Br Dent J. 2004 Oct 23;197(8):479-83
Dept of Restorative Dentistry, Liverpool University Dental Hospital, Pembroke Place, Liverpool L3 5PS, UK. a.milosevic@liv.ac.uk
OBJECTIVE: To determine the strength of association (expressed as Odds Ratios) of
potential risk factors with erosion and tooth wear in 14-year-old schoolchildren.
DESIGN: A random sample of 2,385 children were selected by a stratified two-stage
technique based on schools and children. SETTING: Schools in NW England. METHODS: Tooth
wear was assessed by one examiner on three surfaces of all 12 anterior teeth (labial,
incisal and palatal) and the occlusal surface of all four first molars using a
four-point scale. Enamel wear was scored 0, dentine exposure <1/3 scored 1, >1/3
scored 2 and secondary dentine or pulpal exposure, scored 3. A questionnaire enquired
about general health, dental health, habits and the frequency of intake of a wide
range of foods and drinks. RESULTS: The Odds Ratios for tooth wear on any surface
for habits, reflux and certain foods were: bruxism, 1.10; stomach upset, 1.45;
pickles 1.86; vinegar 1.36; salt and vinegar crisps 1.33; brown/other sauces 1.57.
Similarly, the odds ratios for potentially erosive drinks were: fizzy drinks 1.32;
sport drinks 1.58; herbal/lemon tea 3.97. The frequency of intake was bi-modal with
397 children drinking a can per day and 207 drinking two cans per day. A significant
number drank acidic beverages at bedtime but this was not associated with dental
erosion. CONCLUSION: Although odds ratios greater than unity indicate an association,
this was not high for carbonated beverages and many other acidic foods or drinks.
Examining at fourteen years may not be ideal, as the determinants of erosion/tooth
wear have not acted for long, the indices do not discriminate sufficiently and
proportionately few subjects have dentine exposed on smooth surfaces.