IADR Abstract Archives
Tooth Wear and Its Etiology: Common Clinical (mis)Conceptions
Objectives: To investigate the predictive value of commonly thought major risk factors (acids in diet, presence of tooth wear, bruxism and reflux) at baseline and tooth wear progression over time.
Methods: To evaluate predictive values 34 patients with moderate to severe tooth wear were questioned at baseline regarding bruxism habits, diet (acidic drinks) and acid reflux through questionnaires. Tooth Wear Index was measured at baseline through clinical exam. The etiological factors were dichotomized except for acidic drinks, which were included both as a dichotomized and continuous variable. Intra-oral scans (IOS) were taken at baseline and again 3 or 5 years later. Tooth wear progression was measured using the 3D Wear Analysis protocol on 64 surfaces per dentition, scoring the highest profile loss per surface in millimeters. Height loss was recalculated to mm/year, and patients were dichotomized into high and low tooth wear groups. Fisher-exact test, sensitivity, specificity, positive predictive value (PPV) were calculated for the dichotomized etiological factors. For acidic drinks as a continuous factor, the Area Under Curve (AUC) was also calculated.
Results: Bruxism, TWI-score and acid reflux resulted in insignificant differences with low predictive values between high and low wear patients. Acidic drinks dichotomized had a PPV of 84.6%, sensitivity of 78.6%, specificity of 75%, and was able to distinguish between low and high wear progression groups (p=0.026). Acidic drinks as a continuous factor had an AUC of 0.821.
Conclusions: The predictive value of self-reported bruxism and acid reflux on tooth wear progression is low, as well as the TWI score. Patients should be informed that a high acidic intake can predict higher progression of tooth wear and clinicians should be aware that acidic diet can have a significant effect on both mechanical and erosive tooth wear.
Methods: To evaluate predictive values 34 patients with moderate to severe tooth wear were questioned at baseline regarding bruxism habits, diet (acidic drinks) and acid reflux through questionnaires. Tooth Wear Index was measured at baseline through clinical exam. The etiological factors were dichotomized except for acidic drinks, which were included both as a dichotomized and continuous variable. Intra-oral scans (IOS) were taken at baseline and again 3 or 5 years later. Tooth wear progression was measured using the 3D Wear Analysis protocol on 64 surfaces per dentition, scoring the highest profile loss per surface in millimeters. Height loss was recalculated to mm/year, and patients were dichotomized into high and low tooth wear groups. Fisher-exact test, sensitivity, specificity, positive predictive value (PPV) were calculated for the dichotomized etiological factors. For acidic drinks as a continuous factor, the Area Under Curve (AUC) was also calculated.
Results: Bruxism, TWI-score and acid reflux resulted in insignificant differences with low predictive values between high and low wear patients. Acidic drinks dichotomized had a PPV of 84.6%, sensitivity of 78.6%, specificity of 75%, and was able to distinguish between low and high wear progression groups (p=0.026). Acidic drinks as a continuous factor had an AUC of 0.821.
Conclusions: The predictive value of self-reported bruxism and acid reflux on tooth wear progression is low, as well as the TWI score. Patients should be informed that a high acidic intake can predict higher progression of tooth wear and clinicians should be aware that acidic diet can have a significant effect on both mechanical and erosive tooth wear.