Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists

Non-carious cervical lesions (NCCLs) and associated factors: A multilevel analysis in a cohort study in southern Brazil

AIM

To investigate the prevalence of non-carious cervical lesions (NCCLs) and their association with individual and tooth-related factors in adults from the 1982 Pelotas Birth Cohort.

MATERIALS AND METHODS

Participants were interviewed and clinically examined at the age of 31. NCCL was defined as loss of dental tissue without bacterial involvement in the cervical region. Independent variables were the socioeconomic, demographic, behavioural, and clinical characteristics. Associations were tested using a multilevel Poisson regression model.

RESULTS

Five-hundred and thirty-nine participants were clinically examined, with a 26% prevalence of NCCLs, which were more prevalent in the maxilla (56.5%) and in premolars (72.9%). In the multilevel analysis, women presented lower prevalence than men [prevalence ratio (PR) 0.59 (0.48-0.73)]; those who reported smoking at both 22 and 30 years of age had more NCCLs than those who never smoked [PR 1.65 (1.31-2.07)]; and high-frequency brushers presented higher prevalence than low-frequency brushers [PR 1.26 (1.03-1.55)]. Gingival recession increased 10 times the prevalence of NCCLs [PR 10.03 (8.15-12.35)], while the presence of periodontal pockets (≥4 mm) reduced the prevalence of NCCLs [PR 0.43 (0.28-0.66)].

CONCLUSIONS

NCCLs were more prevalent in males, smokers, and those with higher frequency of toothbrushing. While the presence of periodontal pockets was associated with a lower prevalence of NCCLs, gingival recession was a strong clinical indicator for the presence of NCCLs.

Two-year randomized clinical trial of different restorative techniques in non-carious cervical lesions and MMP activity in gingival crevicular fluid

OBJECTIVES

To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid.

MATERIALS AND METHODS

Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2 years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used.

RESULTS

No differences in clinical performance were found among groups. Group I had lower retention at 2 years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2 years. MMP-2 decreased after 1 year, and its activity increased back to the initial level after 2 years, mainly for groups I, II, and III. MMP-9 increased after 1 year, and it was reduced to the initial level after 2 years, mainly for group I.

CONCLUSIONS

All restorative techniques performed similarly in NCCLs after 2 years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2 years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2 years of clinical functioning and have similar effects on MMPs present in crevicular fluid.

Prevalence and severity of non-carious cervical lesions and dentin hypersensitivity: association with oral-health related quality of life among Brazilian adults

Objectives

To assess the association between dentin hypersensitivity (DH) (with or without non-carious cervical lesions (NCCL)) and physical and psychosocial oral health impact.

Methods

A cross-sectional population-based study with one-stage random sample of adults living in a Brazilian municipally was conducted between 2018 and 2019. Interviews and oral examinations were performed by calibrated examiners (Kappa ≥0.7). The participant was considered as having physical and psychosocial impact if at least one item of the Oral Health Impact Profile (OHIP-14) was experienced fairly often or very often. NCCL was assessed by the Tooth Wear Index (codes 2 to 4) and DH was evaluated by a tactile test with a probe in the cervical area of teeth. The combination of these clinical variables resulted in categories of the independent variable: without DH or NCCL, NCCL without DH, DH without NCCL, and both DH with NCCL. The covariables were sociodemographic and economic factors, health habits, and oral conditions. Associations were investigated by Poisson Regression models using Direct Acyclic Graph (Stata 17).

Results

Of 197 adults, 59.3% had oral health impact and 31.3% had DH with NCCL. Higher frequency of oral health impact was observed in adults with DH alone. A higher impact on the physical pain dimension of the OHIP-14 was observed in adults with DH and NCCL (PR: 2.46; 95% CI: 1.21–5.00) and with DH alone (PR: 2.03; 95% CI: 1.21–3.41).

Conclusion

NCCL and DH are common conditions in adults and the presence of DH is associated with higher oral health impact. Regardless the presence of NCCL, DH is associated with the physical pain dimension of OHRQoL.

Factors Associated with Noncarious Cervical Lesions in Different Age Ranges: A Cross-sectional Study

OBJECTIVES

 Understanding the possible risk factors of noncarious cervical lesion (NCCL) is important for prevention and clinical management of the condition. The aim of this study was to investigate the factors associated with the prevalence of NCCL among adolescents, adults, and elderly people.

MATERIALS AND METHODS

 A cross-sectional study involving 501 participants aged 15 years or older was conducted. Participants were examined to assess the number of natural teeth and the prevalence and severity of NCCL by calibrated examiners. Data on age, gender, harmful toothbrushing habits, and acidogenic diet were collected through individual interviews. Multivariate Poisson's regression models were used to evaluate the association between the independent variables and the prevalence of NCCL according to the three age groups: 15 to 39, 40 to 64, and 65 years or older. RESULTS : The prevalence of NCCL among participants was 62.5% (95% confidence interval: 58.2-66.7). Among 15- to 39-year-old participants, the mean of NCCL was higher in males, those with lower number of teeth and acidogenic diet intake. Males aged 40 to 64 years and those with harmful brushing habits were more likely to present higher mean of NCCL. Elderly people with harmful toothbrushing habits had a greater mean of NCCL.

CONCLUSION

 Demographic (age and gender), clinical (number of teeth), and behavioral characteristics (harmful brushing habits and acidogenic diet) were meaningful factors associated with NCCL severity. The above-mentioned relationships varied between age groups.

Examining relationship between occupational acid exposure and oral health in workplace

Background

Acid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health.

Methods

From 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health.

Results

The results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03–5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN.

Conclusion

Our study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Epidemiological investigation of non-carious cervical lesions and possible etiological factors

Background

Epidemiological studies of non-carious cervical lesions (NCCLs) are being conducted in all geographical regions, which is completely justified, considering the high frequency of these lesions and possible consequences. Data obtained from such studies are of great importance because, beside describing the extent and degree of lesions, they can also point to specific etiological factors. The purpose of this study was to analyze the frequency and distribution of NCCLs among the patients of Faculty of Dentistry in Pancevo, Serbia, and to investigate the impact of certain etiological factors on the frequency of NCCLs.

Material and Methods

The study included 394 patients, who were clinically examined for the presence of NCCLs and interviewed about potential etiological factors using specially designed questionnaire. Saliva samples were analyzed for 30 patients with multiple NCCLs (≥3) and 30 patients without signs of cervical lesions and restorations. Subject – level logistic regression was used to analyze the association of potential etiological factors and presence of NCCLs and Wilcoxon test for the quantity and quality of saliva.

Results

NCCLs were diagnosed at 68.5% from total number of respondents, 15% from all present teeth were affected. The highest prevalence was recorded on premolars. Presence of lesions significantly increased with age. Frequent consumption of citrus fruit was associated with the presence of NCCLs. Significantly lower frequency of NCCLs was recorded among subjects who frequently chew gums. Significantly lower pH values of unstimulated and stimulated saliva were recorded in the group of patients with multiple NCCLs compared to control group.

Conclusions

This study showed high frequency of NCCLs among subjects of different age. Premolars were the most frequently affected. Age, frequent consumption of citrus fruit and lower salivary pH value were associated with an increased occurrence of NCCLs. Chewing gums habit was associated with an decreased occurrence of NCCLs.

Key words:NCCL, abrasion, erosion, abfraction, saliva.