THE INFLUENCE OF INTRINSIC FACTORS ON EROSIVE TOOTH WEAR IN A COHORT STUDY

The interplay of causative and protective factors on the erosive tooth wear process is complex and little is known about the long-term effects. The aim of the present study was to assess the long-term influence of self-reported intrinsic factors (gastroesophageal reflux disease (GERD), alcohol abuse, heavy use of alcohol, multiple pregnancies and eating disorders) on erosive tooth wear in adults. Saliva secretion and bruxism were also taken into account.

Methods: Of the total Northern Finland Birth Cohort 1966, those living in or within 100km of the city of Oulu (n=3,181) were invited for a dental examination. Of them, 1,962 (61.6%) participated, comprising the final study group. A standardized clinical dental examination was conducted in Oulu between 4/2012-6/2013 by seven calibrated dentists. Erosive tooth wear was assessed using the Basic Erosive Wear Examination Index (BEWE, 0 –18). Clinical data was supplemented by postal questionnaires conducted in 1997/1998 and 2012/2013 and hospital registers. The participants were divided into severe (BEWE sum≥9) and no to moderate (BEWE sum=0-8) erosive wear groups, and logistic regression models were applied. The Ethical Committee of the Northern Ostrobothnia Hospital District approved the study.

Results: Selected intrinsic factors were quite rare and explained only 5.9% of the difference in the prevalence and severity of erosive wear. Daily symptoms of GERD (OR3.8, CI 1.2-12.0) and hyposalivation (OR3.8,CI 1.2-11.8) were the strongest risk indicators for severe erosive wear. Additionally, variables associated with elevated risk for severe erosive wear were diagnosed alcoholism at any point (OR2.5,CI 0.7-9.7) and self-reported heavy use of alcohol in both questionnaires (OR2.0,CI 0.6-6.2). Even low-dose long-term consumption of alcohol was associated with erosive wear.

Conclusions: In this cohort sample, intrinsic factors such as GERD or alcoholism alone are relatively uncommon causes of erosive wear. The role of long-term use of alcohol in erosion may be bigger than presumed.