Erosive tooth wear status of institutionalized alcoholic patients under rehabilitation therapy in the north of Portugal

Abstract

The objective of the study was to determine the erosive tooth wear (ETW) status of institutionalized patients for alcohol misuse rehabilitation therapy in the north of Portugal. Descriptive, analytical, and cross-sectional study, conducted on 277 individuals (83.4% men) with an average age of 43.6±8.4years, institutionalized at Instituto da Droga e Toxicodependência-Delegação Regional Norte (IDT-Norte). ETW prevalence and severity were assessed by Eccles and Jenkins index. Multivariate logistic regression was used to identify ETW risk factors. Subjects with ETW risk identification according to biological and behavioral exposure were determined in the study. ETW prevalence was 98.6%. In the cohort, 51.3% showed localized ETW lesions, 40.1% generalized ETW lesions, and 7.2% enamel ETW lesions, more frequently localized in maxilla. From the examined dental surfaces (n=15,598), 11,493 had erosive wear lesions: 92.4% (95% CI 91.7-93.1%) of all occlusal surfaces, 71.9% (95% CI 70.7-73.1%) of all palatal/lingual, and 56.7% (95% CI 55.4-58.1%) of all buccal surfaces. Buccal and lingual surfaces showed 43.2 and 41.8% enamel erosive wear lesions; occlusal surfaces had 43.4% localized erosive wear lesions in dentin. The main ETW risk factors were as follows: age, gastroesophageal reflux disease over 1year, daily intake of alcohol ≥240g (grams), and intra-oral location in anterior region; 46.2% of the participants had erosive risk by exposure to biological and behavioral factors. The ETW status showed high values for disease prevalence and severity, mainly located in the maxilla, and high frequency of erosive wear lesions at occlusal, buccal, and lingual surfaces, resulting from simultaneous exposure to several risk factors. For ETW differential diagnosis, the association of both clinical and biological/nutritional/behavioral risk factors should be done for each studied population.