Dental erosion in French adolescents

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.

Malocclusions and oral dysfunctions: A comprehensive epidemiological study on 359 schoolchildren in France

OBJECTIVES

The purpose was to conduct a comprehensive study of malocclusions and oral dysfunctions on 11-year-old children and to study the risk factors associated with malocclusions.

MATERIAL AND METHODS

A cross-sectional descriptive epidemiological survey was conducted among 359 children in France. A clinical examination was conducted, and orthodontic and oral functional data were collected. In addition, the need for orthodontic treatment was evaluated using the criteria defined by of the French National Authority for Health (HAS). Finally, a univariate and multivariate analysis was performed to assess the risks associated with malocclusions.

RESULTS

Most children (88%) exhibited a malocclusion, regardless of gender (p = .912). The examination of oral functions identified a large number of swallowing (87%) and respiration (42.7%) disorders. The presence of malocclusion was statistically linked to the low position of the tongue at rest (p < .001), abnormal swallowing (p = .03), and improper mouth breathing (p = .001). After a multivariate analysis, the type of respiration (odds ratio [OR] = 3.2 [1.4-7.3]) and the position of tongue at rest (OR = 3.43 [1.7-7.1]) were the two most prominent factors in the prediction of emerging malocclusion.

CONCLUSION

This epidemiological survey reveals a high prevalence of dental malocclusions and functional disorders. Oral respiration and the low position of the tongue at rest are the most important factors in the prediction of a malocclusion.

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.

Knowledge on and treatment practices of erosive tooth wear among Finnish dentists

OBJECTIVES

To investigate Finnish dentists' knowledge on and means of recording, detecting and diagnosing erosive tooth wear (ETW). Treatment options and possible differences in treatment decisions between general and specialized dentists were also evaluated.

MATERIALS AND METHODS

An electronic questionnaire was sent by e-mail to 3664 Finnish dentists. Respondents' gender, age, work experience, field of specialty, and practice location were requested. The questionnaire also included a patient case where the dentists were asked about their choice of treatment. Statistical analyses were performed using means, proportions, and cross tabulations.

RESULTS

Response rate was 24% (n = 866). Almost all respondents (98.0%) recorded ETW in patient files, but only 4.1% used a detailed scoring system. Of the respondents, 64.4% usually found the cause of ETW. Use of carbonated beverages (84.3%), energy drinks (57.0%), and reflux disease (53.1%) were reported to be probable causes. The majority of the respondents (80.9%) usually assessed patient's dietary history while 1.9% evaluated saliva secretion rate. When asked about treatment decisions of ETW patients, the differences between general dentists and specialized dentists were not as obvious as hypothesized.

CONCLUSIONS

This study suggests that the Finnish dentists who participated in this survey are able to detect and/or diagnose erosive tooth wear, but there is variation in recording it. The differences in treatment decisions between general dentists and specialized dentists seem to be moderate. The treatment practices for ETW are not established and further research to create clinical guidelines seems to be needed.

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.

Fracture load of CAD/CAM ultrathin occlusal veneers luted to enamel or dentin

OBJECTIVES

To evaluate, in vitro, the fracture load of IPS e.max CAD occlusal veneers at thicknesses of either 0.3 or 0.6 mm luted to enamel or dentin.

MATERIALS AND METHODS

Fifty human molars were randomly distributed into five groups (n = 10): G1 - healthy teeth (control); G2-0.3-mm-thick veneers luted to enamel; G3-0.6-mm-thick veneers luted to enamel; G4-0.3-mm-thick veneers luted to dentin; and G5-0.6-mm-thick veneers luted to dentin. After the luting procedures, the specimens were immersed in distilled water at 37°C for 24 hours and then subjected to mechanical loading (10⁶  cycles at 200 N load). The specimens were subjected to a fracture load test in a universal testing machine. Two-way ANOVA and Tukey's test (α = 0.05) were used to analyze data.

RESULTS

Only the thickness factor was significant (P = .002). Values of fracture load followed by distinct letters represent significant differences (P < .05): G1 (3204 N ± 730)^ab ; G2 (3144 N ± 729)^ab ; G3 (2489 N ± 606)^b ; G4 (3591 N ± 776)^a ; and G5 (2770 N ± 598)^ab .

CONCLUSION

IPS e.max ultrathin occlusal veneers luted to enamel or dentin obtained fracture load comparable to that of the healthy tooth.

CLINICAL SIGNIFICANCE

IPS e.max CAD ultrathin occlusal veneers at 0.3 or 0.6-mm-thick seem to provide good perspectives in relation to the clinical use.

Erosive tooth wear and use of psychoactive substances among Finnish prisoners

BACKGROUND

The aim of the study was to evaluate the prevalence and severity of erosive tooth wear (ETW) and its association with dental caries and the use of psychoactive substances among Finnish prisoners.

METHODS

One hundred voluntary prisoners (90.9%) from the Pelso Prison participated in this cross-sectional clinical study between September 2014 and February 2015. Fifty prisoners were also interviewed using the one-on-one interviewing technique for their background factors and use of psychoactive substances. Basic Erosive Index (BEWE) (0-18) was used to measure erosive tooth wear. Decayed (D), missing (M), filled (F) and the number of remaining teeth (T) and DMFT were reported. The association between the different variables was tested and analysed by using cross tabulation. To test the association between the variables a logistic regression analysis was conducted.

RESULTS

Almost all (90%) of the subjects had need for preventive and operative treatment for ETW. In addition, one in five (19%) suffered from severe erosive tooth wear. The use of psychoactive substances and pharmaceuticals is common, yet no association with ETW was found. Smoking and alcohol consumption were more common among younger prisoners than the older ones. There is an increased risk for ETW among older prisoners and major alcohol consumers. Past caries experience was associated with dental erosion.

CONCLUSIONS

Erosive tooth wear is common among Finnish prisoners in their thirties. ETW is associated with dental caries and daily alcohol consumption.

Erosive tooth Wear in special Olympic athletes with intellectual disabilities

Background

Special Olympics (SO) events represent an opportunity to obtain considerable information regarding intellectual disable (ID) patients. Studies done with SO data have shown an overview of the oral health status of these athletes; however, no information exists regarding the erosive tooth wear (ETW). Therefore, the aim of this study is to determine the presence and severity of ETW in athletes with ID who participated in the SO Belgium 2016.

Methods

The study population consisted in 232 athletes with ID who participated in the SO special smiles program, Belgium 2016. For analysis, the sample was divided in three groups: a) athletes with ID under the age of 25 not diagnosed with Down Syndrome (DS) (n = 174), b) athletes with DS under the age of 25 (n = 39) and c) athletes with DS from 25 and older ages (n = 58). Two calibrated dentists performed dental examinations using the Basic Erosive Wear Examination Index (BEWE). The BEWE sum > 0 was used to determine prevalence of ETW. Severity was determined by two- indicators: 1) By risk levels (low, medium and high risk) proposed by the BEWE index, and 2) by the highest score reached per subject in at least one tooth (BEWE1, 2 or 3). Chi-square test and Mann-Whitney U test were used to detect significant differences among different groups (p < 0.05).

Results

The prevalence of ETW for young athletes with ID was 51.14%. Within these athletes, the DS group presented a significant higher mean BEWE sum (4.67, SD 5.64) and prevalence of ETW (69.2%BEWE> 0) when compared to athletes without DS (mean BEWE sum: 1.96, SD 3.47 and 46.3% BEWE> 0; p < 0.05). Furthermore, a significantly higher percentage of athletes with DS were considered at high risk of ETW (p < 0.05).

Conclusions

As a conclusion, half of the young athletes with ID presented at least one affected surface with ETW. The recorded prevalence and severity of ETW for the younger group of athletes with DS was distinctly higher than the athletes with ID not having DS. This shows the need to generate knowledge in order to provide correct management and prevention of erosive tooth wear in populations with ID.

Caries reporting in studies that used the International Caries Detection and Assessment System: A scoping review

OBJECTIVE

To explore how caries was reported in studies that employed the International Caries Detection and Assessment System (ICDAS).

METHODS

A systematic database search up to August 2017 was carried out using PubMed, Ovid MEDLINE, Cochrane library and ISI Web of Science electronic databases. Only studies that used the ICDAS for dental caries examinations were included. Studies were excluded if the examination was done only for the validation or the calibration of the ICDAS and/or if the examination was not done for the whole dentition. Measures used to report caries were considered.

RESULTS

A total of 126 papers met the inclusion criteria. Forty-four different synthesis measures were used to report caries. Most of the studies used a combination of multiple measures to report patient's caries level. These reporting measures cluster into four main groups: the number of individual ICDAS scores (ie, total counts of every score); the number of decayed surfaces/teeth (ie, total counts of combined caries scores for surfaces or teeth); measures of caries experience (ie, total counts of combined caries scores, filled and/or missing surfaces or teeth); and measures of central tendency and dispersion. The number of decayed surfaces and individual ICDAS scores were the most commonly used measures. Three studies used mean ICDAS score (ie, total ICDAS scores divided by the number of teeth), two used mean ICDAS score of carious teeth (ie, total ICDAS scores divided by the number of carious teeth) and two used the maximum ICDAS score (ie, highest ICDAS score recorded). The total ICDAS score was used only once. Many studies synthesized from the ICDAS the number of decayed, missing and filled teeth/surfaces (dmft/DMFT, dmfs/DMFS) as a measure of caries experience.

CONCLUSIONS

There are variations among studies in the utilization of the system to summarize caries. Most studies presented caries data using the categorical characteristics of the ICDAS.

Prevalência de erosão dentária e fatores associados em uma população de escolares

Resumo Introdução Erosão dentária é a perda irreversível de tecido dentário, sem envolvimento bacteriano, cujo aumento de prevalência, nos últimos anos, tem sido alarmante. Objetivo Determinar a prevalência de erosão dentária, bem como fatores associados, em escolares de 06 a 13 anos, na cidade de Campina Grande, Paraíba. Material e método A seleção das escolas foi realizada por amostragem casual simples sem reposição. Após assinatura do Termo de Consentimento Livre e Esclarecido, e do Termo de Assentimento, os exames foram realizados por um examinador previamente calibrado, com a criança sentada em uma cadeira escolar, em frente ao examinador, sob luz natural. Para a determinação da presença e do grau de erosão dentária, foi utilizado o índice de BEWE. Os dados foram analisados por meio do software Statistical Package for the Social Sciences (SPSS para Windows, versão 18.0, SPSS Inc, Chicago, IL, EUA) e adotou-se nível de significância de 5%. Resultado A prevalência de erosão dentária na população avaliada foi de 78,2%. Não foi possível associar a presença das lesões com os fatores socioeconômicos e dietéticos. Apenas a variável Aplicação Tópica de Flúor (ATF) apresentou relação estatisticamente significativa (p=0,012). Conclusão A alta prevalência de erosão dentária na população avaliada demonstra a necessidade da implementação de medidas assistenciais e preventivas, em curto e longo prazo.

Monitoring the progression of erosive tooth wear (ETW) using BEWE index in casts and their 3D images: A retrospective longitudinal study

OBJECTIVE

To determine if the Basic erosive tooth wear index (BEWE index) is able to assess and monitor ETW changes in two consecutive cast models, and detect methodological differences when using the corresponding 3D image replicas.

METHODS

A total of 480 pre-treatment and 2-year post-treatment orthodontic models (n = 240 cast models and n = 240 3D image replicas) from 120 adolescents treated between 2002 and 2013 at the Gent Dental Clinic, Belgium, were scored using the BEWE index. For data analysis only posterior sextants were considered, and inter-method differences were evaluated using Wilcoxon Signed Rank test, Kappa values and Mc Nemar tests (p < 0.05). Correlations between methods were determined using Kendall tau correlation test.

RESULTS

Significant changes of ETW were detected between two consecutive models when BEWE index was used to score cast models or their 3D image replicas (p < 0.001). A strong significant correlation (τb: 0.74; p < 0.001) was shown between both methods However, 3D image-BEWE index combination showed a higher probability for detecting initial surface changes, and scored significantly higher than casts (p < 0.001). Incidence and progression of ETW using 3D images was 13.3% (n = 16) and 60.9% (n = 56) respectively, with two subjects developing BEWE = 3 in at least one tooth surface.

CONCLUSIONS

BEWE index is a suitable tool for the scoring of ETW lesions in 3D images and cast. The combination of both digital 3D records and index, can be used for the monitoring of ETW in a longitudinal approach. The higher sensibility of BEWE index when scoring 3D images might improve the early diagnosis of ETW lesions.

CLINICAL SIGNIFICANCE

The BEWE index combined with digital 3D records of oral conditions might improve the practitioner performance with respect to early diagnosis, monitoring and managing ETW.

Dental erosion, prevalence and risk factors among a group of adolescents in Stockholm County

Aims

To investigate the prevalence and risk factors of dental erosion (DE) among a group of adolescents in Stockholm County.

Materials and methods

This cross sectional cohort study was conducted at three clinics of the Public Dental Service in Stockholm County. Fifteen and 17 year old adolescents (1335) who scheduled their regular dental health examination were asked to participate. After drop-outs a sample of 1071 individuals, 547 males and 524 females were enrolled in the study. Presence of erosive wear was diagnosed (yes/no) on marker teeth by trained dentists/dental hygienists and photographs were taken. The adolescents answered a questionnaire regarding oral symptoms, dietary and behavioural factors. Two calibrated specialist dentists performed evaluation of the photographs for severity of DE using a modified version of the Simplified Erosion Partial Recording System (SEPRS).

Results

DE was clinically diagnosed in 28.3% of 15 years old and 34.3% of 17 years old. Severe erosive wear (grade 3 and 4 according to SEPRS) was found in 18.3% of the adolescents based upon the intra-oral photographs. DE was more prevalent and severe among males than females. Clinically diagnosed erosive lesions correlated significantly with soft drink consumption (p < 0.001), the use of juice or sport drinks as a thirst quencher after exercise (p = 0.006) and tooth hypersensitivity when eating and drinking (p = 0.012). Furthermore, self-assessed gastric reflux was a factor strongly associated with DE (p < 0.001).

Conclusion

The study indicated that DE was common among adolescents in Stockholm County and associated with both internal and external risk factors.

The Influence of Behavioural and Sociodemographic Risk Indicators on Erosive Tooth Wear in Flemish Adolescents, Belgium

Although Belgium has recently been ranked as the second highest consumer of soft drinks in Europe, no data on erosive tooth wear (ETW) are currently available. Therefore, the aim of this cross-sectional study was to determine the prevalence and associated risk indicators of ETW in adolescents residing in the region of Flanders, Belgium. Convenience sampling was used to recruit participants from different types of Belgian schools: general and vocational/technical education. Three calibrated dentists performed the dental examinations and a self-reported questionnaire was applied to evaluate risk indicators related with ETW. ETW was classified using the Basic Erosive Wear Examination (BEWE) index, and the overall prevalence was calculated using BEWE sum >0. The Kruskal-Wallis test, the Mann-Whitney U test, and logistic regression analysis were performed to evaluate frequencies and risk associations. From a total of 613 recruited adolescents (mean age: 15.1 years, SD: 0.8), 48.6% presented at least one affected tooth surface by ETW (BEWE sum >0), 14.4% (n = 88) scored BEWE sum >2, and the highest score obtained was BEWE sum = 8. Two predictive variables were found to have an association with ETW: vocational/technical type of education (OR: 1.49; 95% CI: 1.03-2.13) and frequent consumption of soft drinks (OR: 2.08; 95% CI: 1.38-3.14). In conclusion, ETW is a common condition presented with low severity among Flemish adolescents. Additionally, the frequent consumption of soft drinks and being part of a vocational/technical education appear to be risk indicators for ETW in this population. The latter indicates the need for specific orientated oral health promotion programmes for the prevention of ETW in Flemish adolescents.

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.

Prevalence and Indicators of Tooth Wear among Chinese Adults

Numerous epidemiological studies have focused on the prevalence and related indicators of tooth wear. However, no sufficient studies have been conducted with Chinese adults. The purpose of this study was to assess the prevalence of tooth wear and identify related indicators among adults aged 36 to 74 years in Wuhan City, P.R. China. A cross-sectional and analytic study was conducted with 720 participants, aged 35–49 yrs and 50–74 yrs, in 2014. Each age group included 360 participants, of which 50% were males and 50% were females. All participants completed a questionnaire before examination. Tooth wear was assessed using the modified Basic Erosive Wear Examination (BEWE) index. The data were analyzed using the chi-square test and binary logistic regression analysis. The prevalence of tooth wear was 67.5% and 100% in the 35–49 and 50–74 age groups, respectively. The prevalence of dentin exposure was 64.7% and 98.3%, respectively. A significantly higher prevalence of tooth wear and dentin exposure was found in the 50–74 yr group than in the 35–49 yr group (p < 0.05). Critical indicators of tooth wear and dentin exposure included high frequency of acidic drinks and foods consumption, low socio-economic status, and unilateral chewing. The frequency of changing toothbrushes and the habit of drinking water during meals were associated with tooth wear. In addition, the usage of hard-bristle toothbrushes and consuming vitamin C and aspirin were found to be linked with dentin exposure. In conclusion, the prevalence of tooth wear and dentin exposure observed in Chinese adults was high, and the results revealed an association between tooth wear and socio-behavioral risk indicators.

Association of erosive tooth wear and dental caries in Northern Finland Birth Cohort 1966 - an epidemiological cross-sectional study

BACKGROUND

The main aim of this cross-sectional study was to investigate the prevalence and severity of erosive tooth wear and its association with dental caries and socio-demographic factors among middle-aged Finnish adults.

METHODS

Of the total Northern Finland Birth Cohort 1966 (n = 12,058), a convenience sample (n = 3181 adults) was invited for an oral health examination of which 1962 (61.7 %) participated, comprising the final study group. Clinical examinations were carried out by trained and calibrated dentists. Erosive tooth wear was assessed by sextants using the Basic Erosive Wear Examination Index (BEWE, 0-18) and dental caries at surface level using the ICDAS criteria (0-6). Socio-demographic data were obtained from a postal questionnaire. A logistic regression model was generated to test the association of the variables.

RESULTS

The prevalence of erosive tooth wear was 75 % and the mean of the BEWE sum score was 3.4 (SD 3.30). Almost half of the members needed non-invasive or invasive measures to prevent further progression of the condition. Of those with erosive lesions, 14.6 % suffered from severe erosive tooth wear. There was a strong positive relationship between the presence of severe erosive tooth wear (BEWE sum score ≥9) and male gender and restorative treatment need.

CONCLUSIONS

Erosive tooth wear is a common finding in Finnish adult population; almost one in ten suffer from severe erosive tooth wear. Restorative treatment need seems to be associated with severe erosive tooth wear.

Erosive Tooth Wear and Related Risk Factors in 8- and 14-Year-Old Greek Children

The aim of the present study was to investigate the erosive tooth wear of primary and permanent teeth and its association with related risk factors. Two groups of Greek children aged 8 (n = 329) and 14 years (n = 263) were examined in the classroom using the Basic Erosive Wear Examination (BEWE) index. Data concerning risk factors were collected using questionnaires. Dental caries (DMFS/dmfs) was also recorded. The data were analyzed using the t test, one-way ANOVA, multiple regression analysis, Fisher's exact test, and the χ2 test. In the 8-year-olds, the primary teeth showed a predominantly medium level of wear and the permanent teeth no wear. A majority of the 14-year-olds exhibited low risk levels of wear. The most frequently affected dental surface in both age groups was the occlusal surface of the mandibular posterior teeth. In the 8-year-olds, BEWE scores and the prevalence of wear in the primary teeth was influenced by gender (p = 0.020). In their permanent teeth, soft drink consumption (p < 0.0001) and preference for lemon/vinegar (p = 0.041) significantly affected wear prevalence and BEWE scores, while habitually retaining soft drinks in the mouth influenced wear prevalence (p = 0.008), risk (p = 0.004), and BEWE scores (p = 0.022). In the 14-year-olds, wear prevalence was significantly affected by the consumption of lemon-flavored candies (p = 0.016) and soft drinks (p = 0.050). BEWE scores were significantly affected by gender (p = 0.022) and soft drink consumption (p = 0.030). Gender influenced tooth wear risk in both age groups (p = 0.010 and p = 0.021, respectively). The results of this study indicate that erosive tooth wear differed between primary and permanent teeth and was influenced by gender and dietary factors.