The use of index teeth vs. full mouth in erosive tooth wear to assess risk factors in the diet: a cross-sectional epidemiological study
López-Macías, Adriana M.
Bartlett, David W.
Pitts, Nigel B.
Gamboa, Luis Fernando
Journal of dentistry, 0300-5712, Vol. 88, 2019
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Objective:To assess common dietary erosive-tooth-wear (ETW) risk in university students from an exotic-fruitcountry comparing index teeth vs. full mouth ETW assessment.Methods:Ariskfactors’questionnairewasappliedon60118–25yearsoldsubjectsinBogotá-Colombia.Trainedexaminers assessed clinically: ETW (BEWE) on all buccal, occlusal and lingual surfaces and ICDAS caries ex-perience (ICDAS-DMFS). Full-arch and index-teeth (buccal of upper-central incisors and occlusal of lower-firstmolars) maximum-BEWE score categorized patients into: with- (2–3) and without wear (0–1). These werecomparedintermsofdemographic,clinical,dietaryandotherfactorswithcrudeandlogisticregressionmodels.Results:Students’ mean age was 20.0 ± 1.9 (77.7% females). Most consumed fruits were erosive/extremelyerosive (57%).Prevalenceofwear was73%(full-mouth)vs.19.6%(index-teeth). Full-mouth-BEWEcorrelatedsignificantly with teeth-index-BEWE score but low (0.31, p < 0.001). Besides anterior-teeth incisal surfaces,occlusal of lower molars (16%) and buccal of upper central incisors (3.3%) showed highest wear frequency.Strawuseor1-hwaitingfortoothbrushingdidn’tshowaprotectiveeffect.ETWwassignificantlyassociatedonindex teeth with frequent intakes of dietary acids(≥3 daily-acidicdrinks and ≥4 daily-fruitportions) (single-variable-logistic regression: OR 4.41, p=0.22 and OR 1.60, p=0.035; multivariable-logistic regression: OR4.47, p=0.022andOR1.63,p=0.036respectively).No significantdifferences werenoticedbetween groupswhen the full-mouth maximum score was used.Conclusion:ThisyoungcohortshoweddietaryETWassociatedwithfrequentdietaryacids’intakesandgradingETW on index teeth vs. full mouth was a more sensitive measurement method to assess underlying ETW riskfactors. The teeth index has promising usefulness for the clinic and epidemiology.Clinical Significance:Using index teeth (buccal of upper central incisors and occlusal of lower first molars) forETW(BEWE)assessmentallowedtoshowassociationinyoungadultsbetweenfrequentdailyexoticfruits/fruitjuicesdietary-acidconsumptionandETW,representingalesstimeconsumingclinical/epidemiologicalmethodof ETW measurement than a full mouth examination
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