The relationship between dentine hypersensitivity, dietary acid intake and erosive tooth wear

To assess the interplay between dietary acid intake, toothbrushing and erosive tooth wear as aetiological factors in self-reported DH MATERIALS AND METHODS: This is a secondary analysis on previously collected data from 600 participants with (n=300) and without (n=300) severe erosive tooth wear. Participants recruited from restorative clinics of King's College London Dental Institute (REC Ref 14/EM/1171) were questioned on their self-reported DH, frequency and timing of dietary acid intake, habits associated with consumption of dietary acids and tooth brushing habits. Erosive tooth wear was assessed using Basic Erosive Wear Examination (BEWE). Differences in diet and brushing habits between those with self-reported DH and those without were analysed using descriptives and logistic regression in SPSS vers. 24.

Of those reporting with DH (n=272), a greater number spent ≥10min eating fruit per sitting, (n=46) and had a drinking habit such as sipping, swishing or holding drinks in the mouth (n=72) compared to those without DH (n=26 OR 2.72, 95%CI [1.32-5.61], p=0.007 and n=38 OR2.33, 95%CI [1.40-3.88], p=0.001, respectively). More DH participants used a soft toothbrush (n=36) compared to those without DH (n=18 OR 2.35, 95%CI [1.20-4.59], p=0.013). No association was observed with frequency of daily toothbrushing or dietary acid intake.

Contact time between the tooth and the acid may be a more important risk factor for DH compared to frequency of dietary acid intake or frequency of toothbrushing. Other possible aetiological factors should be considered. CLINICALTRIALS.

NCT02449434 CLINICAL SIGNIFICANCE: Increased contact time with dietary acids and sipping swishing or holding drinks in the mouth prior to swallowing should be addressed as an aetiological factor in DH. Toothpaste abrasivity and toothbrush filament stiffness may play a greater role in DH compared to frequency of toothbrushing.