Dynamics of tooth erosion in adolescents: A 3-year longitudinal study

Abstract

Objectives

The aim of the present study was to estimate the prevalence, incidence and progression of tooth erosion on both mouth and tooth level over a 3-year period in a sample of adolescents. The study also aimed to investigate age, gender and socio-economic influences.

Methods

Tooth erosion was recorded three times with 1.5 years intervals in a sample of 622 children, aged 10–12 years at baseline.

Results

Tooth erosion was present in 30.4% of the 11-year-olds, and 44.2% in 15-year-olds. Deep enamel or dentin was eroded in 1.8% of the 11-year-olds and in 23.8% of the 15-year-olds. Significantly more boys than girls showed tooth erosion as did children from a low socio-economic background compared with other children. The incidence of new tooth surfaces exhibiting erosion, in erosion-free children, decreased significantly with age, while the progression in children with erosion did not change. The incidence of tooth erosion in upper incisors and lower first molars decreased significantly with age. In upper incisors, a statistical significant relationship between SES and incidence was found, with lower incidences for higher SES. For first molars, only a relationship between gender and incidence was found, with a lower incidence for girls.

Conclusions

The incidence of new tooth surfaces exhibiting erosion, in erosion-free children, decreased significantly with age. In children with tooth erosion the condition progressed steadily. On tooth level the incidence decreased significantly with age for upper incisors and lower first molars. There was a difference in influence of background variables on the incidence of tooth erosion between molars and upper incisors.

Introduction

Prevalence studies on tooth erosion show varying results. A review of epidemiological studies that were carried out among children in the age range 9–17 years shows a prevalence of tooth erosion between 11% and 100%.¹ This wide prevalence range is due to different examination standards used and different non-homogeneous groups examined. Furthermore, prevalence studies are often not specific for erosion, but report tooth wear in general, which makes direct comparisons of the results difficult. The many cross-sectional prevalence studies on tooth erosion in different age samples give an idea about how the presence of tooth erosion and age are related. Summarizing the results from several epidemiological studies involving erosive tooth wear in children and adolescents, Jaeggi and Lussi¹ concluded, that with increasing mean age of the population group examined, there is a trend towards more erosive lesions detected. However, to gain insight into the incidence and progression of tooth erosion longitudinal studies on tooth erosion are necessary.

The prevalence of tooth erosion seems to be higher in boys than in girls.2, 3, 4, 5, 6 The relationship between the presence of tooth erosion and socio-economic status is controversial. Several studies found that more children with a low socio-economic status suffer from tooth erosion compared with other children,2, 6, 7 while other research groups report the opposite.4, 8, 9

Longitudinal studies on tooth erosion are scarce. Only three longitudinal studies have been performed to assess the incidence of tooth erosion in adolescents. In a cohort of 12-year-old children, an incidence of 12.3% over 2 years was found.³ The longitudinal observation of orthodontic study models of adolescents revealed an incidence of 18% over 5 years.¹⁰ We reported an incidence of 24.2% over 1.5 years in a sample of 10–12-year-old children.²

No gender or socio-economic influence on the incidence of tooth erosion was found. However, progression defined as an increase in lesion depth and/or in number of lesions, was 61.0% over 1.5 years in children with erosion and was higher in boys than in girls. Dugmore and Rock³ reported the development of new or more advanced erosive lesions in 27% of the children over 2 years, which was significantly higher in white children from deprived socio-economic groups than in whites from other social backgrounds.

In an earlier study, we presented the 1.5 years interim results on prevalence, incidence, progression and distribution of tooth erosion in a cohort of adolescents (mean age 11.9 years). The analyses were based on examination round and mouth level. Erosion at baseline was present in 32.2 of the children and increased to 42.8% over 1.5 years. Of the erosion-free children 24.2% developed signs of tooth erosion (2). The present study aimed to estimate the prevalence, incidence and progression of tooth erosion on both mouth and tooth level over a 3-year period, in the same cohort of adolescents. The longer follow-up period led to a larger variation of ages which enabled an age based analysis. The study also investigated age, gender and socio-economic influences.