Prevalence of dentine hypersensitivity, erosive tooth wear, gingival recession and periodontal health in seven European countries

Objectives
To determine the prevalence and associated risk indicators for dentine hypersensitivity (DH), erosive tooth wear (ETW), gingival recession (GR), and gingival inflammation (bleeding on probing, BOP), with clinical and questionnaire data from seven European countries.

Methods
A cross-sectional, observational, seven-European country, epidemiological study in systemically healthy adults. Participants completed a questionnaire regarding oral hygiene, diet and lifestyle factors. A clinical examination, by calibrated examiners, measured DH (Schiff; participant yes/no), ETW (basic erosive tooth wear examination, BEWE), GR (mm), and BOP (yes/no).

Results
3551 participants completed the study, mean age 44±17.4, 43.6% male, 26.1% rural dwellers. DH (Schiff ≥1) was seen in 75.9% of participants, ETW (BEWE ≥1) in 97.6%, GR (≥1 mm) in 87.9%. 65.7% participants had BOP≥10% sites, 34.3% BOP<10% with probing depths ≤3 mm. DH, ETW, GR and BOP increased markedly during young adult life. Thereafter, GR and ETW continued to increase, DH declined after around age 38-47, and BOP plateaued after age 48. DH was significantly associated with ETW (p<0.001) and GR (p<0.01); GR was significantly associated with BOP on lingual surfaces (p=0.017). There were significant associations between increased full mouth BOP≥10% and reduced brushing duration and exercise frequency (p<0.001); increased DH and heartburn (p<0.001); decreased DH (p<0.001), ETW (p<0.001) and BOP≥10% (p=0.002) with powered toothbrush use.

Conclusions
Prevalence of oral conditions assessed was high, greater than in the majority of the GR, DH and ETW literature. Periodontal health was seen in a third of sampled individuals. All these conditions varied markedly by country and age.

Clinical Significance
Oral diseases and conditions were highly prevalent throughout the seven European countries investigated. For the majority, these conditions are eminently preventable and treatable by changing behaviours. Upstream policy changes are needed to address these health challenges, to raise awareness and to empower individuals with oral health education and support.