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

Abstract

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.

School Food Policies Related to Soft Drink and Fruit Juice Consumption as a Function of Education Type in Flanders, Belgium

“…Our previous findings suggested the existence of a possible link between school type, consumption of soft drinks and prevalence of ETW in Belgium [11]. The need to clarify this correlation motivated the present study, which is the first in its kind investigating the SFP related to acidic beverage consumption.…”

“…A previous study of ETW in Belgium showed that type of education (vocational/technical) was a predictive variable for ETW risk in adolescents (odds ratio (OR): 1.49; 95% CI: 1.03–2.13). A higher prevalence of ETW was shown in students registered to vocational/technical schools (VSE) where a significantly higher intake of acidic beverages occurred and a lower socioeconomic status (SES) was present [11]. This link between education type, SES, and level of soft drink consumption was similarly shown in Norway by Mulic et al 2012 [13].…”

“…The process involves an accelerated loss of dental hard tissue that, if not prevented, could cause significant oral health problems affecting the durability of the dentition [8]. The frequent consumption of acidic beverages has been associated several times with ETW risk [9,10], and evidence indicates that the consumption of more than one can of drink/day should be considered to be a risk indicator for the presence of ETW [11,12]. Representatives of schools and parents must be aware of the potential erosive effect that acidic beverages have on their children’s dentition in order to restrict access to them in the school environment.…”

“…In 2010, 42% of Flemish adolescents reported drinking soft drinks daily [16]. Belgium has one of the highest per capita consumption of acidic beverages (number four in Europe with >120 L/capita/year) [17], and there is an apparent influence of school regulations on adolescents’ dietary decisions [11,14]. Therefore, the present study aimed to investigate the current SFP related to acidic beverages present in schools and to identify possible SFP differences between two lines of education: vocational/technical (VSE) and general secondary education (GSE).…”

Diagnosis, risk assessment, and treatment decisions for tooth wear in daily practice: a case presentation survey among Belgian dentists

“…These findings are in accordance with those by Kanzow et al [13], who reported that dentists who followed continuous education courses dealing with erosive tooth wear were able to detect lesions in enamel more frequently than dentists who had not participated in any course. In the context of the Belgian practicing dentists, the early diagnosis of erosive tooth wear is of relevance due to its high prevalence in adolescents [27]. Conversely, distinct defects of erosive tooth wear were easily detected by most of the dentists, as observed by Kanzow et al [13].…”