The relationship between incisal/oclusal wear, dentine hypersensitivity and time after the last acid exposure in vivo

OBJECTIVE: The aim of this study was to investigate the relationship between tooth wear and dentine hypersensitivity on occlusal/incisal tooth surfaces and the time since dietary acid consumption.

METHOD: 350 subjects were recruited from hospital and general practice in SE England aged 19-34 years old. The severity of tooth wear and dentine hypersensitivity was calculated on occlusal/incisal tooth surfaces per subject using Basic Erosive Wear Examination (BEWE) and Cumulative Hypersensitivity Index (CHI) scores respectively at each appointment. The CHI score relied on evaporative stimuli applied to each occlusal/incisal tooth surface. The subjects were also asked about the time since their last acidic food or drink consumption.

RESULT: Tooth wear was recorded in 93% (n=327) of subjects and dentine hypersensitivity was recorded in 56% (n=196) of subjects. A positive statistically significant relationship existed between the severity of tooth wear and severity of dentine hypersensitivity recorded using BEWE and CHI on occlusal/incisal tooth surfaces (p<0.01). Dentine hypersensitivity and tooth wear were correlated with consumption of acidic beverages (p<0.01). The severity of dentine hypersensitivity on occlusal/incisal tooth surfaces was associated with the time since the subject's last acidic food consumption (p<0.01). Among those subjects who consumed an acidic beverage within 60min of their appointment, 87.2% (n=130) had dentine hypersensitivity. Among subjects who had consumed the acidic beverage more than 1h previously, the prevalence of dentine hypersensitivity was 12.8% (n=19).

CONCLUSION: The severity of tooth wear on occlusal/incisal tooth surfaces is associated with the dentine hypersensitivity severity. Subjects who consume dietary acidic beverages more recently are more likely to have dentine hypersensitivity.

CLINICAL SIGNIFICANCE: Occlusal tooth surfaces suffer erosive, attritive and abrasive tooth wear. Tooth wear is important in the aetiology of dentine hypersensitivity on these surfaces. Dentine hypersensitivity is more likely initiated if subjects consume acidic beverages more recently. This supports clinically the episodic nature of dentine hypersensitivity caused predominately by active erosive tooth wear.