Objectives (i) To develop, validate, and apply in practice a new risk assessment tool
for erosive tooth wear (ETW) including a risk factors questionnaire and a saliva secretion
evaluation, which combined with a clinical index, can be part of an ETW composite
scoring system; (ii) to assess ETW lesions and current and past erosive challenges
in younger age groups. Methods The Tooth Surface Loss/Erosion Working Group of the
European Association of Dental Public Health consisted of an international panel of
experts designed the survey component of the new tool (Erosive Wear Assessment of
Risk-EWAR) and confirmed its construct and content validity. After receiving ethical
approvals and informed consents, the EWAR tool (questionnaire + saliva secretion evaluation)
was applied in a multicenter cross-sectional study with 207 participants aged 15-21
years old from four countries (Finland, Greece, Romania, the USA). BEWE score was
used for the clinical assessment of ETW. Results A total of 58.5% of participants
had ETW. 10.9% and 20.3% of participants had low secretion of stimulated (< 1 ml/min)
and unstimulated saliva (< 0.25 ml/min), respectively. The following factors were
bivariately significantly associated with ETW: energy drink consumption, low secretion
of stimulated saliva, juices consumption, erosive drink consumption for quenching
thirst between meals, erosive drink kept in the mouth, feeling pain/icing after consuming
something acidic or cold, and co-existence of other type of tooth wear. In regression
analysis, only energy drink consumption (OR = 3.5, 95% CI: 1.39, 8.9), low secretion
of stimulated saliva (OR = 36.3, 95% CI: 4.71, 78.94), and feeling pain/icing (OR
= 8.8, 95% CI: 1.92, 40.04) remained significant. Conclusions The examiners of the
study reported that the EWAR tool appeared to be an affordable and easy-to-use instrument.
Some challenges occurred during the saliva collection process. Inferential analysis
revealed that the risk factors/indicators of low stimulated salivary flow, energy
drink consumption, and pain/icing with ETW were considered the most important in ETW
occurrence.
