Associated risk factors with quantitative erosive tooth wear progression

The aim of this study was to determine predictors of erosive tooth wear (ETW) progression, using novel primary-care quantitative analysis techniques.

In a single-centre, prospective, observational cohort longitudinal study, adolescents, aged 11-18 years, underwent a baseline BEWE examination, validated risk factors questionnaire and baseline intraoral scan (IOS, TRIOS 3.0, 3Shape, Copenhagen, Denmark). One year later a repeat scan was taken. Quantitative analysis of wear progression (volume loss) on first permanent molars and upper central incisors was performed using previously published protocols. Multilevel linear regression was used to investigate the associations between baseline predictors and volume loss per mm².

A total of 295 dental surfaces (131 incisors and 164 molars) in 70 patients were analysed for this study. The mean age of participants at baseline was 15.0 years (SD: 0.79), and the average time between scans was 11.8 months (1.61 SD; range 10-13). The mean volume loss per mm² of dental surfaces was -0.013 mm³ (SD: 0.009). Greater volume loss was observed amongst adolescents with higher baseline BEWE scores and those whose parents had lower education as well as on molar than incisor surfaces. No associations were found with dietary acid intake and intrinsic acid exposure when baseline levels of tooth wear, parental education and other factors were controlled for.

The findings help to characterise groups at greater risk of ETW and would indicate that improved screening and upstream preventative measures should form the basis of a preventative program.

Intra-orals scans and registration software might improve the ability to diagnose, monitor and prevent the early loss of dental hard tissue.