The Prevalence of Tooth Wear among a Group of Yemeni Adults.

  • Safa Al-hammadi Restorative and Prosthodontic Department, College of Dentistry, University of Science and Technology, Yemen.
  • Mohammed Dubais Restorative and Prosthodontic Department, College of Dentistry, University of Science and Technology, Yemen.
  • Ahmed Madfa Department of Conservative Den-tistry, Faculty of Dentistry, Dhamar University, Dhamar, Yemen.Department of Restorative Dental Science, Collage of Dentistry, University of Hail, Hail, Kingdom of Saudi Arabia.


This study aimed at investigating tooth wear prevalence and determining the associated factors among a group of Yemeni adults. It is a preliminary cross-sectional and analytical investigation conducted on 600 participants aged 20–50 years. The participants were purposively selected from two main cities (Sana’a and Aden) with an equal sample size and divided equally by gender. For administering a questionnaire, interviews were conducted with all participants before clinically examining them. Using the Tooth Wear Index (TWI), tooth wear was assessed. Data were analyzed using the chi-square test to identify the relationship between tooth wear and associated factors., Tooth wear was prevalent among 78.67% of the participants; of which 64.83% were in anterior teeth, 63.83% in posterior teeth, 74% in maxillary teeth, and approximately 74.5% in mandibular teeth. It also was 100% prevalent in the 31-40 and 41-50 age groups, while it was 67.2% in the 20-30 age group. This showed that tooth wear prevalence was significantly higher in the two oldest groups than in the youngest group (p<0.001). Moreover, khat chewing, location, highly frequent consumption of foods and high frequency of acidic drinks consumption were critical indicators of tooth wear. Besides, a low education level, smoking and a low socio-economic status were associated with tooth wear. Finally, the study revealed that tooth wear is highly prevalent among adults in two Yemeni cities, and socio-behavioral risk indicators such as khat chewing and cigarette smoking have a significantly association with tooth wear.


1. Shellis RP, Addy M. The interactions between attrition, abrasion and erosion in tooth wear. Monogr Oral Sci. 2014;25:32-45
2. Lussi A, Carvalho TS. Erosive tooth wear: a multifactorial condition of growing concern and increasing knowledge. Monogr Oral Sci. 2014;25:1-15.
3. Wetselaar P, Lobbezoo F. The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions. J Oral Rehabil. 2016;43(1):69-80.
4. Bartlett D, Dugmore C. Pathological or physiological erosion—is there a relationship to age? Clin Oral Investig. 2008;12(1):27-31.
5. Imfeld T. Dental erosion. Definition, classification and links. Eur J Oral Sci. 1996;104(2):151-5.
6. Krishna M, Rao K, Goyal K. Prosthodontic management of severely worn dentition: including review of literature related to physiology and pathology of increased vertical dimension of occlusion. J Indian Prosthodont Soc. 2005;5(2):89.
7. Al-Salehi SK. Restorative Management of Intrinsic and Extrinsic Dental Erosion. J Indian Prosthodont Soc. 2014;14(1):215-21.
8. Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: etiology, diagnosis, and treatment options. Clin Cosmet Investig Dent. 2016;8:79.
9. Donachie M, Walls A. The tooth wear index: a flawed epidemiological tool in an ageing population group. Community Dent Oral Epidemiol. 1996;24(2):152-8.
10. Liu B, Zhang M, Chen Y, Yao Y. Tooth wear in aging people: an investigation of the prevalence and the influential factors of incisal/occlusal tooth wear in northwest China. BMC oral health. 2014;14(1):65.
11. Árnadóttir IB, Sæmundsson SR, Holbrook WP. Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors. Acta Odontol Scand. 2003;61(1):25-8.
12. Van Rijkom H, Truin G, Frencken J, König K, Van’t Hof M, Bronkhorst E, et al. Prevalence, distribution and background variables of smooth-bordered tooth wear in teenagers in The Hague, The Netherlands. Caries Res. 2002;36(2):147-54.
13. Dugmore C, Rock W. The prevalence of tooth erosion in 12-year-old children. Br Dent J. 2004;196(5):279-82.
14. Christopher Deery B, Wagner F, Simon PR, Stat DA. The prevalence of dental erosion in a United States and a United Kingdom sample of adolescents. Pediatr Dent. 2000;22(6).
15. 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(1):8.
16. Mulic A, Skudutyte‐Rysstad R, Tveit AB, Skaare AB. Risk indicators for dental erosive wear among 18‐yr‐old subjects in Oslo, Norway. Eur J Oral Sci. 2012;120(6):531-8.
17. Isaksson H, Birkhed D, Wendt L-K, Alm A, Nilsson M, Koch G. Prevalence of dental erosion and association with lifestyle factors in Swedish 20-year olds. Acta Odontol Scand. 2014;72(6):448-57.
18. Al‐Majed I, Maguire A, Murray JJ. Risk factors for dental erosion in 5–6 year old and 12–14 year old boys in Saudi Arabia. Community Dent Oral Epidemiol. 2002;30(1):38-46.
19. Lee A, He L, Lyons K, Swain M. Tooth wear and wear investigations in dentistry. J Oral Rehabil.. 2012;39(3):217-25.
20. Smith BG, Bartlett DW, Robb ND. The prevalence, etiology and management of tooth wear in the United Kingdom. J Prosthet Dent. 1997;78(4):367-72.
21. Elgazzar HA. Raising returns: The distribution of health financing and outcomes in Yemen. 2011.
22. Al‐Ashtal A, Johansson A, Omar R, Johansson Ak. Dental erosion in groups of Yemeni children and adolescents and the modification of an erosion partial recording system. Int J Paediatr Dent. 2017;27(4):283-92.
23. Bartlett DW, Lussi A, West N, Bouchard P, Sanz M, Bourgeois D. Prevalence of tooth wear on buccal and lingual surfaces and possible risk factors in young European adults. J Dent. 2013;41(11):1007-13.
24. Yadav S. A Study on Prevalence of Dental Attrition and its Relation to Factors of Age, Gender and to the Signs of TMJ Dysfunction. J Indian Prosthodont Soc. 2011;11(2):98-105.
25. Smith B., Knight JK. An index for measuring the wear of teeth. Br Dent J. 1984;156:435-8.
26. Nunn JH. Prevalence of dental erosion and the implications for oral health. Eur J Oral Sci. 1996;104(2):156-61.
27. Margaritis V, Nunn J. Challenges in assessing erosive tooth wear. Erosive Tooth Wear. 25: Karger Publishers; 2014. p. 46-54.
28. Wei Z, Du Y, Zhang J, Tai B, Du M, Jiang H. Prevalence and indicators of tooth wear among Chinese adults. PloS one. 2016;11(9):e0162181.
29. Liu B, Zhang M, Chen Y, Yao Y. Tooth wear in aging people: an investigation of the prevalence and the influential factors of incisal/occlusal tooth wear in northwest China. BMC oral health. 2014;14(1):1.
30. Ganss C, Klimek J, Lussi A. Accuracy and consistency of the visual diagnosis of exposed dentine on worn occlusal/incisal surfaces. Caries Res. 2006;40(3):208-12.
31. Bartlett D, Ganss C, Lussi A. Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig. 2008;12(1):65-8.
32. Dixon B, Sharif M, Ahmed F, Smith A, Seymour D, Brunton P. Evaluation of the basic erosive wear examination (BEWE) for use in general dental practice. Br Dent J. 2012;213(3):E4.
33. López-Frías FJ, Castellanos-Cosano L, Martín-González J, Llamas-Carreras JM, Segura-Egea JJ. Clinical measurement of tooth wear: Tooth wear indices. J Clin Exp Dent. 2012;4(1):e48.
34. Gupta VV, Asawa K, Bhat N, Tak M, Bapat S, Chaturvedi P, Philip-George P, Chitkara N, Patel MN, Shinde K, Sidhu PK. Assessment of oral hygiene habits, oral hygiene practices and tooth wear among fertilizer factory workers of Northern India: A Cross sectional study. J Clin Exp Dent. 2015;7(5):e649.
35. Deshpande S. Investigation of Tooth Wear and its Associated Etiologies in Adult Patients Visiting Dental Institute in India. Dentistry. 2015;5(1):1.
36. Chrysanthakopoulos NA. Prevalence of tooth erosion and associated factors in 13-16-year old adolescents in Greece. J Clin Exp Dent. 2012;4(3):e160.
37. Spijker AVt, Rodriguez JM, Kreulen CM, Bronkhorst EM, Bartlett DW, Creugers NH. Prevalence of tooth wear in adults. Int J Prosthodont. 2009;22(1).
38. Bernhardt O, Gesch D, Splieth C, Schwahn C, Mack F, Kocher T, Meyer G, John U, Kordass B. Risk factors for high occlusal wear scores in a population-based sample: results of the Study of Health in Pomerania (SHIP). Int J Prosthodont. 2004;17(3).
39. Hegde MN, Singh SK. Prevalence of tooth wear and its relation to dietary habit among general population. J India Dent Assoc. 2008;2:369-71.
40. Ahlberg J, Lobbezoo F, Ahlberg K, Manfredini D, Hublin C, Sinisalo J, Könönen M, Savolainen A. Self-reported bruxism mirrors anxiety and stress in adults. Medicina oral, patologia oral y cirugia bucal. 2013;18(1):e7.
41. Jain R, Hegde M. Dental attrition–Aetiology, diagnosis and treatment planning: a review. J Dent Med Sci. 2015;14:60-6.
42. Shetty S, Pitti V, Babu CS, Kumar GS, Deepthi B. Bruxism: a literature review. J Indian Prosthodont Soc. 2010;10(3):141-8.
43. Chuajedong P, Kedjarune‐Leggat U, Kertpon D, Chong-suvivatwong V, Benjakul P. Associated factors of tooth wear in southern Thailand. J Oral Rehabil. 2002;29(10):997-1002.
44. Zhang J, Du Y, Wei Z, Tai B, Jiang H, Du M. The prevalence and risk indicators of tooth wear in 12-and 15-year-old adolescents in Central China. BMC oral health. 2015;15(1):120.
45. Muller-Bolla M, Courson F, Smail-Faugeron V, Bernardin T, Lupi-Pégurier L. Dental erosion in French adolescents. BMC Oral Health. 2015;15(1):147.
46. Diaz‐Rubio M, Moreno‐Elola‐Olaso C, Rey E, Locke III G, Rodriguez‐Artalejo F. Symptoms of gastro‐oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population. Aliment Pharmacol Ther. 2004;19(1):95-105.
47. McGrath C, Bedi R. The association between dental anxiety and oral health‐related quality of life in Britain. Community Dent Oral Epidemiol. 2004;32(1):67-72.
48. Bartlett D, Fares J, Shirodaria S, Chiu K, Ahmad N, Sherriff M. The association of tooth wear, diet and dietary habits in adults aged 18–30 years old. J Dent. 2011;39(12):811-6.
49. Pineda ÁEG-A, Borges-Yáñez SA, Lussi A, Irigoyen-Camacho ME, Medina FA. Prevalence of erosive tooth wear and associated factors in a group of Mexican adolescents. J Am Dent Assoc. 2016;147(2):92-7.
50. Ehlen LA, Marshall TA, Qian F, Wefel JS, Warren JJ. Acidic beverages increase the risk of in vitro tooth erosion. Nutr Res. 2008;28(5):299-303.
51. Kassim S, Islam S, Croucher RE. Correlates of nicotine dependence in UK resident Yemeni khat chewers: a cross-sectional study. Nicotine Tob Res. 2011;13(12):1240-9.
52. Nagarajappa R, Ramesh G. Tooth wear among tobacco chewers in the rural population of Davangere, India. Oral Health Prev Dent. 2012;10(2).
53. De Laat A, van Steenberghe D, Lesaffre E. Occlusal relationships and temporomandibular joint dysfunction. Part II: Correlations between occlusal and articular parameters and symptoms of TMJ dysfunction by means of stepwise logistic regression. J Prosthet Dent. 1986;55(1):116-21.
How to Cite
AL-HAMMADI, Safa; DUBAIS, Mohammed; MADFA, Ahmed. The Prevalence of Tooth Wear among a Group of Yemeni Adults.. Journal of Oral Research, [S.l.], v. 8, n. 6, p. 478-487, dec. 2019. ISSN 0719-2479. Available at: <>. Date accessed: 03 aug. 2021. doi: