Erosive tooth wear – knowledge and treatment preferences among dental hygienists
DOI:
https://doi.org/10.2340/aos.v85.46261Keywords:
Erosive tooth wear, preventive measures, dental hygienists, young adultsAbstract
Objective: Erosive tooth wear (ETW) is generally recognized as a widespread condition and a rising concern within the oral healthcare system. This study aimed to investigate dental hygienists` experiences and treatment methods regarding ETW in young adults.
Material and methods: A questionnaire was sent to 1,084 Norwegian dental hygienists working in both public and private dental services. In total, 313 responded (response rate 28.9%). After excluding 47 respondents who did not meet the inclusion criteria of working with young adults (15–30 years), 266 dental hygienists were included in the final analyses (24.5% of those invited).
Results: In total, 96% of the study population of 266 dental hygienists reported recording ETW in the register, with the public dental service doing so more frequently than the private sector. Sports drinks, energy drinks and soft drinks were believed to be the primary risk indicators of ETW, analogously across groups. Furthermore, there was consensus that the most frequently performed preventive measures were dietary guidance and self-administration of fluoride rinse and/or tablets.
Conclusions: Overall, this study suggests that, in our sample, dental hygienists possess substantial knowledge of ETW and hold strong views on potential improvements in their work as healthcare professionals.
Downloads
References
Schlueter N, Amaechi BT, Bartlett D, Buzalaf MAR, Carvalho TS, Ganss C, et al. Terminology of erosive tooth wear: consensus report of a workshop organized by the ORCA and the Cariology Research Group of the IADR. Caries Res. 2020;54(1):2–6. DOI: https://doi.org/10.1159/000503308
Schlueter N, Luka B. Erosive tooth wear – a review on global prevalence and on its prevalence in risk groups. Br Dent J. 2018;224(5):364–70. DOI: https://doi.org/10.1038/sj.bdj.2018.167
Mulic A, Tveit AB, Skaare AB. Prevalence and severity of dental erosive wear among a group of Norwegian 18-year-olds. Acta Odontol Scand. 2013;71(3–4):475–81. DOI: https://doi.org/10.3109/00016357.2012.696689
Mulic A, Fredriksen O, Jacobsen ID, Tveit AB, Espelid I, Crossner CG. Dental erosion: prevalence and severity among 16-year-old adolescents in Troms, Norway. Eur J Paediatr Dent. 2016;17(3):197–201.
Sovik JB, Tveit AB, Storesund T, Mulic A. Dental erosion: a widespread condition nowadays? A cross-sectional study among a group of adolescents in Norway. Acta Odontol Scand. 2014;72(7):523–9. DOI: https://doi.org/10.3109/00016357.2013.875588
Schlueter N, Jaeggi T, Lussi A. Is dental erosion really a problem? Adv Dent Res. 2012;24(2):68–71. DOI: https://doi.org/10.1177/0022034512449836
Seong J, Claydon N, Macdonald E, Garner S, Newcombe RG, West N. A randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge. J Dent. 2017;58:48–53. DOI: https://doi.org/10.1016/j.jdent.2017.01.011
Warreth A, Abuhijleh E, Almaghribi MA, Mahwal G, Ashawish A. Tooth surface loss: a review of literature. Saudi Dent J. 2020;32(2):53–60. DOI: https://doi.org/10.1016/j.sdentj.2019.09.004
Johansson A-K, Omar R, Carlsson GE, Johansson A. Dental erosion and its growing importance in clinical practice: from past to present. Int J Dent. 2012;2012(1):632907. DOI: https://doi.org/10.1155/2012/632907
Lussi A, Schaffner M. Progression of and risk factors for dental erosion and wedge–shaped defects over a 6–year period. Caries Res. 2000;34(2):182–7. DOI: https://doi.org/10.1159/000016587
Peutzfeldt A, Jaeggi T, Lussi A. Restorative therapy of erosive lesions. Monogr Oral Sci. 2014;25:253–61. DOI: https://doi.org/10.1159/000360562
Belmar da Costa M, Delgado AHS, Pinheiro de Melo T, Amorim T, Mano Azul A. Analysis of laboratory adhesion studies in eroded enamel and dentin: a scoping review. Biomater Investig Dent. 2021;8(1):24-38. DOI: https://doi.org/10.1080/26415275.2021.1884558
Helfo. Regelverk for tannlege. Helfo; 2024 [cited 2025 Nov 03]. Available from: https://www.helfo.no/tannlege/regelverk-og- takster-for-tannlege/tilstander-som-kan-gi-rett-til-st%C3%B8nad-til-tannbehandling
Helsedirektoratet. Helserefusjonsdata. 2023 [cited 2025 Jul 20]. Available from: https://opne-data.helserefusjon.no/
McKenzie JF, Seabert DM. Encyclopedia of epidemiology. Boslaugh S, editor. Encyclopedia of Epidemiology. Thousand Oaks (CA): Sage Publications; 2008. p. 839–840.
Chen D, Hayes M, Holden A. A global review of the education and career pathways of dental therapists, dental hygienists and oral health therapists. Br Dent J. 2021;230(8):533–8. DOI: https://doi.org/10.1038/s41415-021-2836-z
Oslo Ui. Tannpleie (Bachelor) Universitetet i Oslo. [cited 2025 Nov 03]. Available from: https://www.uio.no/studier/program/tannpleie/
Helsedirektoratet. God klinisk praksis i tannhelsetjenesten. 2011 [cited 2025 Nov 03]. Available from: https://www.helsedirektoratet.no/veiledere/god-klinisk-praksis-i-tannhelsetjenesten/God%20klinisk%20praksis%20i%20tannhelsetjenesten%20%E2%80%93%20Veileder%20(fullversjon).pdf/_/attachment/inline/3a61ee48-164f-423a-ad02-6748ac1479b3:0506b11f2cd7c642750206443eb93ede8c1687ff/God%20klinisk%20praksis%20i%20tannhelsetjenesten%20%E2%80%93%20Veileder%20(fullversjon).pdf
Ariyanayagam Y. A dental hygienist’s and therapist’s guide to the management of tooth erosion. Prim Dent J. 2016;5(3):58–62. DOI: https://doi.org/10.1177/205016841600500306
Tannhelsetjenesteloven. Lov om tannhelsetjenesten: Norwegian Low of Dental Services; 1983 [cited 2025 Jul 20]. Available from: https://lovdata.no/dokument/NL/lov/1983-06-03-54/
NOU:2023:4 MoHaC. Tid for Handling – Personellet i En Bærekraftig Helse- Og Omsorgstjeneste. Helse- og omsorgsdepartementet; 2023 [cited 2025 Jul 20]. Available from: https://www.regjeringen.no/contentassets/337fef958f2148bebd326f0749a1213d/no/pdfs/nou202320230004000dddpdfs.pdf
Breivik A, Kopperud SE, Khan Q, Mulic A, Stein L. Preventive measures and perceived challenges in delivering oral health care for elderly patients: a survey of dental hygienists in Norway. Acta Odontol Scand. 2025;84:1–9. DOI: https://doi.org/10.2340/aos.v84.42581
Hove LH, Mulic A, Tveit AB, Stenhagen KR, Skaare AB, Espelid I. Registration of dental erosive wear on study models and intra-oral photographs. Eur Arch Paediatr Dent. 2013;14(1):29–34. DOI: https://doi.org/10.1007/s40368-012-0004-5
Mulic A, Árnadòttir IB, Jensdottir T, Kopperud SE. Opinions and treatment decisions for dental erosive wear: a questionnaire survey among Icelandic dentists. Int J Dent. 2018;2018(1):8572371. DOI: https://doi.org/10.1155/2018/8572371
Lussi A, Jaeggi T, Zero D. The role of diet in the aetiology of dental erosion. Caries Res. 2004;38 Suppl 1:34–44. DOI: https://doi.org/10.1159/000074360
Mulic A, Tveit AB, Wang NJ, Hove LH, Espelid I, Skaare AB. Reliability of two clinical scoring systems for dental erosive wear. Caries Res. 2010;44(3):294–9. DOI: https://doi.org/10.1159/000314811
Helsenorge. Who pays your dental bill? 2025 [cited 2025 Jul 20]. Available from: https://www.helsenorge.no/en/payment-for-health-services/who-pays-your-dental-bill/
Tseveenjav B, Virtanen J, Wang N, Widström E. Working profiles of dental hygienists in public and private practice in Finland and Norway. Int J Dent Hyg. 2009;7(1):17–22. DOI: https://doi.org/10.1111/j.1601-5037.2008.00314.x
Hach M, Aaberg KB, Lempert SM, Danielsen B. Work assignments, delegation of tasks and job satisfaction among Danish dental hygienists. Int J Dent Hyg. 2017;15(3):229–35. DOI: https://doi.org/10.1111/idh.12203
Toven NJWoHV. Tannpleiere i Norge. Yrkesaktivitet og arbeidsforhold. Nor Tannlegeforen Tid 2006. 2006.
Ganss C, Young A, Lussi A. Tooth wear and erosion: methodological issues in epidemiological and public health research and the future research agenda. Community Dent Health. 2011;28(3):191–5.
Mulic A, Vidnes-Kopperud S, Skaare AB, Tveit AB, Young A. Opinions on dental erosive lesions, knowledge of diagnosis, and treatment strategies among Norwegian dentists: a questionnaire survey. Int J Dent. 2012;2012:716396. DOI: https://doi.org/10.1155/2012/716396
Michou S, Vannahme C, Ekstrand KR, Benetti AR. Detecting early erosive tooth wear using an intraoral scanner system. J Dent. 2020;100:103445. DOI: https://doi.org/10.1016/j.jdent.2020.103445
Schlenz MA, Schlenz MB, Wöstmann B, Glatt AS, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 24-month results. Clin Oral Investig. 2023;27(6):2775–85. DOI: https://doi.org/10.1007/s00784-023-04858-x
van Nistelrooij N, Maier E, Bronkhorst H, Crins L, Xi T, Loomans BAC, et al Automated monitoring of tooth wear progression using AI on intraoral scans. J Dent. 2024;150:105323. DOI: https://doi.org/10.1016/j.jdent.2024.105323
Witecy C, Ganss C, Wöstmann B, Schlenz M, Schlenz M. Monitoring of erosive tooth wear with intraoral scanners in vitro. Caries Res. 2021;55(3):215–224. DOI: https://doi.org/10.1159/000514666
Mulic A, Tveit AB, Songe D, Sivertsen H, Skaare AB. Dental erosive wear and salivary flow rate in physically active young adults. BMC Oral Health. 2012;12:8. DOI: https://doi.org/10.1186/1472-6831-12-8
Larsen MJ, Poulsen S, Hansen I. Erosion of the teeth: prevalence and distribution in a group of Danish school children. Eur J Paediatr Dent. 2005;6(1):44–7.
Milosevic A, Young PJ, Lennon MA. The prevalence of tooth wear in 14-year-old school children in Liverpool. Community Dent Health. 1994;11(2):83–6.
El Aidi H, Bronkhorst EM, Truin GJ. A longitudinal study of tooth erosion in adolescents. J Dent Res. 2008;87(8):731–5. DOI: https://doi.org/10.1177/154405910808700813
Hasselkvist A, Johansson A, Johansson AK. Dental erosion and soft drink consumption in Swedish children and adolescents and the development of a simplified erosion partial recording system. Swed Dent J. 2010;34(4):187–95.
Okunseri C, Okunseri E, Gonzalez C, Visotcky A, Szabo A. Erosive tooth wear and consumption of beverages among children in the United States. Caries Res. 2011;45(2):130–5. DOI: https://doi.org/10.1159/000324109
Stenhagen KR, Berntsen I, Odegaard M, Mulic A, Tveit AB. Has the prevalence and severity of dental erosion in Norway changed during the last 30 years? Eur J Paediatr Dent. 2017;18(3):177–82.
Almeida e Silva JS, Baratieri LN, Araujo E, Widmer N. Dental erosion: understanding this pervasive condition. J Esthet Restor Dent. 2011;23(4):205–16. DOI: https://doi.org/10.1111/j.1708-8240.2011.00451.x
Marschner F, Kanzow P, Wiegand A. Anamnestic risk factors for erosive tooth wear: systematic review, mapping, and meta-analysis. J Dent. 2024;144:104962. DOI: https://doi.org/10.1016/j.jdent.2024.104962
Helsedirektoratet. Tannhelse-Helsefremmende og forebyggende tiltak for voksne over 20 år 2019 [cited 2025 Jul 20]. Available from: https://www.helsedirektoratet.no/faglige-rad/helsefremmende-og-forebyggende-tannhelsetiltak-for-voksne-over-20-ar
Chan AS, Tran TTK, Hsu YH, Liu SYS, Kroon J. A systematic review of dietary acids and habits on dental erosion in adolescents. Int J Paediatr Dent. 2020;30(6):713–33. DOI: https://doi.org/10.1111/ipd.12643
Bjontegaard MM, Molin M, Kolby M, Torheim LE. Purchase of ultra-processed foods in Norway: a repeated cross-sectional analysis of food sales in 2013 and 2019. Public Health Nutr. 2023;26(9):1743–53. DOI: https://doi.org/10.1017/S1368980023001192
Helsedirektoratet. Utviklingen i norsk kosthold: Helsedirektoratet; 2024 [cited 2025 May 04]. Available from: https://www.helsedirektoratet.no/rapporter/utviklingen-i-norsk-kosthold-2024
Review WP. Soda consumption by country 2025. World Population Review; 2017 [cited 2025 Jul 04]. Available from: https://worldpopulationreview.com/country-rankings/soda-consumption-by-country
Jarvinen VK, Rytomaa II, Heinonen OP. Risk factors in dental erosion. J Dent Res. 1991;70(6):942–7. DOI: https://doi.org/10.1177/00220345910700060601
Carvalho TS, Colon P, Ganss C, Huysmans MC, Lussi A, Schlueter N, et al. Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear – diagnosis and management. Clin Oral Investig. 2015;19(7):1557–61. DOI: https://doi.org/10.1007/s00784-015-1511-7
Dongo D. Norway`s ban on marketing unhealthy food to children. Food Times; [cited 2025 Jul 04]. Available from: https://www.foodtimes.eu/consumers-and-health/norway- ban-unhealthy-food-marketing-children-2025/
World Health Organization. Global strategy and action plan on oral health 2023–2030. 2024. [cited 2025 Sep 10]. Available from: https://www.who.int/publications/i/item/9789240090538
WHO. Childhood overweight and obesity. [cited 2025 Jul 04]. Available from: https://www.who.int/news-room/questions-and-answers/item/noncommunicable-diseases-childhood-overweight-and-obesity
Botero D, Wolfsdorf JI. Diabetes mellitus in children and adolescents. Arch Med Res. 2005;36(3):281–90. DOI: https://doi.org/10.1016/j.arcmed.2004.12.002
Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet. 2001;357(9255):505–8. DOI: https://doi.org/10.1016/S0140-6736(00)04041-1
Arnadottir IB, Holbrook WP, Eggertsson H, Gudmundsdottir H, Jonsson SH, Gudlaugsson JO, et al. Prevalence of dental erosion in children: a national survey. Community Dent Oral Epidemiol. 2010;38(6):521–6. DOI: https://doi.org/10.1111/j.1600-0528.2010.00559.x
SINTEF. Care4YoungTeeth. [cited 2025 Jul 03]. Available from: https://www.careforyoungteeth.no/#Om-prosjektet
Vejrup K, Engel TN, Lillegard HJ, Strand SK, Stein L, Olsen-Bergem H. Health literacy and health-related habits among conscripts in the Norwegian Armed Forces – a cross-sectional survey. Mil Med. 2025;190(7–8):e1686–92. DOI: https://doi.org/10.1093/milmed/usae493
Norton WE, Funkhouser E, Makhija SK, Gordan VV, Bader JD, Rindal DB, et al. Concordance between clinical practice and published evidence: findings from The National Dental Practice-Based Research Network. J Am Dent Assoc. 2014;145(1):22–31. DOI: https://doi.org/10.14219/jada.2013.21
Published
Issue
Section
License
Copyright (c) 2026 Julie Marie Haabeth Brox, Amela Tulek, Qalbi Khan, Amer Sehic, Linda Stein, Anne Breivik, Tor Paaske Utheim, Aida Mulic
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Odontologica Scandinavica publishes high quality original research papers as well as critical reviews relevant on diseases of the oral cavity, their treatment, epidemiology and associated biomaterials and their development.
