematic review investigates the prevalence of erosive tooth wear (ETW) in individuals classified as risk groups (gastroesophageal reflux disease, eating disorders, special diets, acidic beverage, drugs and alcohol, legal drugs and medications, and occupational or sports).

MATERIALS AND METHODS

The research was conducted in nine databases (PubMed/MEDLINE, Embase, Cochrane Library, LILACS/BVS, SciELO, Scopus, Science Direct, Open Grey, and Web of Science) up to April 2024 (PROSPERO CRD42021270150), along with a manual search of grey literature. Observational studies involving children and adults from these previously mentioned risk groups, which provided data on ETW prevalence, were included without date or language restrictions. The methodological quality of studies was evaluated using the Joanna Briggs Institute's Prevalence Data Critical Appraisal Tool. General and subgroup data were meta-analyzed using a random-effects model.

RESULTS

Overall, 4403 studies were retrieved, out of which 148 met the inclusion criteria. Each risk group showed higher prevalences of ETW in these patients in general and subgroup analysis; although subgroup analysis was not possible for all risk groups due to the heterogeneity of the indices found.

CONCLUSIONS

The Legal drugs and Medications risk group showed lower overall prevalence values (30%), while the Drugs and Alcohol risk group obtained higher values (67%). Prevalence rates for other groups were: Gastroesophageal reflux disease (54.1%), Eating Disorders (65%), Special Diets (65.9%), Acidic Beverages (40%), Occupational and Sports (51%).

CLINICAL RELEVANCE

This systematic review highlights that risk groups are indeed at significant risk for the development of ETW and greater preventive care and dental monitoring are needed.

Anamnestic risk factors for erosive tooth wear: Systematic review, mapping, and meta-analysis

OBJECTIVES

Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in permanent dentition.

STUDY SELECTION

Observational studies reporting anamnestic risk factors for erosive tooth wear. Methodological quality and risk of bias were assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Risk factors were visually presented in a heatmap, and where possible, random-effects meta-analyses were performed for the odds ratios (ORs) of risk factors.

SOURCES

Electronic databases (MEDLINE, Embase, Scopus, and Web of Science) and manual searches in February 2023. The protocol was registered in PROSPERO (CRD4202339776).

DATA

A total of 87 publications reporting on 71 studies were included in the systematic review. The studies examined a variety of anamnestic risk factors (n = 80) that were categorized into ten domains (socio-demographics, socio-economics, general health, oral diseases, medication, oral hygiene, food, beverages, dietary habits, and leisure-related risk factors). Meta-analyses revealed significant associations between erosive tooth wear and male gender (padj.<0.001; OR=1.30, 95 % CI: 1.16-1.44), regurgitation (padj.=0.033; OR=2.27, 95 % CI: 1.41-3.65), digestive disorders (padj.<0.001; OR=1.81, 95 % CI: 1.48-2.21), consumption of acidic foods (padj.=0.033; OR=2.40, 95 % CI: 1.44-4.00), seasoning sauces (padj.=0.003; OR=1.28, 95 % CI: 1.13-1.44), nutritional supplements (padj.=0.019; OR=1.73, 95 % CI: 1.28-2.35), and carbonated drinks (padj.=0.019; OR=1.43, 95 % CI: 1.17-1.75). Most included studies exhibited low bias risk.

CONCLUSIONS

Observational studies investigated a variety of anamnestic risk factors for erosive tooth wear. Future studies should employ validated questionnaires, particularly considering the most important risk factors.

CLINICAL SIGNIFICANCE

Erosive tooth wear is a prevalent condition. Clinicians should concentrate primarily on symptoms of gastroesophageal reflux disease and dietary factors when screening patients at risk for erosive tooth wear.

Risk factors of tooth wear in permanent dentition: A scoping review

BACKGROUND

Tooth wear (TW) prevalence is high and increasing and has important consequences on the patient's quality of life. Knowledge of risk factors is crucial to promote diagnosis, prevention strategies and timely interceptive treatment. Many studies have identified TW risk factors.

OBJECTIVE

This scoping review aims to map and describe suspected available factors associated with TW in permanent dentition based on quantitative measurement.

METHODS

The scoping review was conducted using the PRISMA extension of the Scoping Reviews checklist. The search was conducted in October 2022 from the Medline® (PubMed® interface) and Scopus® databases. Two independent reviewers selected and characterised the studies.

RESULTS

2702 articles were identified for assessment of titles and abstracts, and 273 articles were included in the review. The results show a need to standardise TW measurement indices and the study design. The included studies highlighted various factors, classified into nine domains: sociodemographic factors, medical history, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders, behavioural factors, and stress. Results related to chemical TW (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, particularly drinking and eating behaviours, which supports developing public health information campaigns and interventions. Besides chemical, this review identifies evidence of several mechanical TW risk factors, such as toothbrushing and bruxism; the influence of this last factor needs to be further explored.

CONCLUSIONS

TW management and prevention require a multidisciplinary approach. Dentists are in the first line to detect associated diseases such as reflux or eating disorders. Consequently, practitioners' information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.

In Vitro Evaluation of Gastric Acid and Toothbrushing Effect on the Surface State of Different Types of Composite Resins

Background and Objectives: The aim of this in vitro study was to evaluate the effect of gastric acid associated with the effect of toothbrushing on the surface roughness of different types of composite resin used for direct restorations. Materials and Methods: The materials used in this study were two microhybrid (Filtek Z250, Herculite XRV) and two nanohybrid (Filtek Z550, Herculite XRV Ultra) composite resins. Two hundred and forty cylindrical samples with a height of 2 mm and a diameter of 6 mm were divided into four groups (groups A, B, C and D) corresponding to each tested material (n = 60). Each group was divided in two subgroups: subgroup I—the samples were submersed in hydrochloric acid and immediately submitted to toothbrushing; subgroup II—the samples were submitted only to toothbrushing. The simulation of the acid attack was performed by immersing the samples in a 0.01 M hydrochloric acid solution for 90 min. This procedure was followed immediately by toothbrushing simulation with 10,000 cycles. The acid attack and toothbrushing simulation were performed for two times. The surface roughness evaluation was performed with a Proscan 2100 profilometer. Repeated Measures ANOVA and Bonferroni post-hoc tests were used to perform the statistical analysis. Results: Simulation of one year of toothbrushing associated or not to hydrochloric acid exposure increases the surface roughness of microhybrid and nanohybrid composite resins. Six months of toothbrushing associated to six months of hydrochloric acid exposure increase the surface roughness of nanohybrid composite resins. Conclusions: Microhybrid composite resins surface becomes rougher after toothbrush and acid submersion when comparing to nanohybrid composite resins.

Analysis of Erosive Nature of Fruit Beverages Fortified with Calcium Ions: An In Vitro Study Evaluating Dental Erosion in Primary Teeth

Background

Since children frequently consume acidic fruit beverages, dental erosion is common in children. The erosive effects on primary teeth are more profound due to the lesser thickness of enamel and dentin. This study evaluated if calcium fortification of fruit beverages could reduce their erosive potential. Methodology. Tropicana Orange Delight was the fruit beverage chosen and fortified with calcium carbonate. Forty noncarious extracted primary teeth were equally distributed into four groups. Samples in group A were exposed to calcium-fortified fruit beverages and group B to nonfortified fruit beverages for 1, 2, and 3 min. The pH and calcium ion concentration of both the fruit beverages were evaluated from baseline through the test period. Samples in groups C and D were then exposed to fortified and nonfortified fruit beverages for 10, 20, and 30 min. The surface roughness and microhardness of these samples were analysed.

Results

Due to fortification, the pH and calcium ion concentration of fortified beverages was higher compared to nonfortified beverages at baseline. The calcium ion concentration of fortified beverages decreased from baseline in contrast to an increase in the nonfortified beverage group. This indicates that fortified beverage is less erosive in nature. The surface roughness of samples in the fortified beverage group did not decrease significantly from baseline. In the nonfortified beverage group, surface roughness values at 20 and 30 min of exposure were higher than baseline, suggesting that significant erosive changes occur at the prolonged duration of exposure. The microhardness values of samples in the fortified beverage group increased from baseline through the test period, suggestive of resistance to erosion offered by calcium fortification. The microhardness values of samples in the nonfortified beverage group decreased through the test period, suggestive of erosion.

Conclusion

Calcium fortification of this fruit beverage significantly reduces its erosive potential on primary teeth.

The Prevalence of Erosive Tooth Wear and Related Risk Factors in 6- to 12-Year-Old Students

PURPOSE

To evaluate the epidemiological characteristics of erosive tooth wear in primary school students aged 6-12 in Jinzhou, including: prevalence, severity, extent, intraoral distribution and associated risk factors.

MATERIALS AND METHODS

The data collection consists of two parts: the first part is the clinical examination of the participants. All erupted teeth were clinically assessed by three calibrated examiners, and classified according to the basic erosive wear examination (BEWE); The second part is a questionnaire about demographic information, parafunctional movement and lifestyle, completed by the parents or their guardians.

RESULTS

A total of 1,469 children were included in this experiment; erosive tooth wear (ETW) prevalence (BEWE ≥ 1) was 54.9%. According to cumulative BEWE index, the proportion of different ETW severity (high, medium, low, none) was 6.8%, 16.3%, 27.0% and 49.9%, respectively. In an analysis of risk factors, family factor, age, gender, extracurricular study time, oral hygiene habit, bruxism, unilateral mastication and acid diet was associated with the prevalence of ETW.

CONCLUSIONS

This study shows that ETW has a high prevalence in students aged 6-12, and more common in deciduous molars and deciduous canine. Abrasion, attrition and erosion play an important role in ETW.

Tooth wear and socioeconomic status in childhood and adulthood: Findings from a systematic review and meta-analysis of observational studies

OBJECTIVES

To evaluate the association and level of evidence between socioeconomic status (SES) and tooth wear (TW) in children, adolescents, and adults.

DATA

Eligibility criteria comprised population-based observational studies assessing the association between SES and TW in permanent dentition of adolescents and adults. Interventional and descriptive studies or those without an internal comparison between exposed and nonexposed groups were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied where applicable. Risk of bias (RoB) was assessed using the Newcastle-Ottawa scale. Meta-analyses were conducted to estimate the pooled effect measures. Q-statistic, I²statistic, subgroup and sensitivity analyses assessed study heterogeneity.

SOURCES

PubMed/Medline, Embase, Scopus, Web of Science, LILACS, SciELO, Cochrane Library, and Google Scholar databases were searched for articles published in English between 1st January 1980 and 31st March 2021.

RESULTS

Sixty-five studies were included, involving 63,893 participants in over 30 countries. A positive association was found between TW and education (OR=1.25 [0.96; 1.62]), family income (OR=1.18 [0.91; 1.53]), and private school (OR= 1.24 [0.90; 1.72]) among adolescents. Higher educated adults had a lower risk for TW (OR=0.70 [0.52; 0.93]). Most included studies had a moderate RoB. Limitations relating to population representation and assessment methodologies were identified in the included studies.

CONCLUSIONS

SES was associated with TW with its direction depending on the individuals' age. The overall quality of evidence was moderate.

CLINICAL SIGNIFICANC

SES should be included as part of the routine screening and risk assessment for tooth wear.

A systematic review of dietary acids and habits on dental erosion in adolescents

BACKGROUND

Dental erosion is the dissolution of dental hard tissues caused by acids of a non-bacterial origin. Dietary acids are considered the predominant and most controllable factor.

AIM

To synthesise the literature on the effects of dietary acids and habits on dental erosion in the permanent dentition of 10- to 19-year-old adolescents.

MATERIALS AND METHODS

An electronic literature search was undertaken in Cochrane, MEDLINE, CINAHL, Dentistry & Oral Sciences Source via EBSCOhost, and Embase with no restriction on the date of publication.

RESULTS

The initial search identified 449 articles, and 338 remained after removal of duplicates. Seventy-seven articles remained after screening of titles and abstracts, and 52 were eligible for the full-text review. A considerable variety of beverages, food, and dietary habits were reported as risk factors for dental erosion. The most consistent findings implicated the erosive potential of carbonated beverages and the consumption of acidic drinks at bedtime.

CONCLUSIONS

Although results were not consistent between cohort and cross-sectional studies, this review suggests certain dietary risk factors may contribute to dental erosion in adolescents. There is a need for more high-quality cohort studies to establish more conclusive evidence on the role of dietary acids and habits on dental erosion.

Effect of different citrus sweets on the development of enamel erosion in vitro

The increased consumption of citrus sweets can contribute to the development of erosive tooth wear (ETW).

Erosive tooth wear among South Brazilian adolescents, and its association with sociodemographic variables

The aim of this study was to assess the occurrence of erosive tooth wear (ETW) among 15-19-year-old South Brazilian adolescents, regarding prevalence, extent, severity, intraoral distribution, and sociodemographic risk indicators. A population-based cross-sectional survey was conducted in Santa Maria, southern Brazil, and included a representative sample of 15-19-year-old adolescents. Data collection included the application of a questionnaire and a clinical examination. A questionnaire was sent to the parents/legal guardians of the selected students, containing questions on demographic information, socioeconomic characteristics, and living conditions. After tooth cleaning and drying, all erupted permanent teeth were clinically assessed by two calibrated examiners, and classified according to the Basic Erosive Wear Examination (BEWE). The association between explanatory variables and the outcomes (ETW prevalence and extent) was assessed using Poisson regression models (both unadjusted and adjusted). A total of 1,197 adolescents were included in the study (participation rate of 72.3%). The overall prevalence of ETW was 57%. Severe ETW affected 16% of the sample. Overall, this adolescent population presented 13.3 affected surfaces, and 8.34 affected teeth. In the risk assessment analysis, gender, skin color, socioeconomic status, and family income were significantly associated with ETW. Boys, white adolescents, and those with higher socioeconomic status were more affected by ETW. This population-based cross-sectional study revealed that the prevalence of ETW was high, and that it was associated with sociodemographic variables in this South Brazilian population of adolescents.

Prevalence and factors associated with dental erosion in individuals aged 12-30 years in a northeastern Brazilian city

Background/Purpose

Dental erosion in young individuals has increased significantly in recent years, due to changes in lifestyle. Thus, the present study investigated the prevalence and factors associated with dental erosion in individuals aged 12–30 years in the city of Imperatriz of Maranhão, Brazil.

Materials and methods

A cross-sectional study was conducted on 335 individuals who answered a questionnaire consisting of variables related to dental erosion. Afterwards, the individuals were subjected to clinical examinations and the basic erosive wear examination index was used to classify their teeth according to the presence and severity of dental erosion.

Results

Descriptive statistics, the chi-square test, Poisson univariate and multivariate regression were performed at 5% level of significance. The sample was characterized by 204 females (60.9%), the majority of whom were from 12 to 19 years of age (78.5%), among whom 28.7% presented dental erosion. Their monthly family income was from 1 to 3 minimum wages (56.4%). The variables that were significantly associated with the outcome were family income, chewing gum, and consumption of soft-drinks/juices before going to sleep (p=0.03, p=0.001, and p=0.04, respectively). Individuals who chewed chewing gum were 2.27 times (95% CI =1.43–3.60) more likely to present dental erosion than those who did not chew gum. Individuals who ingested soft drinks or juices were 2.30 times (95% CI =1.30–4.10) more likely to present dental erosion.

Conclusion

The prevalence of erosion reflected the need for programs of prevention and guidance for patients about the etiological factors of the disease.

Dental erosion in groups of Yemeni children and adolescents and the modification of an erosion partial recording system

BACKGROUND

The prevalence of dental erosion is rising especially among children and adolescents and its grading needs further investigation.

AIMS

To determine the prevalence and severity of dental erosion in groups of Yemeni children and adolescents, and to clinically compare an erosion partial recording system (EPRS) with a proposed modified-simplified version (EPRS-M).

DESIGN

Of 6163 individuals aged 5-6, 13-14 and 18-19 years, 911 were randomly selected, of which 668 participated in the study. Dental erosion was graded using EPRS. EPRS-M was proposed, and its sensitivity and specificity was calculated in relation to EPRS.

RESULTS

Prevalence of erosion extending into dentine on at least one tooth was 6.8% among 5- to 6-year-olds, 3.0% among 13- to 14-year-olds and 14.6% among 18- to 19-year olds. The highest prevalence was 19.2% among girls aged 18-19 years which was significantly higher than boys (10.4%) in the same age group (P = 0.044). Sensitivity and specificity for EPRS-M in relation to EPRS were 85.7% and 100% for primary teeth, and 84.1% and 100% for permanent teeth.

CONCLUSIONS

Dental erosion was common among children and older teenagers and highest among older girls but less common among younger teenagers. The tested accuracy of EPRS-M qualifies it to be used as an initial quick detection tool in future dental erosion research.

Prevalence and Extrinsic Risk Factors for Dental Erosion in Adolescents

OBJECTIVE

This manuscript examined the prevalence and extrinsic risk factors for dental erosion (DE) in early and middle adolescents in Pasto, Colombia.

STUDY DESIGN

Dental erosion was evaluated in a random sample of 384 individuals aged 10-15 years attending three primary and high schools in this cross-sectional study. Clinical dental assessment for DE was done using O'Sullivan index. Data on general sociodemographic variables and extrinsic risks factors were obtained. Descriptive and univariate binary logistic regression analyses were performed.

RESULTS

Dental erosion was observed in 57.3% of individuals. The univariate binary logistic regression analysis showed that frequency of drinking natural fruit juices (OR 2.670, 95% CI 1.346 - 5.295, P=0.004) and their pH (OR 2.303, 95% CI 1.292 - 4.107, P=0.004) were more associated with the odd of DE in early adolescence. However, a high SES (OR 10.360, 95% CI 3.700 - 29.010, P<0.001) and frequency of snacks with artificial lemon taste (OR 3.659, 95% CI 1.506 - 8.891, P=0.003) were highly associated with the risk of DE in middle adolescence.

CONCLUSIONS

The results suggest that DE is a prevalent condition in adolescents living in a city in southern Colombia. The transition from early to middle adolescence implies new bio-psychosocial changes, which increase the risk for DE.

The Impact of the Demineralized Organic Matrix on the Effect of TiF4 Varnish on the Progression of Dentin Erosive Loss

This in vitro study compared the effect of TiF4 varnish with that of NaF varnish, applied on pre-eroded bovine dentin samples, with respect to the progression of erosive loss, in the presence or absence of the demineralized organic matrix (DOM). One hundred and sixty bovine dentin samples were pre-eroded (0.1% citric acid, pH 2.5, 30 min). Half of the samples were subjected to the DOM removal (collagenase solution, 5 days). Samples with and without the DOM were treated according to the groups (n = 20 with DOM and 20 without DOM/group): TiF4 varnish (2.45% F), NaF varnish (2.45% F), placebo varnish (without fluoride) and control (no treatment). Thereafter, the treated samples were submitted to erosive challenges 4 × 90 s/day (0.1% citric acid, pH 2.5) during 7 days. Between the challenges, the samples were immersed in artificial saliva. The dentin erosive loss was measured using contact profilometry (µm, n = 15). Five dentin samples per group were prepared for energy-dispersive X-ray spectroscopy analysis. Data were compared using 2-way ANOVA/Bonferroni test (p < 0.05). Both fluoride varnishes were effective in reducing the erosive loss progression regardless of the dentin condition when compared to placebo varnish and control groups. Despite the fact that the TiF4 varnish was more effective than the NaF varnish for both dentin conditions (p < 0.001), its effect was significantly reduced in the absence of DOM (p < 0.05). It can be concluded that the TiF4 varnish is the best treatment in reducing the progression of dentin erosive loss (100%) in vitro, but its protective effect is more pronounced in the presence of DOM.

Surface roughness of composite resins subjected to hydrochloric acid

The purpose of this study was to determine the influence of hydrochloric acid on surface roughness of composite resins subjected to brushing. Sixty samples measuring 2 mm thick x 6 mm diameter were prepared and used as experimental units. The study presented a 3x2 factorial design, in which the factors were composite resin (n=20), at 3 levels: microhybrid composite (Z100), nanofilled composite (FiltekTM Supreme), nanohybrid composite (Ice), and acid challenge (n=10) at 2 levels: absence and presence. Acid challenge was performed by immersion of specimens in hydrochloric acid (pH 1.2) for 1 min, 4 times per day for 7 days. The specimens not subjected to acid challenge were stored in 15 mL of artificial saliva at 37 oC. Afterwards, all specimens were submitted to abrasive challenge by a brushing cycle performed with a 200 g weight at a speed of 356 rpm, totaling 17.8 cycles. Surface roughness measurements (Ra) were performed and analyzed by ANOVA and Tukey test (p≤0.05). Surface roughness values were higher in the presence (1.07±0.24) as compared with the absence of hydrochloric acid (0.72±0.04). Surface roughness values were higher for microhybrid (1.01±0.27) compared with nanofilled (0.68 ±0.09) and nanohybrid (0.48±0.15) composites when the specimens were not subjects to acid challenge. In the presence of hydrochloric acid, microhybrid (1.26±0.28) and nanofilled (1.18±0,30) composites presents higher surface roughness values compared with nanohybrid (0.77±0.15). The hydrochloric acid affected the surface roughness of composite resin subjected to brushing.

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

Objective

This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF₄ and NaF on dentin erosive loss.

Material and Methods

Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl₂/NaF/AmF (Erosion Protection^®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF₄ (pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF₄ (pH 4.4); 5) 0.063% NaF+0.036% TiF₄ (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05).

Results

Mouthrinses containing TiF₄ or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF₄ (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF⁴ (58.3%), SnCl₂/NaF/AmF (52%) and 0.063% NaF+0.036% TiF₄ (40%). NaF solution (13.3%) did not significantly differ from control.

Conclusion

The daily application of experimental mouthrinse containing TiF₄ and NaF has the ability to reduce dentin erosion, as well as Erosion Protection^® and TiF₄ alone.

A 4 year prospective longitudinal study of progression of dental erosion associated to lifestyle in 13-14 year-old Swedish adolescents

OBJECTIVES

To evaluate the progression of dental erosion in 13-14 year-olds after 4 years, and its association with lifestyle and oral health.

METHODS

227 randomly selected 13-14 year-olds from a Public Dental Clinic, Örebro, Sweden, were investigated. A clinical examination was performed which included dental caries/gingival/plaque status, as well as grading of dental erosion at the tooth surface and participant levels in "marker teeth", including buccal/palatal surfaces of 6 maxillary anterior teeth (13-23), and occlusal surfaces of first molars. An interview and a questionnaire regarding drinking habits and other lifestyle factors were completed. All investigations were repeated at follow-up. The participants were divided into high and low progression erosion groups and logistic regression statistics were applied.

RESULTS

175 individuals participated at follow-up. Progression occurred in 35% of the 2566 tooth surfaces. 32% of the surfaces had deteriorated by one severity grade (n=51 individuals) and 3% by two grades (n=2 individuals). Boys showed more severe erosion than girls at the follow-up. Among the variables predicting greater progression, a lower severity of erosive wear at baseline had the highest OR (13.3), followed in descending order by a "retaining" drinking technique, more frequent intake of drinks between meals, low GBI and lesser sour milk intake, with reference to the baseline recording. Using these five variables, sensitivity and specificity were 87% and 67% respectively, for predicting progression of erosion.

CONCLUSIONS

Progression of erosive lesions in Swedish adolescents aged 13-14 years followed up to age 17-18 years was common and related to certain lifestyle factors.

CLINICAL SIGNIFICANCE

In permanent teeth, dental erosion may develop early in life and its progression is common. Dental health workers should be made aware of this fact and regular screenings for erosion and recording of associated lifestyle factors should be performed.

Analysis of Dental Enamel Surface Submitted to Fruit Juice Plus Soymilk by Micro X-Ray Fluorescence: In Vitro Study

OBJECTIVE

This paper aimed to analyze the in vitro industrialized fruit juices effect plus soy to establish the erosive potential of these solutions.

MATERIALS AND METHODS

Seventy bovine incisors were selected after being evaluated under stereomicroscope. Their crowns were prepared and randomly divided into 7 groups, using microhardness with allocation criteria. The crowns were submitted to the fruit juice plus soy during 15 days, twice a day. The pH values, acid titration, and Knoop microhardness were recorded and the specimens were evaluated using X-ray microfluorescence (µXRF).

RESULTS

The pH average for all juices and after 3 days was significantly below the critical value for dental erosion. In average, the pH value decreases 14% comparing initial time and pH after 3 days. Comparing before and after, there was a 49% microhardness decrease measured in groups (p < 0.05). Groups G1, G2, G5, and G6 are above this average. The analysis by μXRF showed a decrease of approximately 7% Ca and 4% P on bovine crowns surface. Florida (FL) statistical analysis showed a statistically significant 1 difference between groups. Thus, a tooth chance to suffer demineralization due to industrialized fruit juices plus soy is real.

Dental erosion in French adolescents

Background

Since the 2000s, different epidemiological studies focusing on the prevalence or the aetiology of DE in adolescents recognised them as an at-risk population due to their eating behaviours. None was carried out in French adolescents.

The primary objective of this study was to assess the prevalence of dental erosion (DE) using the total BEWE score among adolescents in the department of Alpes Maritimes, France. The secondary objectives were to observe changes in prevalence estimates depending on both the cutoffvalue of total BEWE score with different teeth/dental surfaces examined, and to identify the related risk factors.

Methods

A cross-sectional study in a multistage random sample of 339 14-yr-old schoolchildren was carried out in 2014. The children completed a self-administered questionnaire concerning diet and oral habits. Caries was assessed with ICDAS-II (International Caries Detection and Assessment System-II) criteria and erosion with BEWE (Basic Erosive Wear Examination) index. The total BEWE score was calculated to assess the DE prevalence with two cutoff values (3 and 1). Data were analysed using descriptive statistics and logistic regression models.

Results

The 331 children were aged 14.4 ± 0.5 years. The DE prevalence was 39 % using a total BEWE score ≥ 3. With a cutoff total BEWE score of 1 (at least one affected tooth), the prevalence varied from 3.9 to 56.8 % depending on the teeth/surfaces that were used for the analysis. The DE prevalence, assessed with only first molars and maxillary incisors, was about 54 %. The risk factors for DE (total BEWE score ≥ 3) were daily consumption of acidic beverages (OR: 4.0; 95 % CI: 2.1–7.6) and acidic sweets (OR: 3.2; 95 % CI: 1.2–8.0), low socio economic category (OR: 2.4; 95 % CI: 1.1–5.0) and visible dental biofilm (OR: 2.0; 95 % CI: 1.2–3.4).

Conclusion

Depending on the method chosen, the prevalence varied from 3.9 to 56.8 % among these adolescents. Thus, a consensus on choice of index, teeth to examine and age at assessment is necessary to standardise measurement of DE prevalence.

Assessment of Tooth Wear Among Glass Factory Workers: WHO 2013 Oral Health Survey

BACKGROUND

Glass factory workers are often exposed to the hazardous environment that leads to deleterious oral health and subsequently, general health. We planned to determine the effects of the particulates present in the milieu on the tooth wear among workers.

AIM

To assess tooth wear among glass factory workers in Jaipur, Rajasthan, India.

SETTINGS AND DESIGN

A descriptive cross-sectional survey was conducted among 936 glass workers in Jaipur, Rajasthan, India from January-June 2014.

MATERIALS AND METHODS

A survey proforma was designed for tooth wear evaluation with the help of WHO Oral Health Assessment form 2013 (for adults). Information regarding oral health practices, adverse habits and dietary habits, demographic details was gathered and clinical parameters were recorded.

STATISTICAL ANALYSIS

The Chi-square test, t-test, One-way Analysis of Variance and a Stepwise multiple linear regression analysis.

RESULTS

The most prevalent form of erosion was enamel erosion (589, 62.93%) with few subjects of deeper dentinal erosion and the difference was statistically significant (p=0.001). Dental erosion was found to be higher among males compared to females. Years of experience and educational status were identified as best predictors for dental erosion.

CONCLUSION

It was concluded that there was considerable evidence of dental erosion found among the factory workers. Due to ignorance on social, cultural and health aspects, professional approach with regular dental care services for detection of early symptoms and planning of preventive strategies is warranted.

Estimated prevalence of erosive tooth wear in permanent teeth of children and adolescents: an epidemiological systematic review and meta-regression analysis

OBJECTIVES

The main purpose of this systematic review was to estimate the prevalence of dental erosion in permanent teeth of children and adolescents.

METHODS

An electronic search was performed up to and including March 2014. Eligibility criteria included population-based studies in permanent teeth of children and adolescents aged 8-19-year-old reporting the prevalence or data that allowed the calculation of prevalence rates of tooth erosion. Data collection assessed information regarding geographic location, type of index used for clinical examination, sample size, year of publication, age, examined teeth and tissue exposure. The estimated prevalence of erosive wear was determined, followed by a meta-regression analysis.

RESULTS

Twenty-two papers were included in the systematic review. The overall estimated prevalence of tooth erosion was 30.4% (95%IC 23.8-37.0). In the multivariate meta-regression model use of the Tooth Wear Index for clinical examination, studies with sample smaller than 1000 subjects and those conducted in the Middle East and Africa remained associated with higher dental erosion prevalence rates.

CONCLUSIONS

Our results demonstrated that the estimated prevalence of erosive wear in permanent teeth of children and adolescents is 30.4% with high heterogeneity between studies. Additionally, the correct choice of a clinical index for dental erosion detection and the geographic location play an important role for the large variability of erosive tooth wear in permanent teeth of children and adolescents.

CLINICAL SIGNIFICANCE

The prevalence of tooth erosion observed in permanent teeth of children and adolescents was considerable high. Our results demonstrated that prevalence rate of erosive wear was influenced by methodological and diagnosis factors. When tooth erosion is assessed, the clinical index should be considered.