The establishment of an erosion risk assessment model in preschool children

Abstract

There is a general consensus that the prevalence of erosive tooth wear is increasing in the younger generations in parallel with a predilection for unhealthy eating habits. It is recognized that behavioural habits are established earlier on in life. To date clinical evidence on the prevalence and behavioural factors that contribute to dental erosion in preschool children is sparse in the literature.

In this dissertation, we initially conducted a cross sectional study in the primary dentition of the preschool-aged child across the Maltese islands, in order to establish the prevalence of dental erosion as measured by the BEWE index, and associated contributing dietary and behavioural risk factors explored through parent-directed questionnaires. We also explored the interaction of the various coactive factors giving rise to erosive dental wear and dental caries, the latter measured with the ICDAS index. In the second part of the study we re-examined longitudinally a selected cohort of the same children, at least two years apart. This allowed us to monitor the progression of dental erosion, as well as to generate an age-specific risk assessment model for the clinical condition in preschool children.

Baseline prevalence of 71 % and 81 % erosive tooth wear were reported in the three and five-year- old cohort and both yielded an incidence ratio of 0.8 over two and three years respectively. Erosive dental wear was not significantly associated with the child's quality of life and was not perceived as an oral health related issue by parents. The risk variables for the younger cohort were demographically based while those for the older cohort tended towards individual dietary choices. The presence of plaque and consumption of erosive beverages associated with sports activities were common risk factors for both erosive wear and dental caries.

The predictive risk models were age specific and identified sociodemographic and behavioural variables as contributory factors for further erosive tooth wear.

In conclusion the prevalence of erosive dental wear was high in the primary dentition of the preschool-aged child across the Maltese islands and was associated with modifiable risk factors. This study established different risk predictive models for erosive; tooth wear which may be utilized both clinically and on a community level. Such insight may help direct both individual and community level preventive measures.