ORAL HEALTH-RELATED QUALITY OF LIFE AND RISK FACTORS IN PATIENTS WITH TOOTH WEAR

Abstract

 The aim of this study was to determine the association between the degree of erosive tooth wear, measured by Basic Erosive Wear Examination (BEWE) index, and daily habits and behavior, quality of life and psychosocial conditions related to oral health. Material and method: The study included 259 participants aged between 35 and 65 years, divided into three groups according to the degree of tooth wear: 1. patients with diagnosed non-carious lesions with BEWE stage 2, 2. patients with BEWE stage 3 and 3. control group - persons without erosive or other forms of oral pathology. Data collection was carried out during routine dental visits in 2025 at the University Dental Clinical Center "St. Panteleimon" in Skopje. After the dental examination, participants were asked to complete three questionnaires: the OHIP-MAK-14 structured questionnaire, which is used to measure oral health-related quality of life (OHRQoL), the Disease Behavior and Knowledge Questionnaire, and the Perceived Stress Scale (PSS). All data were then analyzed using the Statistical Package for the Social Sciences (SPSS), version 26. Results: Patients with more severe erosion reported greater consumption of certain acidic products, especially alcoholic beverages and lozenges, with the difference that the BEWE 3 group consumed more alcohol, while the BEWE 2 group consumed more lozenges. The patients' awareness of erosive lesions was highest in the BEWE 2 category and lowest in the control group. Oral hygiene maintenance was the weakest in the severe erosion group, and when choosing a toothbrush, especially the use of hard brushes, it was more common in patients with erosive lesions. Patients with a higher degree of erosion than BEWE stage 3 had a higher prevalence of bruxism, higher perceived stress and poorer oral health-related quality of life. These results highlight a clear trend: as the severity of erosive lesions increases, so does the reported effect on quality of life. The present findings indicate a consistent and significant association between the severity of erosive tooth wear, as measured by the BEWE, and a wide range of behavioral, psychosocial, and oral health-related outcomes. Conclusion: All dietary and behavioral factors showed clear gradients consistent with erosion severity, suggesting that erosive tooth wear is multifactorial and not attributable to a single dietary or behavioral source. Future studies should aim to include more respondents, preferably with age-balanced subgroups.

Keywords: non-carious dental damage, risk factors, quality of life, public health in dentistry.