Objective: To assess the influence of self-reported intrinsic factors [gastroesophageal reflux disease (GERD), long-term alcoholism, long-term heavy use of alcohol and multiple pregnancies] on erosive tooth wear in a middle-aged cohort sample. Materials and Methods: Of the total Northern Finland Birth Cohort (NFBC 1966), a convenience sample (n = 3,181) was invited for an oral health examination in 2012-2013, of which 1,962 participated, comprising the final study group. Erosive tooth wear was assessed by sextants using the Basic Erosive Wear Examination Index (BEWE, 0-18). Clinical data were supplemented by questionnaires conducted in 1997/1998 and 2012/2013. The participants were divided into severe (BEWE sum ≥9) and no-to-moderate (BEWE sum 0-8) erosive wear groups, and the logistic regression model was applied. Results: Selected intrinsic factors were quite rare in this cohort sample and explained only 5.9% of the difference in the prevalence and severity of erosive wear. Daily symptoms of GERD [odds ratio (OR) 3.8, confidence interval (CI) 1.2-12.0] and hyposalivation (OR 3.8, CI 1.2-11.8) were the strongest risk indicators for severe erosive wear. Additionally, variables associated with an elevated risk for severe erosive wear were diagnosed alcoholism at any point (OR 2.5, CI 0.7-9.7) and self-reported heavy use of alcohol in both questionnaires (OR 2.0, CI 0.6-6.2). Even low-dose long-term consumption of alcohol was associated with erosive wear. Conclusions: In this cohort sample, intrinsic factors such as GERD or alcoholism alone are relatively uncommon causes of erosive tooth wear. The role of long-term use of alcohol in the erosion process may be bigger than presumed.

1.
Ali RA, Egan LJ: Gastroesophageal reflux disease in pregnancy. Best Pract Res Clin Gastroenterol 2007;21:793-806.
2.
Bardolia P, Burnside G, Ashcroft A, Milosevic A, Goodfellow SA, Rolfe EA, Pine CM: Prevalence and risk indicators of erosion in thirteen- to fourteen-year-olds on the isle of man. Caries Res 2010;44:165-168.
3.
Bardsley PF, Taylor S, Milosevic A: Epidemiological studies of tooth wear and dental erosion in 14-year-old children in North West England. Part 1: the relationship with water fluoridation and social deprivation. Br Dent J 2004;197:413-416.
4.
Bartlett DW, Fares J, Shirodaria S, Chiu K, Ahmad N, Sherriff M: The association of tooth wear, diet and dietary habits in adults aged 18-30 years old. J Dent 2011;39:811-816.
5.
Bartlett D, Ganss C, Lussi A: Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig 2008;12:65-68.
6.
Bartlett DW, Lussi A, West NX, Bouchard P, Sanz M, Bourgeois D: Prevalence of tooth wear on buccal and lingual surfaces and possible risk factors in young European adults. J Dent 2013;41:1007-1013.
7.
Buzalaf MA, Hannas AR, Kato MT: Saliva and dental erosion. J Appl Oral Sci 2012;20:493-502.
8.
Current Care Guidelines: caries management (in Finnish). http://www.kaypahoito.fi/web/kh/suositukset/suositus?id=hoi50078 (accessed March 1, 2016).
9.
Di Fede O, Di Liberto C, Occhipinti G, Vigneri S, Lo Russo L, Fedele S, Lo Muzio L, Campisi G: Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center case-control study. J Oral Pathol Med 2008;37:336-340.
10.
Dukic W, Dobrljevic TT, Katunaric M, Milardovic S, Segovlc S: Erosive lesions in patients with alcoholism. J Am Dent Assoc 2010;141:1452-1458.
11.
El Aidi H, Bronkhorst EM, Huysmans MC, Truin GJ: Multifactorial analysis of factors associated with the incidence and progression of erosive tooth wear. Caries Res 2011;45:303-312.
12.
Fares J, Shirodaria S, Chiu K, Ahmad N, Sherriff M, Bartlett D: A new index of tooth wear: reproducibility and application to a sample of 18- to 30-year-old university students. Caries Res 2009;43:119-125.
13.
Foster RK, Marriott HE: Alcohol consumption in the new millennium - weighing up the risks and benefits for our health. Nutr Bull 2006;31:286-331.
14.
Hara AT, Zero DT: The potential of saliva in protecting against dental erosion. Monogr Oral Sci 2014;25:197-205.
15.
Hede B: Determinants of oral health in a group of Danish alcoholics. Eur J Oral Sci 1996;104:403-408.
16.
Hellwig E, Lussi A, Goetz F: Influence of human saliva on the development of artificial erosions. Caries Res 2013;47:553-558.
17.
Holbrook WP, Furuholm J, Gudmundsson K, Theodors A, Meurman JH: Gastric reflux is a significant causative factor of tooth erosion. J Dent Res 2009;88:422-426.
18.
Jarvinen VK, Rytomaa II, Heinonen OP: Risk factors in dental erosion. J Dent Res 1991;70:942-947.
19.
Jensdottir T, Arnadottir IB, Thorsdottir I, Bardow A, Gudmundsson K, Theodors A, Holbrook WP: Relationship between dental erosion, soft drink consumption, and gastroesophageal reflux among Icelanders. Clin Oral Investig 2004;8:91-96.
20.
Khan F, Young WG, Daley TJ: Dental erosion and bruxism. A tooth wear analysis from south east Queensland. Aust Dent J 1998;43:117-127.
21.
Laine MA: Effect of pregnancy on periodontal and dental health. Acta Odontol Scand 2002;60:257-264.
22.
Larsen MJ, Poulsen S, Hansen I: Erosion of the teeth: prevalence and distribution in a group of Danish school children. Eur J Paediatr Dent 2005;6:44-47.
23.
Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, de Leeuw R, Manfredini D, Svensson P, Winocur E: Bruxism defined and graded: an international consensus. J Oral Rehabil 2013;40:2-4.
24.
Lussi A, Hellwig E: Risk assessment and causal preventive measures. Monogr Oral Sci 2014;25:220-229.
25.
Moazzez R, Bartlett D: Intrinsic causes of erosion. Monogr Oral Sci 2014;25:180-196.
26.
Moazzez R, Bartlett D, Anggiansah A: Dental erosion, gastro-oesophageal reflux disease and saliva: how are they related? J Dent 2004;32:489-494.
27.
Mulic A, Skudutyte-Rysstad R, Tveit AB, Skaare AB: Risk indicators for dental erosive wear among 18-yr-old subjects in Oslo, Norway. Eur J Oral Sci 2012;120:531-538.
28.
Northern Finland Birth Cohort official website. http://www.oulu.fi/nfbc/ (accessed January 15, 2016).
29.
Pace F, Pallotta S, Tonini M, Vakil N, Bianchi Porro G: Systematic review: gastro-oesophageal reflux disease and dental lesions. Aliment Pharmacol Ther 2008;27:1179-1186.
30.
Robb ND, Smith BG: Prevalence of pathological tooth wear in patients with chronic alcoholism. Br Dent J 1990;169:367-369.
31.
Ronkainen J, Agreus L: Epidemiology of reflux symptoms and GORD. Best Pract Res Clin Gastroenterol 2013;27:325-337.
32.
Rytomaa I, Jarvinen V, Kanerva R, Heinonen OP: Bulimia and tooth erosion. Acta Odontol Scand 1998;56:36-40.
33.
Schlueter N, Tveit AB: Prevalence of erosive tooth wear in risk groups. Monogr Oral Sci 2014;25:74-98.
34.
Simpura J (ed): Finnish Drinking Habits: Results from Interview Surveys Held in 1968, 1976 and 1984. Helsinki, Foundation for Alcohol Studies, 1987.
35.
Smith BGN, Robb ND: Dental erosion in patients with chronic alcoholism. J Dent 1989;17:219-221.
36.
Søvik JB, Vieira AR, Tveit AB, Mulic A: Enamel formation genes associated with dental erosive wear. Caries Res 2015;49:236-242.
37.
Vakil N, Van Zanten SV, Kahrilas P, Dent J, Jones R, Bianchi LK, Cesario KB: The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-1920, 1943.
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