This research proposes to characterize diagnostics, clinical management, and perceptions about erosive tooth wear (ETW) among dental professionals and, secondarily, to use perceptions of ETW among dental patients to more accurately situate implications for dental care. ETW refers to the irreversible loss of tooth structure, having dental erosion as the primary etiological factor. The clinical importance ascribed to ETW by dental professionals worldwide contrasts sharply with the low salience of ETW among dentists in the U.S. Epidemiological data indicate that ETW in the U.S. may be a very common problem that worsens with older age; however, perceptions of ETW by dental professionals and by patients appear to be mismatched with the known epidemiological and clinical impacts of ETW. The sparse body of knowledge available on ETW has largely been limited to laboratory evaluations of ETW mechanics and some epidemiological estimates. Lack of accurate connections between ETW and its causative/risk factor(s), and limited knowledge about perceptions by dental professionals and patients, are fundamental gaps in the scientific and professional literature. We hypothesize that ETW is an under-appreciated condition due to limited awareness of U.S. dental practitioners about its appearance, risk factors, and management. To test the hypothesis and characterize the relevant phenomena, we propose a three-stage approach.
The Specific Aims (SAs) of the UG3 phase are: SA 1. Refine survey and clinical data collection methods and tools, and render them ready for implementation.
This aim builds directly on our considerable pilot data. SA 2. Assemble strategies, identify target populations, design means for participant contact, and strategize data collection through collaboration of grantees with NDPBRN regions and Coordinating Center partners.
The Specific Aims of the UH3 phase will structure the implementation of the three stages of the research to: SA 3 (Stage 1). Establish detection thresholds and characterize perceptions of ETW in a sample of NDPBRN practitioners. Survey administration will be through a web platform, offering contrasts of dental conditions to ascertain if practitioners detect ETW and, if so, at what level of severity they distinguish ETW as pathological. SA 4 (Stage 2). Determine prevalence, severity, risk factors, and key indicators of ETW in dental patients ages 18-35, 36-55, and 56-70 via clinical examination, in a sample of NDPBRN dental offices. SA 5 (Stage 3). Determine ETW perceptions by patients examined in Stage 2. A web platform similar to the one used in Stage 1 will be employed in Stage 3, adapted to patient evaluations and perceptions. This investigation proposes to establish the role of various ETW risk factors and to measure the perceptions of ETW in both practitioners and patients in the NDPBRN. Such foundation will lead to actionable strategies to raise awareness and support the accurate diagnosis and appropriate management of ETW.

Public Health Relevance

The clinical importance ascribed to erosive tooth wear (ETW) by dentists worldwide contrasts with its low salience in the U.S., and, although ETW poses a challenge to oral health and dental care, we lack accurate knowledge about ETW perceptions by dental professionals and patients. We propose to quantify the ETW profile in real-life dental practice, to establish the role of risk factors, and to measure perceptions of ETW in both practitioners and patients. This project will provide the foundation for U.S.-specific, actionable strategies to raise awareness about ETW and to support appropriate diagnosis and management of ETW.

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
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Special Emphasis Panel (ZDE1)
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Fischer, Dena
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Indiana University-Purdue University at Indianapolis
Schools of Dentistry/Oral Hygn
United States
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