Tooth wear and oral-health-related quality of life in dentate adults

Abstract

Objectives: This study estimated the extent to which tooth wear, adjusted for (oral) health risk indicators, impacts adversely on the Oral-Health-Related Quality of Life (OHRQoL) of dentate adults.

Methods: A cross-sectional study was conducted and had a convenience sample of 570 adults ≥18 years old with at least one bilateral molar occlusal contact. Participants answered a self-applied questionnaire (ICC=0.71) consisting of four domains: socio-demographics, oral care attendance, (oral) health conditions and lifestyle, complaints and oral-health-related quality of life (OHIP-14). Tooth wear was clinically assessed using the Basic Erosive Wear Examination index by two examiners, whose inter-examiner reliability were k=0.76-0.80.

Results: The outcome was a high score on the OHRQoL (median split ≥ 7). The prevalence of tooth wear was 75.0%. Only 30.2% of adults reported impacts on at least 1 performance parameter affected 'fairly often' or 'very often'. The hierarchical logistic regression showed that participants 35-54 years old (OR=2.1), who were ever prevented from regular oral health care due to costs of care (OR=3.6), who ingested acidic beverages ≥ daily (OR=1.7), who had tooth sensitivity (OR= 2.9) and those having the impression that their teeth have changed appearance (OR= 5.9) were significantly more likely to report lower OHRQoL than their counterparts. The severity of tooth wear was not significant when considering moderate and severe cases together.

Conclusions: Although the prevalence of tooth wear was high, its severity and impact on OHRQoL were limited. However, distal and proximal indicators for tooth wear were mediators for impaired OHRQoL and treatment needs.

Clinical significance: Prevalence and severity of tooth wear had limited impact on OHRQoL in adults. Distal and proximal indicators for tooth wear were mediators for impaired OHRQoL. The understanding of these relationships offers an opportunity to assess in depth the treatment needs and quality of life of patients affected by tooth wear.

Keywords: Abrasion; Adults; Attrition; Erosive tooth wear; Quality of life; Tooth wear.