A survey on the prevalence and risk indicators of erosive tooth wear among adolescents in Guangzhou, South China

Abstract

The term "tooth wear" (TW) is used to describe the loss of dental hard tissues (Viz. enamel and dentine) caused by friction between occlusal surfaces and food during masticatory or non-masticatory processes; between the occlusal surfaces of opposing teeth, with no involvement of dental caries or trauma; or by demineralisation through the action of nonbacterial extrinsic or intrinsic acids. 1 TW can be divided into the subtypes mechanical wear(attrition and abrasion) and chemical wear(erosion, erosive tooth wear, ETW). 2 The aetiology of TW is multifactorial. 3 Dietary factors, acidic medications, oral health behaviours and associated systematic diseases can causeSummary Background: Erosive tooth wear (ETW) has become a crucial oral health problem over the decades in China.Objectives: To explore the prevalence and risk indicators of ETW among adolescents in Guangzhou, south China. Methods:A cross-sectional survey of 720 participants was conducted in Guangzhou, using an equal-sized, stratified, multistage random sampling approach. The participants were from two different age groups (12-and 15-year-olds), 360 per group. The ratio of males to females was 1:1 in each group. ETW was recorded utilising the basic erosive wear examination (BEWE) index as the dependent variable. Independent variables included age, gender, region, socioeconomic status, dietary factors, oral health measures and others. Results:The prevalence rates (weighted) of ETW and dentin exposure (DE) were 56.1% and 26.2% among adolescents in Guangzhou, with mean teeth (weighted) of 1.8 ± 2.5 and 0.6 ± 1.5, respectively. No matter the prevalence or the mean teeth, the 15-year-olds were higher than the 12-year-olds; the mean teeth of ETW of males was higher than that of females; the mean teeth of ETW and DE of the adolescents of low socioeconomic status were higher than those of high socioeconomic status.Medium to high risk levels were found for 10.1%. In the multiple regression model, age, gender and taking acidic foods/drinks before sleep were associated with ETW. Conclusions:Moderate ETW in the permanent dentition was common among adolescents in Guangzhou. However, the teeth involved were low. Dietary factors and demographics were the main risk indicators. K E Y W O R D Sadolescent, cross-sectional survey, erosive tooth wear, oral epidemiology, risk indicator

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

“…Either self‐administered questionnaires (n = 46) or structured interviews (n = 5) were used to analyse dietary patterns and habits, with one study utilising a single application 24‐hour food recall 33 . Of these, questionnaires were validated for adolescents in only 11 studies, 28,34‐43 whereas the types of food/beverages evaluated were validated in five studies 44‐48 . Ten studies validated for both 49‐58 .…”

“…No significant associations were identified between DE incidence and timing of dietary acid intake at bedtime, before or after brushing 78 . Five cross‐sectional studies found a directly proportional relationship between the consumption of acidic drinks or foods at bedtime and DE 45,52,53,59,62 . One of these identified lemon juice, carbonated drinks, lemon, and sour candy to be the most harmful 53 …”

“…33 Of these, questionnaires were validated for adolescents in only 11 studies, 28,[34][35][36][37][38][39][40][41][42][43] whereas the types of food/ beverages evaluated were validated in five studies. [44][45][46][47][48] Ten studies validated for both. [49][50][51][52][53][54][55][56][57][58] Bivariate or multivariate analysis was conducted in all studies to determine statistical significance.…”

“…78 Five cross-sectional studies found a directly proportional relationship between the consumption of acidic drinks or foods at bedtime and DE. 45,52,53,59,62 One of these identified lemon juice, carbonated drinks, lemon, and sour candy to be the most harmful. 53 In summary, apart from carbonated beverages, no other beverages, food, or dietary habits have shown an overwhelming conclusive or significant association with DE.…”

Different Risk Factors for Erosive Tooth Wear in Rural and Urban Nepal: A National Study

“…According to a recent meta-analysis, the current world-wide prevalence of ETW among children and adolescents is 30% and it has been suggested to be increasing [3,4]. Research on the topic in Asian countries is inconclusive [2], and the prevalence figures vary between low and moderate [5][6][7]. Even though ETW has also gained interest recently in Asian countries, to our knowledge, no studies concerning ETW among Nepalese children and adolescents has been done.…”