DENTAL EROSION AMONG 12 YEAR-OLD HUNGARIAN SCHOOLCHILDREN

Abstract

Dental erosion seems to be a growing problem with more erosive lesions on permanent teeth among schoolchildren (Lussi 2006.) Early identification of erosion allows prevention for at-risk patients. No national erosion examinations have been carried out in Hungary in children. WHO pathfinder surveys were undertaken regularly in 12 year olds. The aim of the present study was find the prevalence, severity of dental erosion and to identify associated risk factors among 12 year old schoolchildren in Hungary.

Methods: This cross-sectional survey was carried out with the pathfinder examinations at 14 different urban and rural areas in 2012. Stratified sampling was used, the children included were representative of Hungarian children. There were different number of children in the different geographic areas. The full sample frame was 644 children, there were 28 refusals, 15 drop outs absent children, and 22 children were excluded if the child was over 13 years or under the age of 12 years, or with fix orthodontic appliance. Ethical approval, parental consent and the Hungarian Chief Medical Officer gave permission for the survey. A total of 579 randomly selected children (287 boys, 292 girls) were clinically examined in school dental offices by one trained examiner. Only the first permanent molars and incisors were included. The Basic Erosive Wear Examination (BEWE) scoring system (Bartlett et al. 2008) was used to record erosion. A self-administered questionnaire was used to evaluate oral hygiene and nutritional habits, the amount and frequency of foods and drinks consumed, and the mothers educational level. The data were analysed using SPSS version 17 and Pearsons Chi-Square Test.

Results: The mean age of the children was 12.6 years. 123 children (21.2%) showed signs of erosion. There was no statistically significant difference between genders; 60 boys (20.9%) and 63 girls (21.6%) were affected. The highest percentage of mild erosion was found on the occlusal surfaces of the mandibular first molars, followed by the upper incisors and molars. No dentinal erosion was found. The mean BEWE score was 0.39. When the incisal edges of the front teeth were included, the prevalence was 62.9 % (364 children) and the BEWE score was (1.21). There were considerable differences in erosion prevalence and level between geographic locations and location types. There was a strong correlation (p<0.01) between erosion and daily consumption of erosive drinks. The BEWE score was higher in children whose mothers reported lower education (p<0.00).

Conclusions: The prevalence of erosion in Hungary was not as high compared to some European studies. Severity level was low and only enamel erosion was found. A strong association between erosion and acidic drinks intake was documented, similar to many researchers. The correlation was high regarding mothers education level. The cumulative BEWE scores matched to risk level and may provide a guide towards preventive and other clinical management. The present national erosion data indicate that more attention must be given for risk children and also for risk areas. Our results are good tool / basis for later examinations to follow measure and compare the erosion condition in adolescents.