Prevalence, severity and associated factors of erosive tooth wear among 18-39-year-old adults residing in five cities in China

Erosive tooth wear (ETW) has garnered increased attention within the dental community and is now widely recognized by oral health professionals, owing to its rising prevalence and clinical significance. Epidemiological data on ETW in China remain scarce. The aim of this study was to estimate the prevalence, severity and associated factors of erosive tooth wear among 18-39-year-old adults residing in five cities in China. A cross-sectional study was conducted among adults residing in five major cities (Shanghai, Guangzhou, Wuhan, Chengdu and Xi’an) in China. An equal-sized, stratified, multistage sampling was used. ETW was clinically assessed using the Basic Erosive Wear Examination (BEWE) index. Participants were required to complete a self-administered questionnaire, consisting of sociodemographic information, oral health care behavior, dietary habits, and general/oral health history. Statistical analyses included descriptive statistics, univariable logistic regression, and multivariable binary logistic regression to identify factors associated with ETW. A total of 3,405 adults (47.9% male), aged 18 to 39 years, with a mean age of 29.0 years (standard deviation:6.3 years) were included in the oral examination and questionnaire. The prevalence of ETW (defined as having at least one tooth with a BEWE ≥ 2 on any surface) was 63.7% (95% CI: 62.2%-65.3%) among these adults. Most participants (56.7%) had a BEWE score sum ≤ 8, while 7.8% had a BEWE sum > 13, indicating severe hard tissue loss. Multivariable logistic regression showed that sex, age, daily alcohol consumption and city of residence were independently associated with ETW ( p < 0.05); other dietary and behavioural variables did not show independent associations after adjustment. Erosive tooth wear is prevalent among 18-39-year-old adults residing in five studied Chinese cities. The findings indicate that demographic (age, sex, city of residence) and daily alcohol consumption are associated with ETW. Severe hard tissue loss was observed in a notable subset of participants, underscoring the need for early detection and risk-based preventive management.