Resumen
Background: Erosive tooth wear (ETW) has been defined as the accelerated loss of mineralized dental tissue due to the combined effects of acid erosion and mechanical wear (abrasion of attrition). Its aetiology is multifactorial and complex. The progressive, cumultative and irreversible characteristics of ETW as well as its tendency to progress with aging, justify the investigation of possible risk indicators for its occurrence in young populations. This is the first study assessing the occurrence of ETW on permanent teeth of uruguayan school children. Aims: to assess the prevalence, extent, severity and intraoral distribution of ETW and its association with socioeconomic, environmental and behavioral characteristics among 12-year-old schoolchildren in Montevideo, Uruguay. Methods: A population-based cross-sectional survey was conducted using a representative sample of 12-year-old school children, attending 32 public and 12 private schools, from August/2011 to July/2012. Firstly, 44 schools were randomly selected being 32 publics and 12 privates. All of 12-year-old schoolchildren attending such schools were invited to participate. Data was collected through two structured questinnaires prior to clinical oral examination: one sent to parents/legal guardians (socioeconomic status, parents' educational level, housing conditions, general health medical and dental history) and another were answered by the school children (behavioural and dietary habits). Clinical examination was performed by two calibrated examiners (kappa>= 0.7) in order to record the presence intervals and severity of ETW according to the Basic Erosive Wear Examination (B.E.W.E.) score system. Prevalence and extent rates and their respective 95% confidence intervals (95% CI) were estimated. The association between severe ETW and its possible associated factors were analyzed using Logistic regression models. Results: In this study, 1136 schoolchildren were examined, 19.1% from private schools and 80.9% from public schools, yielding a response rate of 66.6%. The overall prevalence of ETW was 52.9% (n=601), being mild erosion in the vast majority of cases (48.5%) (n=554). Severe ETW was detected in 4.4% of schoolchildren (n=47). The overall prevalence of ETW was detected in 4.4% of schoolchildren (n=47). The overall preavalence of ETW differed significantly between categories of gender, socioeconomic status and only between categories of gender in the severe ETW analysis. Regarding overall extent of ETW, significant differences were found between categories of gender, socioeconomic status and the habit of swish before swallow. In regards to extent of severe ETW, significant variables were swish before swallow and brushing frequency. In the adjusted analysis, males (OR= 3.22, 95% CI= 1.50-6.89) and the consumption of yogurt >= times a day (OR=3.98, 95% CU=1.18-13.47) were associated with the presence of severe ETW. The most frequently affected teeth were the upper incisors at the palatal surfaces followed by first molars (occlusal surfaces). Conclusions: The high prevalence suggests that ETW may be considered a public health problem among 12-year-old uruguayan schoolchildren. The increased risk among boys shuld be taken into account int he development of preventive strategies against ETW.(AU)
