Erosive Tooth Wear Severity and Impact on Quality of Life

Objectives: To evaluate (i) the construct validity of intra-oral scanners compared with clinical examination (CE) in assessing erosive tooth wear (ETW) in individuals with low and high risk (presence of etiological factors), using the Basic Erosive Tooth Wear Examination (BEWE) index; and (ii) if individuals with ETW evaluated through BEWE scores obtained with the different methods present a more negative impact on their quality of life.
Methods: Participants were allocated into two groups (n=40): high (presence of at least one etiological factor of ETW) and low risk for ETW. They respond to an oral health-related quality of life questionnaire (OHIP-26). Subjects were subjected to a CE for ETW using the BEWE. Afterwards, BEWE was determined in digital models obtained with two intra-oral scanners (T5: TRIOS5–3shape; and VV: Virtuo Vivo–Straumann). For (i), the risk of ETW as the outcome and the scores obtained with the methods were the independent variables. Unadjusted analyses were made, and adjusted models were built. Odds Ratio (OR) and 95% confidence intervals were calculated. For (ii), the OHIP-26 total score was the outcome. The same independent variables were considered, and the unadjusted and adjusted models were derived through negative binomial regression analysis. The rate ratio (RR) and 95%Cis were calculated. The significance level was of 5%.
Results: All methods presented construct validity as they were able to discriminate between subjects with low and high risk for ETW: CE (OR/95%Cis: 1.78/1.25-2.54), T5 (1.99/1.35-2.94), and VV (2.01/1.35/2.98). For all methods, subjects with higher BEWE scores showed greater negative impact on their quality of life (p=0.01): CE (RR/95%Cis: 1.03/1.01-1.06), T5 (1.03/1.01-1.06), and VV (1.03/1.01-1.06).
Conclusions: All methods were capable of distinguishing between subjects with low and high risk of ETW. Individuals with higher BEWE scores obtained with the different methods present a more negative impact on their quality of life.