Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase

BACKGROUND

Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition.

OBJECTIVE

This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population.

METHODS

We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models.

RESULTS

Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values.

CONCLUSIONS

The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.

Prevalence of dental attrition and its relationship with dental erosion and salivary function in young adults

OBJECTIVES

The aim of this study was to estimate the prevalence of dental attrition in a young adult population and to explore associated factors.

METHOD AND MATERIALS

Dental students aged 18 to 40 years old with a minimum of 24 natural teeth were invited to take part in this cross-sectional study. Their demographic information, medical history, perceived stress, frequency of dietary acid intake, and frequency of oral habits were obtained through several questionnaires. Assessment of each type of tooth wear (erosion, attrition, and abrasion) was performed according to the tooth wear evaluation system (TWES 1.0). All participants underwent salivary tests. Statistical analysis was performed by chi-squared or Mann-Whitney tests and logistic regression models.

RESULTS

In total, 178 participants (88 women and 90 men) with a median age of 22 years were included and of those 74.7% (95% confidence interval [CI], 68% to 81%) had dental attrition. Univariate analysis revealed positive associations for male sex, age, body mass index, awake bruxism frequency, and erosive tooth wear with the presence of dental attrition. Multivariable logistic regression (Nagelkerke r2 = 0.31) indicated that dental attrition was associated with erosive tooth wear (adjusted odds ratio [aOR], 6.3; 95% CI, 2.8 to 14.2), body mass index (aOR, 1.3; 95% CI, 1.1-1.5), and age (aOR, 1.2; 95% CI 1.0 to 1.3).

CONCLUSION

Dental attrition is present in most young adults of Catalonia. The associated factors were erosive tooth wear, body mass index, and age. Slight alterations of salivary parameters do not seem to predict dental attrition. (Quintessence Int 2023;54:168-175; doi: 10.3290/j.qi.b3622405).

Sex-specific reference values for the crown heights of permanent anterior teeth and canines for assessing tooth wear

OBJECTIVE

We propose sex-specific reference values for the clinical crown height of anterior teeth and canines.

MATERIAL AND METHODS

In this cross-sectional study, 1426 teeth were analysed from 169 undergraduate and postgraduate dental students (83 women and 86 men, median age 22 years). Teeth with worn or totally restored incisal edges, or gingival inflammation were excluded. Age, gender and body height were recorded and the degree of tooth wear was scored according to the quantification module of the Tooth Wear Evaluation System. The clinical crown heights of all anterior teeth and canines were measured from the gingival margin to the incisal edge with a digital calliper. Reference values for tooth groups were obtained at the percentiles 10, and expressed by sex if there was a significant difference between men and women.

RESULTS

Mean crown heights were bigger in men than in women for each tooth group (p = .028). Clinical crown heights showed sexual dimorphism at the 10^th percentiles for all tooth groups except for mandibular anterior teeth.

CONCLUSIONS

For assessing tooth wear, the sex-specific reference values for the clinical crown height of young adults Caucasoids range from 7.5 mm to 9.0 mm in women and from 7.5 mm to 9.5 in men.