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Med Oral Patol Oral Cir Bucal. 2009 Aug 1;14 (8):e377-84.

Analytic cross-sectional study on dental erosion experience

maxillary than in mandibular dental arches (Wilcoxon test, p<0.001). Median values of dental erosion sever- ity in all maxillary dental surfaces were significantly different (Fridman test, p<0.001 followed by Wilcoxon test, p<0.033 for all the comparisons), being the most severe erosion lesion found in anterior teeth palatine surfaces (Wilcoxon test, p<0.001) followed by posterior teeth occlusal surfaces (Wilcoxon test, p<0.001), and by anterior teeth incisive edges (Wilcoxon test, p<0.003). In mandibular dental arches, the most severe dental erosion lesions evidence were found in posterior teeth occlusal surfaces (Wilcoxon test, p<0.001) followed by anterior teeth incisal and lingual surfaces (Wilcoxon test, p<0.04). From the unadjusted assessment of associations be- tween dental erosion experience and measures/co- variates of interest (Table 1) for occlusal surface, the maxillary (OR=2.04), anterior teeth (OR=0.38), age 40 years or higher (OR=1.55), being single or divorced (OR=1.4), academic education of less than 9 years of study (OR=0.63), being unemployed/retired (OR=1.38), alcohol addiction of more than 10 years (OR=1.41), to smoke (OR=2.35), to drink before breakfast (OR=1.31), having gastro-oesophageal reflux (OR=1.67), brushing teeth less than 2 times a day (OR=1.74) and the use of mouthwash (OR=1.68) were statistically significant. For palatine surface, the maxillary (OR=4.16), anterior teeth (OR=4.20), age 40 years or higher (OR=0.72), aca- demic education of less than 9 years of study (OR=0.75), having vomits due to alcohol intoxication (OR=1.61), having gastro-oesophageal reflux (OR=1.78) and brush- ing teeth less than 2 times a day (OR=1.8) were statisti- cally significant. For buccal surface, the anterior teeth (OR=1.51), being single or divorced (OR=1.63), academ- ic education of less than 9 years of study (OR=0.65), be- ing unemployed/retired (OR=0.65), to smoke (OR=2.12) and having gastro-oesophageal reflux (OR=1.67) were statistically significant. The multivariate model, assessed by logistic regres- sion (Table 2), for the occlusal dental surface included the following conditions as independently associated with dental erosion experience (level >0): the maxil- lary (OR=2.52), anterior teeth (OR=0.36), age 40 years or higher (OR=1.52), academic education of less than 9 years of study (OR=0.5), being unemployed/retired (OR=1.64), alcohol addiction of more than 10 years (OR=1.59), to smoke (OR=3), to drink before sleeping (OR=2.7) (to drink before breakfast did not remained significant and to drink before sleeping became signifi- cant) and having gastro-oesophageal reflux (OR=2.15). For palatine surface the model included the following conditions as independently associated with dental ero- sion prevalence (level >0): the maxillary (OR=7.77), an- terior teeth (OR=7.75), age 40 years or higher (OR=0.46), being single/divorced (OR=1.56), academic education

of less than 9 years of study (OR=0.48), being unem- ployed/retired (OR=1.68), daily alcohol intake equal or higher than 240 g (OR=1.62), heroine use (OR=0.06) and cocaine use (OR=6.72), to drink before breakfast (OR=0.63), to drink before sleeping (OR=1.67), hav- ing gastro-oesophageal reflux (OR=2.84) and brushing teeth less than 2 times a day (OR=1.72). For this sur- face civil state, employment status, daily alcohol intake, heroine and cocaine use, to drink before breakfast and sleeping were new covariates included by the multi- variate model. For buccal surface the model included the following conditions as independently associated with dental erosion prevalence (level >0): the maxillary (OR=1.62), the anterior teeth (OR=1.93), being single or divorced (OR=2.06), academic education of less than 9 years of study (OR=0.48), heroine use (OR=0.1), to smoke (OR=2.16), to drink before sleeping (OR=1.85) having vomits due to alcohol intoxication (OR=0.59), and having gastro-oesophageal reflux (OR=2.91).

Discussion Despite the limitation regarding the number of patient’s clinically observed (50 patients), this cohort constitutes 12.4% of the total (N=404) CRAN internment treat- ments patients done in the year 2005. However, it is important to enhance that, in this cross-sectional study, dental erosion experience and severity were statistically analysed by dental teeth (n=1064) according to intra- oral location. The socio-demographic CRAN patients indicators related to professional situation criteria in- dicate that 15 (30%) were unemployed, 32 (64%) were employed and 3 (6%) retired. These data come close to the study of Enberg et al. (2001) in 85 alcoholic patients with ages between 30 and 64 years old, where 12 (14.1%) were unemployed, 63 (74.1%) employed and 10 (11.8%) were retired (11), although statistical evidence confirm the existence of significant differences (Chi-square test, 2 d.f., p=0.004) between those and our results. The En- berg et al. (2001) survey results revealed that 85 alcohol- ic patients had 255.2 g/day average alcohol consumption (11). CRAN’s patients had a similar daily average alco- hol consumption (265.7 g/day) and no significant differ- ences for the mean alcohol consumption (g/day) were found for these two surveys (one sample t test, p=0,673). Alcohol consumption in northern Europe is at a histori- cal high and is continuing to increase. The decline seen in south-western Europe over past decades seems to be coming to an end. In some countries of the European Region, unrecorded consumption accounts for a sub- stantial part of total consumption and this makes direct comparisons between countries difficult (1). Kranzler et al. (1990) said that usually alcoholic patients oral hygiene is deficient and inefficacious, translating this fact in bacterial deposits increment and consequently in high prevalence of periodontal pathology, of dental car-

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