Distribution of dental erosion and its related factors among workers in factories that use acids

Seung-Min Park; Myung-Seop Shin; Mi-Sun Kong; Hyun-Duck Kim

doi:10.11149/jkaoh.2016.40.4.222

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Park, Shin, Kong, and Kim: Distribution of dental erosion and its related factors among workers in factories that use acids

Original Article

J Korean Acad Oral Health 2016;40(4):222-230.

Published online: 15 December 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.4.222

Distribution of dental erosion and its related factors among workers in factories that use acids

Seung-Min Park^1,^#, Myung-Seop Shin^1,^2,^#, Mi-Sun Kong¹, Hyun-Duck Kim^1,^2,

¹Seoul National University School of Dentistry, Seoul, Korea

²Department of Preventive and Social Dentistry, Seoul, Korea

Corresponding Author: Hyun-Duck Kim Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8680 Fax: +82-2-765-1722 E-mail: hyundkim@snu.ac.kr

^# Park and Shin are co-first authors who contributed equally to this work.

Received 11 October 2016 Revised 29 October 2016 Accepted 2 December 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

No evidence has been found on various types of dental erosion, except for occupational dental erosion. This study aimed to evaluate the distribution of four types of dental erosion (occupational, dietary, systemic, and gastric) and its associated factors among workers in factories that use acids.

Methods

Of 89,034 workers from 4,625 factories that use acids, 716 workers from 38 factories were selected for this cross-sectional epidemiological study by using three-stage stratified cluster sampling. Evaluation for dental erosion was performed by a trained dentist by using Kim's criteria, and a saliva sample was collected directly from each participant. Data on acid sources and associated factors were collected by using questionnaires. By using a complex sample analysis, the T test and Rao-Scott chi-square test were applied to analyze the distribution of four acid factors and to evaluate the associated factors.

Results

The prevalence of overall dental erosion was 37.7% for occupational dental erosion, 23.1% for dietary dental erosion, 3.1% for systemic dental erosion, and 3.2% for gastric dental erosion. The prevalence of severe dental erosion was 10.5% for occupational dental erosion, 7.1% for dietary dental erosion, 1.8% for systemic dental erosion, and 1.7% for gastric dental erosion. The factors associated with dental erosion were age, sex, acid exposure, dental cervical abrasion, and dental attrition.

Conclusions

Our data showed that the prevalence of dental erosion was high, moderate, and low in occupational, dietary, and gastric and systemic dental erosions, respectively, among workers exposed to acids. The related factors differed according to the types of dental erosion. Our data suggested that different types of promotion programs for dental erosion should be considered according to acid source.

Keywords: Associated factor, Dental erosion, Epidemiology, Source of acid, Workers exposed to acids

References

1. Imfeld T. Dental erosion. Definition, classification and links. Eur J Oral Sci. 1996; 104:151–155.

2. ten Gate JM, Imfeld T. Preface. Eur J Oral Sci. 1996; 104:149–149.

3. Kim HD, Kim JB. An epidemiological study on dental erosion among industrial workers exposed to acids in Korea. J Korean Acad Oral Health. 1994; 18:303–338.

4. Kim HD. Occupational dental erosion by tooh type. J Korean Acad Oral Health. 2000; 24:309–318.

5. Zero DT. Etiology of dental erosion-extrinsic factors. Eur J Oral Sci. 1996; 104:162–177.

6. Kim H, Douglass CW. Associations between occupational health behaviors and occupational dental erosion. J Public Health Dent. 2003; 63:244–249.

7. Barbour ME, Lussi A. Erosion in relation to nutrition and the environment. Monogr Oral Sci. 2014; 25:143–154.

8. Hara AT, Carvalho JC, Zero DT. Causes of dental erosion: extrinsic factors. Amaechi BT. Dental Erosion and Its Clinical Management. Springer;2015. p. 69–96.

9. Dodds MW, Yeh CK, Johnson DA. Salivary alterations in type 2 (non-insulin-dependent) diabetes mellitus and hypertension. Community Dent Oral Epidemiol. 2000; 28:373–381.

10. Lasisi TJ, Fasanmade AA. Salivary flow and composition in diabetic and non-diabetic subjects. Niger J Physiol Sci. 2012; 27:79–82.

11. Buzalaf MAR, Hannas AR, Kato MT. Saliva and dental erosion. J Appl Oral Sci. 2012; 20:493–502.

12. Scaramucci T, Carvalho JC, Hara AT, Zero DT. Causes of dental erosion: intrinsic factors. Amaechi BT. Dental Erosion and Its Clinical Management. Springer;2015. p. 35–67.

13. Kim JB, Paik DI, Moon HS, Kim HD. Knowledge opinion and practices about oral health of workers exposed to acids in Korea. J Korean Acad Oral Health. 1997; 21:155–184.

14. Kim JB, Paik DI, Kim HD. Distribution and management of occupational dental ersoion. Incheon: Korea Occupational Safety & Health Agency;2004.

15. Kim HD, Hong YC, Choi CH, Bae KH, Han DH, Shin MS, et al. Investigation on oral health management and promotion for workers exposed to acids. Incheon: Korea Occupational Safety & Health Agency;2014.

16. Kim HD. Developing oral health program for workers exposed to chemicals. Incheon: Korea Occupational Safety & Health Agen-cy;2008.

17. Kim HD. A guideline of oral examination for workers. Seoul: Korea Occupational Safety & Health Agency;1998.

18. Kim HD, Kim JB, Paik DI, Moon HS. Incidence and distribution of cervical dental erosion. J Korean Acad Oral Health. 1997; 21:9–10.

19. Cole A, Eastoe J. Biochemistry and oral biology. London: Wright;1988. p. 476–7.

20. Choi CH, Kim BI, Kwon HK. Dental erosion prevalence and risk factors in galvanizing and battery manufacture factory workers. J Korean Acad Oral Health. 2002; 26:535–554.

21. Kim EJ, Lee HJ, Lee EJ, Bae KH, Jin BH, Paik DI. Effects of pH and titratable acidity on the erosive potential of acidic drinks. J Korean Acad Oral Health. 2012; 36:13–19.

22. Aguiar YPC, Santos FGD, Moura EFdF, Costa FCMD, Auad SM, Paiva SMd, et al. Association between dental erosion and diet in Brazilian adolescents aged from 15 to 19: a population-based study. Scienti-ficWorldJournal. 2014; 2014.

23. Manaf ZA, Lee MT, Ali NH, Samynathan S, Jie YP, Ismail NH, et al. Relationship between food habits and tooth erosion occurrence in Malaysian University students. Malays J Med Sci. 2012; 19:56–66.

24. Wiegand A, Müller J, Werner C, Attin T. Prevalence of erosive tooth wear and associated risk factors in 2-7-year-old German kindergarten children. Oral Dis. 2006; 12:117–124.

25. Zero DT, Lussi A. Erosion-chemical and biological factors of importance to the dental practitioner. Int Dent J. 2005; 55:285–290.

26. Hara AT, Zero DT. The potential of saliva in protecting against dental erosion. Monogr Oral Sci. 2014; 25:197–205.

27. Bartlett D, Coward P. Comparison of the erosive potential of gastric juice and a carbonated drink in vitro. J Oral Rehabil. 2001; 28:1045–1047.

28. Braga SRM, De Oliveira E, Sobral MAP. Morphological and mineral analysis of dental enamel after erosive challenge in gastric juice and orange juice. Microsc Res Tech. 2011; 74:1083–1087.

29. de Matos LF, Pereira SM, Kaminagakura E, Marques LS, Pereira CV, van der Bilt A, et al. Relationships of beta-blockers and anxiolytics intake and salivary secretion, masticatory performance and taste perception. Arch Oral Biol. 2010; 55:164–169.

30. Kagawa R, Ikebe K, Enoki K, Murai S, Okada T, Matsuda K, et al. Influence of hypertension on pH of saliva in older adults. Oral Dis. 2013; 19:525–529.

Fig. 1.

Questionnaires and responses.

Fig. 2.

Prevalence of overall dental erosion (A) and severe dental erosion (B) according to acid sources.

Table 1.

Characteristics of participants

Variables	Category	N	Occupation				P-value^†
			Non-Manufacturing^¶		Manufacturing
			N	%* (95% CI)	N	%* (95% CI)
Age (years)	<29	137	26	27.5 (22.1-33.7)	111	72.5 (66.3-77.9)	0.189
	30-39	249	40	22.1 (13.7-33.8)	209	77.9 (66.2-86.3)
	40-49	232	21	17.3 (11.7-24.8)	211	82.7 (75.2-88.3)
	≥50	98	8	15.0 (6.9-29.5)	90	85.0 (70.5-93.1)
Sex	Male	624	68	16.6 (11.3-23.8)	556	83.4 (76.2-88.7)	<0.001
	Female	92	27	46.0 (41-51)	65	54.0 (49-59)
Occupational acid exposure (year)	<1	272	42	22.4 (14.7-32.6)	230	77.6 (67.4-85.3)	0.052
	1-5	184	30	27.5 (19.7-36.9)	154	72.5 (63.1-80.3)
	6-10	68	9	12.7 (7.2-21.5)	59	87.3 (78.5-92.8)
	≥11	192	14	15.7 (10.5-22.8)	178	84.3 (77.2-89.5)
Sour food	Little	420	60	24.1 (19.6-29.3)	360	75.9 (70.7-80.4)	0.069
	Much	294	35	17.3 (10.6-26.9)	259	82.7 (73.1-89.4)
Diabetes	No	703	93	20.8 (15.5-27.4)	610	79.2 (72.6-84.5)	0.578
	Yes	13	2	27.5 (8.2-61.8)	11	72.5 (38.2-91.8)
Hypertension^¶	No	691	93	21.3 (15.6-28.3)	598	78.7 (71.7-84.4)	0.008
	Yes	25	2	10.3 (6.1-17)	23	89.7 (83-93.9)
Rumination	No	675	89	21.2 (15.8-27.9)	586	78.8 (72.1-84.2)	0.222
	Yes	38	6	17.3 (10.1-28.1)	32	82.7 (71.9-89.9)
Income (million won/year)	<15	18	2	12.2 (8.7-16.9)	16	87.8 (83.1-91.3)	0.007
	<30	184	34	22.4 (13.6-34.7)	150	77.6 (65.3-86.4)
	<50	265	38	24.2 (18.2-31.4)	227	75.8 (68.6-81.8)
	<70	131	11	17.3 (12.7-23.2)	120	82.7 (76.8-87.3)
	≥70	114	10	12.4 (10.1-15.2)	104	87.6 (84.8-89.9)
Smoking	No	410	63	24.3 (18.1-31.8)	347	75.7 (68.2-81.9)	0.034
	Yes	304	32	16.5 (10.3-25.3)	272	83.5 (74.7-89.7)
Drinking	No	210	41	32.2 (24.3-41.3)	169	67.8 (58.7-75.7)	<0.001
	Yes	506	54	16.4 (12-21.9)	452	83.6 (78.1-88)
Tooth brushing	≤2	312	39	18.7 (12.5-27.1)	273	81.3 (72.9-87.5)	0.050
	≥3	401	55	22.8 (18.1-28.4)	346	77.2 (71.6-81.9)
Mask protection	No	366	66	30.5 (24.2-37.8)	300	69.5 (62.2-75.8)	<0.001
	Yes	350	29	10.4 (6.9-15.6)	321	89.6 (84.4-93.1)
Dental cervical abrasion	No	585	84	22.1 (16-29.7)	501	77.9 (70.3-84)	0.131
	Yes	121	11	16.2 (10.3-24.5)	110	83.8 (75.5-89.7)
Dental attrition	No	629	89	22.7 (17-29.6)	540	77.3 (70.4-83)	0.035
	Yes	77	6	11.6 (5.7-22)	71	88.4 (78-94.3)
Saliva flow rate (ml/min)		698	94	0.276^‡ (0.018)	604	0.311^‡ (0.009)	0.099^‡

*Weighted value for the total population of 89,034 person.

^¶ Non-Manufacturing includes laboratory workers.

^† Obtained by Rao-Scott Chi-Square Test.

^‡ Obtained by T-test in complex sample analysis. Values represent mean (standard error). Bold denotes statistical significance at P<0.05.

Table 2.

Prevalence of acid sources among participants (n=716)

Variable	Source of acid
		Occupational	Dietary	Systemic	Gastric
		Occupational	Dietary	Systemic	Gastric	n	%* (95% CI)	n	%* (95% CI)	n	%* (95% CI)	n	%* (95% CI)
Total	444	62.5 (55.7-68.8)	294	45.3 (36.3-54.6)	30	3.7 (2.4-5.8)	38	6.0 (4.5-8.1)
Age
<40 years	232	61.3 (53.7-68.4)	192	54.3 (41.4-66.6)	5	1.4 (0.5-3.7)	20	5.9 (3.6-9.7)
≥40 years	212	64.3 (56.7-71.3)	102	31.1 (28.4-34)	25	7.4 (5.4-10.1)	18	6.2 (4.9-7.7)
Sex
Male	406	65.2 (56.7-72.9)	251	46.3 (36-56.9)	27	4.1 (2.5-6.6)	32	6.4 (4.7-8.7)
Female	38	46.5 (40-53.1)	43	39.6 (34.4-45)	3	1.7 (0.9-2.9)	6	3.6 (2.9-4.5)
Occupational acid exposure
No	0	0.0 (0-0)	119	47.0 (35.1-59.3)	10	2.7 (1.4-5.3)	13	7.7 (3.6-15.7)
Yes	444	100.0 (100-100)	175	44.3 (36.9-51.9)	20	4.4 (2.7-6.9)	25	5.0 (3.7-6.8)
Dental cervical abrasion
No	372	63.7 (57.7-69.4)	244	46.3 (36-56.9)	20	3.4 (2.1-5.4)	32	6.2 (4.2-8.9)
Yes	67	57.7 (43.3-70.9)	47	41.4 (37-45.9)	10	5.9 (3.2-10.7)	6	5.7 (3.8-8.4)
Dental attrition
No	389	62.2 (54.7-69.1)	261	45.0 (37.4-52.8)	27	3.8 (2.5-5.6)	32	5.3 (4.3-6.5)
Yes	50	66.4 (59-73.2)	30	48.7 (30.4-67.4)	3	3.8 (1.2-11.3)	6	11.2 (6.6-18.2)

Weighted value for the total population of 89,034 person. All of the results are from the multiple responses.

Table 3.

Prevalence of overall dental erosion (G1-5) according to acid sources exposed (n=716)

Variable	Prevalence of overall dental Erosion* (%)
		Source of acid
	Occupational		P	Dietary		P	Systemic		P	Gastric		P
		No (n=272)	P	Yes (n=444)	No (n=422)	P	Yes (n=294)	No (n=686)	P	Yes (n=30)	No (n=678)	P	Yes (n=38)
Total	51.8	60.8	0.005	57.9	56.5	0.738	56.8	74.3	0.029	57.3	61.8	0.342
Age
<40 years	38.5	50.9	<0.001	44.2	47.1	0.751	46.0	58.8	0.495	45.6	56.4	0.051
≥40 years	74.1	75.9	0.669	72.1	82.3	0.005	75.0	78.9	0.513	75.9	69.9	0.227
Sex
Male	57.6	64.4	0.055	64.2	59.3	0.255	61.7	72.5	0.127	61.9	67.8	0.269
Female	30.3	31.6	0.71	26.1	38.2	0.026	29.7	100.0	<0.001	32.0	0.0	<0.001
Acid exposure
No	51.8		-	51.4	52.2	0.824	51.1	75.7	0.058	52.5	47.6	0.326
Yes	60.8		-	61.6	59.3	0.688	60.2	73.7	0.072	60.1	74.8	<0.001
Dental cervical abrasion
No	44.1	59.6	<0.001	54.9	52.4	0.644	53.2	77.0	0.004	53.7	60.0	0.137
yes	86.4	68.1	0.001	72.3	80.8	0.135	76.4	66.2	0.492	76.1	71.7	0.423
Dental attrition
No	47.3	60.1	0.001	57.0	52.8	0.064	54.5	74.9	0.009	55.5	53.1	0.8
Yes	84.1	65.5	0.009	64.4	78.6	0.419	71.8	70.3	0.918	69.7	88.0	0.001

*Weighted value for the total population of 89,034 person. All of the results are from the multiple responses. Obtained by Rao-Scott Chi-Square Test. Bold denotes statistical significance at P<0.05.

Table 4.

Prevalence of severe dental erosion (G3-5) according to the acid sources exposed (n=716)

Variable	Prevalence of severe dental Erosion* (%)
	Source of acid
	Occupational		P	Dietary		P	Systemic		P	Gastric		P
	No (n=272)	Yes (n=444)	P	No (n=422)	Yes (n=294)	P	No (n=686)	Yes (n=30)	P	No (n=678)	Yes (n=38)	P
Total	16.7	17.0	0.957	15.8	17.4	0.493	15.9	42.2	<0.001	15.9	32.4	0.002
Age
<40 years	10.5	6.1	0.400	5.5	8.6	0.236	7.3	39.6	0.166	6.0	36.2	<0.001
≥40 years	27.2	33.4	0.243	26.4	41.6	0.004	30.2	43.0	0.161	31.6	26.5	0.387
Sex
Male	18.9	18.8	0.992	17.8	19.2	0.65	17.8	42.5	0.001	17.7	35.5	0.005
Female	8.8	2.1	0.001	5.6	5.8	0.91	5.1	38.4	0.05	5.9	0.0	<0.001
Acid exposure
No	16.7		-	13.0	20.9	<0.001	15.9	18.5	0.075	15.5	32.6	0.053
Yes		17.0	-	17.4	15.3	0.556	15.8	41.6	0.001	16.2	32.2	0.004
Dentinal cervical abrasion
No	12.1	14.8	0.578	12.3	14.6	0.279	12.9	39.4	0.001	12.4	36.0	<0.001
yes	37.7	29.8	0.098	32.6	33.9	0.903	32.0	50.7	0.228	34.4	11.6	<0.001
Attrition
No	12.9	15.3	0.166	14.4	14.0	0.943	13.5	37.9	0.005	13.8	25.7	0.046
Yes	44.4	26.8	0.508	26.0	37.8	0.265	31.2	70.3	0.01	30.2	52.4	0.395

*Weighted value for the total population of 89,034 person. All of the results are from the multiple responses. Obtained by Rao-Scott Chi-Square Test. Bold denotes statistical significance at P<0.05.

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