Global Research Trends in Dental Erosive Wear: A Quantitative Perspective of the Last 3 Decades

An epidemiological scoring system for tooth wear and dental erosive wear

This study aimed to investigate the association between dental erosive wear and potential background, behavioural and dietary risk indicators and to assess whether there is a dose-response relationship between the level of acidic beverage consumption and dental erosive wear among adolescents. Of 846 adolescents (aged 16-18 years) scheduled for dental recall examinations, 795 (94%) accepted to participate. All participants completed a self-administered questionnaire regarding their background (gender and age), tooth-brushing frequency and dietary habits (the amount and frequency of acidic food and beverage consumption as well as the chosen method and manner of consuming acidic drinks). The association between the presence of erosive lesions and the possible risk indicators was assessed by logistic regression analyses. Of all participants examined, 37% had ≥3 surfaces with dental erosions and were considered to be affected individuals. In the present study, multivariate logistic analyses revealed a significant association between the dental erosive wear and high consumption of sour sweets and sports drinks. The tooth-brushing frequency was not significantly associated with dental erosive wear. Additionally, to the best of our knowledge, the results are the first to indicate a dose-response relationship between the daily consumption of acidic drinks and dental erosive wear.

Dental erosive wear is a multifactorial condition that is greatly affected by environmental factors. So far, no study has investigated how dental erosive wear is influenced by variations in enamel formation genes. The aim of the present study was to investigate polymorphisms in genes involved in enamel formation and their influence on enamel susceptibility to dental erosion. DNA samples were collected from 795 Norwegian adolescents aged 16-18 years. Five single-nucleotide polymorphism markers were genotyped in selected candidate genes (ameloblastin, amelogenin, enamelin, tuftelin 1 and tuftelin interacting protein 11), reported to influence enamel formation. Allele and genotype frequencies were compared within two patient groups with dental erosions; all participants with dental erosion and only those with severe dental erosion (erosion extending into dentine). Overrepresentation of the G allele of the enamelin marker was seen in the erosion group compared to the unaffected group (p = 0.047). When erosion severity was considered, statistical significant difference in allele frequency was observed for amelogenin, with the C allele suggesting a protective role (p = 0.02). A suggestive overrepresentation of the TT genotype of the amelogenin marker was also seen in cases with severe erosion (p = 0.049) when compared to cases with no dentine erosion. Amelogenin was also associated with severe erosion in the recessive model; the TT genotype was significantly more frequent in the affected group than in the unaffected group (p = 0.01). The present study suggests that polymorphisms in enamel formation genes are statistically associated with an individual's susceptibility to dental erosive wear.

Dental erosive wear is a multifactorial condition of high prevalence. Nowadays, there is an emphasis on discovering individual genetic predisposition for the development of this condition. Aquaporins (AQPs) are water channel proteins expressed in salivary glands, as well as during tooth development. They are involved in salivary secretion and composition and linked to physiological protection of the oral cavity. The aim of this study was to explore the relationship between different dental erosive wear phenotypes, AQP genes, and selected environmental factors. Data from 705 dental patients were used to investigate the association between dental erosive wear phenotypes and AQPs’ single-nucleotide variants. Phenotypes were further analyzed considering diet and oral hygiene data, using logistic regression analysis, as implemented in PLINK, with the assumption that dental erosive wear is a complex gene-environment model. Associations were found between severe erosive tooth wear and rs2878771 (AQP2) for the genotypic (p = 0.02) and dominant (p = 0.03) models, and rs3736309 (AQP5) for the allelic model (p = 0.02). Logistic regression analyses, after implementing the Bonferroni correction, showed that several significant associations were present when covariates were included, suggesting that a strong environmental component is present. Our results show that dental erosive wear establishes under a gene-environmental complex model.

Objective. This study aimed to investigate the prevalence, distribution and severity of erosive wear in a group of 16–18-year-olds in the western part of Norway. A second aim was to describe possible associations between caries experience, socioeconomic background and origin of birth. Materials and methods. Adolescents (n = 795) attending recall examinations at Public Dental Service (PDS) clinics were also examined for dental erosive wear on index surfaces, using the Visual Erosion Dental Examination scoring system (VEDE). Results. In total, 795 individuals were examined. Dental erosive wear was diagnosed in 59% of the population (44% erosive wear in enamel only, 14% combination of enamel and dentine lesions, 1% erosive wear in dentine only). The palatal surfaces of upper central incisors and occlusal surfaces of first lower molars were affected the most (33% and 48% of all surfaces, respectively). Cuppings on molars were registered in 66% of the individuals with erosive wear. Erosive wear was significantly more prevalent among men (63%) than women (55%) (p = 0.018). Conclusions. There were no significant associations between dental erosive wear and caries experience, socioeconomic background or origin of birth.

The aim of the present study was to describe awareness and attitudes related to dental erosive wear among 18-yr-old adolescents in Oslo and to explore attitudinal differences between participants with and without the condition. All 18-yr-old subjects scheduled for their routine examination at the Public Dental Service clinics during 2008 (n = 3,206) were invited, and 1,456 agreed to participate (a response rate of 45%). The data were collected using structured questionnaires and by clinical examination of the participants. Dental erosive wear was assessed using a pictorial manual - the Visual Erosion Dental Examination scoring system - as a guide. Overall, 88% of participants had heard about dental erosive wear; however, of participants with erosive lesions only 56% were aware of, and only 47% could recall their dentist mentioning, the condition. Participants with erosive wear were more likely to have low or moderate positive attitudes towards acidic drink consumption and to be reluctant to change. In multivariate analyses controlling for gender and behavioural variables, weak or moderate positive awareness of acidic drinks remained significantly associated with higher erosion risk. This study emphasizes the importance of assessment and understanding of awareness and attitudinal aspects in relation to dental erosive wear.

BackgroundLittle attention has been directed towards identifying the relationship between physical exercise, dental erosive wear and salivary secretion. The study aimed i) to describe the prevalence and severity of dental erosive wear among a group of physically active young adults, ii) to describe the patterns of dietary consumption and lifestyle among these individuals and iii) to study possible effect of exercise on salivary flow rate.MethodsYoung members (age range 18-32 years) of a fitness-centre were invited to participate in the study. Inclusion criteria were healthy young adults training hard at least twice a week. A non-exercising comparison group was selected from an ongoing study among 18-year-olds. Two hundred and twenty participants accepted an intraoral examination and completed a questionnaire. Seventy of the exercising participants provided saliva samples. The examination was performed at the fitness-centre or at a dental clinic (comparison group), using tested erosive wear system (VEDE). Saliva sampling (unstimulated and stimulated) was performed before and after exercise. Occlusal surfaces of the first molars in both jaws and the labial and palatal surfaces of the upper incisors and canines were selected as index teeth.ResultsDental erosive wear was registered in 64% of the exercising participants, more often in the older age group, and in 20% of the comparison group. Enamel lesions were most observed in the upper central incisors (33%); dentine lesions in lower first molar (27%). One fourth of the participants had erosive wear into dentine, significantly more in males than in females (p = 0.047). More participants with erosive wear had decreased salivary flow during exercise compared with the non-erosion group (p < 0.01). The stimulated salivary flow rate was in the lower rage (≤ 1 ml/min) among more than one third of the participants, and more erosive lesions were registered than in subjects with higher flow rates (p < 0.01).ConclusionThe study showed that a high proportion of physically active young adults have erosive lesions and indicate that hard exercise and decreased stimulated salivary flow rate may be associated with such wear.

Objectives The objectives of the present study were to assess the consumption of acidic beverages, knowledge and concern about preventing dental erosive wear, and to examine potential associations between these variables, in a sample of high school students. Materials and methods A survey measuring acidic beverage consumption, knowledge and concern about erosive tooth wear was conducted at 13 high schools in Rogaland county, Norway. Results Of the 850 students who completed the questionnaire, 26% reported that they drink acidic beverages every day. There were significant gender differences for the consumption of acidic drinks. The survey also demonstrated that a high proportion of students lacks basic knowledge of what erosive tooth wear is, and that this lack of knowledge is associated with a more frequent intake of acidic beverages. However, students who responded that they are concerned about preventing dental erosive wear reported that they drink soft drinks and energy drinks less frequently than students who are not concerned about this. Conclusions Results from this study support assumptions about a lack of knowledge about dental erosive wear in youth, and that this lack of knowledge is associated with a more frequent intake of acidic drinks.

This chapter presents a newly developed dental erosive wear risk assessment tool designed for use by general dental practitioners, dental educators, and dental students. The tool guides the user through the most common risk factors associated with dental erosive wear, and when combined with the Basic Erosive Wear Examination (BEWE) or other similar scoring system, leads to a final decision on patient risk status. An initial screening section helps the dentist to decide whether it is necessary to perform a more comprehensive dental erosive wear risk assessment. When there is clearly a need for further assessment, all dental erosive wear lesions are then recorded using the index of choice, and the dentist decides how the recorded conditions will be documented. The dentist then uses the Dental erosive wear risk assessment (DEWRA) form, where dietary and oral hygiene habits, general health status, and clinical conditions are evaluated using a thorough patient interview. An overall patient risk category is chosen and the section for treatment planning and advice to the patient can then be used. The last part of this chapter provides a brief explanation of the various risk factors that are included in the DEWRA form.

The aim of the study was to evaluate and compare two dental erosive wear scoring systems, the Visual Erosion Dental Examination (VEDE) and Basic Erosive Wear Examination (BEWE). Seventy-four tooth surfaces (photographs) and 562 surfaces (in participants) were scored by 5 (photographs) or 3 (in participants) clinicians using both scoring systems. The surfaces in the photographs were scored twice. The level of agreement was measured by weighted kappa (ĸ_w). Inter- and intraexaminer agreement showed small variations between the examiners for both systems when scoring the photographs. Slightly higher mean ĸ_w values were found for VEDE (ĸ_w = 0.77) compared with BEWE (ĸ_w = 0.69). When scoring the surfaces in the clinical examination the mean ĸ_w values for the two systems were equal (ĸ_w = 0.73). Interexaminer agreement using VEDE was calculated to see how differentiation between enamel and dentine lesions influenced the variability. The highest agreement was found for score 0 (sound, 86%) and score 3 (exposure of dentine, 67%), while the smallest agreement was shown for score 1 (initial loss of enamel, 30%) and score 2 (pronounced loss of enamel, 57%). The reliability of the two scoring systems proved acceptable for scoring the severity of dental erosive wear and for recording such lesions in prevalence studies. The greatest difficulties were found when scoring enamel lesions, especially initial lesions, while good agreement was observed when examining sound surfaces (score 0) and dentine lesions (score 3).

Objective. To assess the prevalence and severity of dental erosive wear among a group of professional wine tasters. Material and methods. Eighteen wine tasters currently employed at AS Vinmonopolet, Norway (3 women, 15 men; mean age 39 years) and 30 comparison participants (9 women, 21 men; mean age 39 years) were included in the study. The wine tasters were examined by four calibrated clinicians using the Visual Erosion Dental Examination system. Data concerning medical and dietary history, oral hygiene habits and occupational background were obtained from a self-completed questionnaire. Data were analyzed using Fisher's exact test, and examiner agreement was determined by means of linear-weighted kappa and the intra-class correlation coefficient. Results. Nine (50%) of the wine tasters and six (20%) of the comparison group showed clinical signs of dental erosion. Among the wine tasters, 39% had dentine involvement, compared to just 7% of the comparison group. The erosive lesions were mainly found on the occlusal surfaces of mandibular first molars in the wine tasters, whereas for the controls, the palatal surfaces of upper centrals were most often affected. Conclusions. There was a significant difference in the prevalence of dental erosive wear between the two groups, the wine tasters having a higher prevalence and more severely affected surfaces than the comparison group. Half of the wine tasters had no erosive wear and, for the other half, there was no relationship between the duration of their professional life and the extent of erosive wear.

To investigate erosive tooth wear and related variables among adolescents and adults in Israel, utilizing the new basic erosive wear examination (BEWE) scoring system, in an attempt to contribute to the ongoing review, evaluation, and further development of an international standardized index. A cross-sectional, descriptive, and analytic survey was conducted among 500 subjects of five age groups. Dental erosion was measured according to the new BEWE scoring system. Independent variables included gender, age, origin, education, employment status, and diet. A backward stepwise linear regression model was applied to identify significantly associated variables. Fifty percent of the survey subjects demonstrated erosive tooth wear; among them, 10 % had distinct erosion of over 50 % of the dental surface. Total BEWE score differences by age groups were statistically significant; as the age increased, the mean total BEWE scores increased (p < 0.001). The association between acidic foods and erosion was evident among the younger population (p = 0.038). In a multiple regression model, age (p < 0.001) and diet (p = 0.044) achieved statistical significance as variables associated with dental erosive wear. Our study is one of the first to use the BEWE scoring system in an epidemiological survey among adolescents and adults. It was found that the BEWE index is straightforward, easy to conduct, and comfortably accepted by the examinees. The present findings, together with further international research, should contribute toward continued evaluation of the BEWE system as an international standard and thereby, toward more optimal understanding, evidence-based treatment, and prevention of dental erosive wear.

This study aims to investigate the relationship between dental erosion and frequency of non-alcoholic beverage intake in normal-weight, overweight, and obese individuals.&#x0D; The study involved 264 subjects aged 18–60 years with normal weight (control group), overweight and obesity. The frequency of non-alcoholic beverage intake has been assessed. The grade of erosive tooth wear has been measured using the BEWE index (Basic Erosive Wear Examination). When comparing the control and overweight groups, a statistically significant difference has been found between the group with no erosive wear, score 0, and the one with initial enamel surface loss, score 1, (χ2 = 18.633, p &lt; 0.05). When comparing the control and obese groups, a significant difference has been found between the groups with score 0 (χ2 = 19.179, p &lt; 0.05), score 2 (χ2 = 0.160, p &lt; 0.05) and score 3 (χ2 = 0.160, p &lt; 0.05), as well as when comparing the subjects in the control group with score 0 by sex (χ2 = 3.360, p &lt; 0.05). The Kruskal–Wallis test has indicated a statistically significant difference among the three studied groups depending on body weight (BMI), (χ2 = 19.036, p &lt; 0.001), as well as on the non-alcoholic beverage consumption in the individuals affected by erosive wear (χ2 = 57.403, p &lt; 0.001). A relationship between the frequency of intake related to these beverages and the dental erosive wear has been established.

Objective To estimate the prevalence of dental erosive wear among five-year-olds in Bergen, Norway, and to investigate associations between background factors and the condition. Methods A total of 387 children received a dental examination in five Public Dental Service clinics in Bergen, Norway. The parents responded to items about the children’s dental hygiene and drinking habits, type of beverage container, diet, and other habits, and about their own age, educational level and country of origin. We explored background variables for possible associations with the outcome status as worst affected by erosive wear (19.4%, n = 75). Chi-squared statistics and logistic regression (Odds Ratios (OR): 95% Confidence Intervals (CI), served as statistical tools). Results Approximately 80% showed erosive wear (by SEPRS and by adopted diagnostic instrument (78.5% vs 79.8%)). The condition affected maxillary anterior teeth in 13.9% (n = 54), and cuppings in molars in 79.3% (n = 307) of cases. Grinding teeth during the day and/or night (OR: 1.87, CI: 1.07–3.25) and male sex (OR: 1.76, CI: 1.05–2.96) significantly related to outcome status as worst affected by erosive wear, respectively. Conclusion Dental erosive wear was widespread. Grinding teeth and male sex associated with outcome status as worst affected by erosive wear.

Global research trends and hotspots of pelvic floor dysfunction from 2000 to 2024: a bibliometric analysis.