UNIVERSIDADE ESTADUAL PAULISTA
“JÚLIO DE MESQUITA FILHO”
Instituto de Ciência e Tecnologia
Campus de São José dos Campos
ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2023.e3517
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Braz Dent Sci 2023 Jan/Mar;26(1): e3517
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
Conhecimentos e atitudes relacionadas ao desgaste dentário erosivo de provadores de vinho profissionais: um estudo transversal
Bethania Paludo de OLIVEIRA
1
, Marília Afonso Rabelo BUZALAF
2
, Nicole Marchioro dos SANTOS
1
,
Natália Caldeira SILVA
1
, Talita Mendes Oliveira VENTURA
2
, Jonas Almeida RODRIGUES
1
1 – Universidade Federal do Rio Grande do Sul, Departamento de Cirurgia e Ortopedia, Faculdade de Odontologia. Porto Alegre, RS, Brasil.
2 – Universidade de São Paulo, Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru. Bauru, SP, Brasil.
How to cite: Oliveira BP, Buzalaf MAR, Santos NM, Silva NC, Ventura TMO, Rodrigues JA. Knowledge and attitudes related to erosive tooth
wear of professional wine tasters: a cross-sectional study. Braz. Dent. Sci. 2023; 26(1): e3517. https://doi.org/10.4322/bds.2023.e3517
ABSTRACT
Objective: this study aimed to evaluate knowledge and attitudes of professional wine tasters about erosive tooth
wear. Material and Methods: two questionnaires were applied to 56 wine tasters during the 25th National
Evaluation of Wines - Safra 2017 in Bento Gonçalves, Rio Grande do Sul. Descriptive data analysis and the
Fisher’s exact test were performed (p < 0.05). Results: for the analysis, 56 volunteers aged 25-76 years were
included. Most of the volunteers reported attending dentist once a year (55.35%) and their teeth become sorer
after ingesting liquids or acid foods (32.14%) over time. The majority (82.14%) believe wine tasting may
have teeth effects and have already heard about erosive tooth wear (51.78%). However, when asked about
symptomatology, more than half (53.57%) reported not to know. Brushing teeth immediately after ingesting
something (37.5%) and increasing the brushing frequency (33.92%) were the most cited treatment options.
The habit of using mouthwash solutions was signicantly associated with the professionals age (p = 0.039).
Conclusion: the volunteers reported a high intake of acid substances and, although most of them reported to
consult dentist regularly and have already heard about erosive tooth wear, knowledge about this condition is
still limited among these professionals.
KEYWORDS
Attitude; Knowledge; Oral health; Wine; Professional wine tasters.
RESUMO
Objetivo: o objetivo desse estudo foi avaliar o conhecimento e as atitudes de provadores de vinho prossionais
relacionadas ao desgaste dentário erosivo. Material e Métodos: dois questionários foram aplicados a 56 provadores
de vinho durante a 25ª Avaliação Nacional de Vinhos - Safra 2017 no município de Bento Gonçalves, Rio Grande
do Sul. Foi realizada a análise descritiva dos dados e o teste Exato de Fisher (p < 0.05). Resultados: na análise
foram incluídos 56 voluntários com idade entre 25 e 76 anos. A maioria dos voluntários relatou frequentar o
dentista uma vez por ano (55,35%) e que seus dentes, com o passar do tempo, tornaram-se mais doloridos ao
ingerir líquidos ou alimentos ácidos (32,14%). Mais da metade (82,14%) acreditam que as provas de vinho podem
causar algum efeito sobre os dentes e já ouviram falar em desgaste dentário erosivo (51,78%). Porém, quando
questionados sobre a sintomatologia, a maioria (53,57%) armou não ter conhecimento. Escovar os dentes
imediatamente após ingerir algo (37,5%) e aumentar a frequência de escovação (33,92%) foram as opções mais
compreendidas como tratamento. Utilizar soluções para bochecho esteve signicativamente associado à idade dos
prossionais (p=0,039). Conclusão: provadores de vinho prossionais relataram alta ingestão de substâncias
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Braz Dent Sci 2023 Jan/Mar;26(1): e3517
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
INTRODUCTION
Some professions make their professionals
more vulnerable to the action of agents that
cause oral changes due to the functions that
the professionals perform [1]. Professional
wine tasters from all around the world have an
occupational risk: these professionals are more
likely to develop erosive tooth wear because
they have a high frequency of acidic beverage
intake [2-5].
Erosive tooth wear is dened as a chemical-
mechanical process of non-bacterial origin, in
which cumulative loss of hard tissue occurs.
The etiology may be classified as extrinsic or
intrinsic [6-9]. Intrinsic causes include the action
of endogenous acids from gastroesophageal
reux disease, rumination syndrome, alcoholism
or nervous system disorders such as anorexia and
bulimia [10].
However, the extrinsic dietary factors are
the most common etiological agents [11]. Wine,
for example, has a high erosive potential because
of their high acid content derived from their
fruits, being the tartaric and malic acid the most
abundant, its low pH, which varies from 3 to 4,
and its low concentrations of ions relevant to
hydroxyapatite, such as Ca
+2
and PO
4
-3
[5,12-15].
The consumption of wine in Brazil has shown
sharp growth. Data from the International Trade
Secretariat of the Ministry of Industry, Foreign
Trade and Services, for the period starting in
1995 to 2014, showed that Brazilian imports
of foreign wines presented a growth rate of
11.2% per year [16]. Thus, wine production also
increased in Brazil. The main producing region,
Serra Gaucha (Rio Grande do Sul), has shown
increasing sales and the number of wineries in
this area has grown from 439 in 2001 to 738 in
2009 [17]. In addition, according to data from
the International Organization of Vine and
Wine (OIV), Brazil ranked in 2012 among the
20 most important countries in the world in wine
production, occupying the 14th position [16].
With the growing rise of the wine industry
in Brazil, it is necessary to pay attention to
the health of professionals involved in these
processes, because professional wine tasters are
very susceptible to the negative effects of wine
on oral health [18]. During the tasting, the wine
is sipped and rinsed for a time that can vary from
six to 60 seconds, increasing the risk of erosive
tooth wear among professionals [4,13]. In the
long term, the effects of erosive tooth wear may
include tooth sensitivity, tooth yellowing and
pulp necrosis in more severe cases [11,18-20].
Therefore, it is important for dental professionals
to be able to diagnose the condition as early as
possible to identify the possible etiology and
establish appropriate treatment according to the
patient’s prole [21].
It is highlighted the importance of the
patient’s education about the etiology and
consequences of the erosive tooth wear to the
control and management of this process [22,23].
The main strategy to be adopted is the elimination
of the etiological agent through orientation and
awareness about the causes [19,24]. However, it
is known that the elimination of this causal agent
is often difcult to achieve, either for medical,
psychological, social or occupational reasons.
The first stage in any behavior change
program is to assess and understand the internal
and external conditions that affect how an
individual thinks or acts [25]. Thus, the aim of
this study was to evaluate attitudes related to
oral hygiene, eating and occupational habits, as
well as the knowledge of professional wine tasters
related to erosive tooth wear.
MATERIALS AND METHODS
This quantitative, descriptive and cross-
sectional study, whose volunteers were
professional wine tasters, was conducted in
accordance with the 1964 Helsinki Declaration
and it was approved by the local Human Research
and Ethics Committee (#2.024.551). To be
volunteers of this study, 120 professional wine
ácidas e, embora a maioria consulte pelo menos uma vez por ano o dentista e já tenha ouvido falar a respeito
do desgaste dentário erosivo, o conhecimento sobre essa condição ainda é limitado entre esses prossionais.
PALAVRAS-CHAVE
Atitudes; Conhecimento; Saúde oral; Vinho; Provadores de vinho prossionais.
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Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
tasters who participated of the 25th National
Wine Assessment - 2017 Harvest, in Bento
Gonçalves, Rio Grande do Sul, Brazil, were
invited. This event was organized by the Brazilian
Association of Oenology to professional wine
tasters from all over Brazilian states.
After the consent and signature of the
professionals who agreed to participate in
the study, the volunteers answered two
questionnaires used as a tool for data collection.
The rst questionnaire was elaborated by the
researchers to complement data referring
mainly to the overall health of the professional
wine tasters and their eating and oral hygiene
habits. The second questionnaire applied was
a structured and validated questionnaire [26].
This questionnaire contained information on
gender, age, education level and monthly
individual income. In addition, participants also
answered questions about medical history, oral
hygiene, eating and occupational habits. Medical
issues included information about the presence
of systemic diseases, gastroesophageal reux,
rumination syndrome, alcoholism or nervous
system disorders such as anorexia and bulimia.
Regarding eating habits, the number of daily
meals, the frequency and quantity of foods and
beverages that are commonly associated with
erosive tooth wear (such as orange, lemon and
apple juices, carbonated drinks and acidic fruits)
were evaluated. Concerning oral hygiene habits,
participants answered questions regarding the
frequency of dental appointments, number of
daily tooth brushing, interval from the last visit
to the dentist and the items used to perform
oral hygiene, as well as the type of brush.
Regarding occupational information, the time
(in years) working as wine tasters, frequency,
quantity and duration of wine tasting sessions
per week and oral hygiene habits after tasting
were evaluated. Knowledge about erosive tooth
wear has been analyzed with questions about
symptomatology, treatment, whether they
already have heard about erosive tooth wear,
whether they believe wine tasting can affect the
teeth and whether erosive tooth wear may be the
same as dental caries. The participants received
a brief explanation about signs and symptoms
of the erosive tooth wear in the second part of
the second questionnaire, so that they could
proceed with the questionnaire, answering
questions regarding the self-perception of signs
and symptoms, as well as the age at which this
perception occurred and what they would do to
confront this problem.
Statistical analysis
All data were analyzed descriptively. Fisher’s
Exact test was used to assess the relationship
between gender and age with frequency of dental
appointments, to rinse water after wine tastings,
oral hygiene frequency, to use mouthwash, to
perform oral hygiene after wine tastings, to
believe that erosive tooth wear and dental caries
are the same conditions and if the professional
has heard about erosive tooth wear. The variables
chosen were those considered the most clinical
relevance by the researchers and could be
categorized for the test application. The SPSS
software (IBM SPSS Statistics 20.0) was used,
and the level of statistical signicance was set
at p < 0.05.
RESULTS
Participated in the study 56 professional
wine tasters (47 men and 9 women). The median
and mean age were 39 and 42.25, respectively.
The majority (80.35%) had completed higher
education, 14.28% had completed high school
and 5.36% showed incomplete higher education.
Most of the participants reported having individual
monthly income exceeding seven minimum
wages (44.62%), followed by incomes between
three to ve (21.4%), ve to seven (17.8%) and
one to three minimum wages (14.28%).
Regarding the frequency of dental
appointments (Figure 1), more than half
(55.35%) reported going to the dentist at least
once a year, 16.07% said going twice, 14.28%
said going three or four times, 7.14% stated ve
times and a minority (5.36%) reported attending
less than once a year. Half of the professionals
reported that their last dental appointment was
less than six months ago, while 37.5% had last
gone in a period ranging from six to 12 months,
over a year ago (5.36%) and another small
portion did not respond (7.14%). Most reported
performing oral hygiene three times a day
(60.71%), followed by those who perform twice
(19.64%), once (12.5%) or more than three
times a day (7.14%). Toothbrush (96.42%) and
fluoride toothpaste (91.07%) are items used
by almost all professionals. In addition, some
reported to use mouthwash solutions (30.35%),
dental oss (21.42%), interdental brushes (3.6%)
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Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
and only one reported to use unituft brush.
About the bristles of the toothbrush, almost
half (48.21%) use soft bristle brushes, medium
bristles (33.92%), extra soft bristles (5.36%),
some volunteers could not inform the type of
bristles (12.5%) and only one of them reported
to use a hard bristle brush.
The majority (51.78%) of professionals
have heard of erosive tooth wear, while 44.64%
said they had never heard and two did not know
or had difficulty to respond (Figure 2). Most
(78.5%) answered to know that erosive tooth
wear is not the same as dental caries, while
two volunteers have confused these conditions.
Regarding the erosive tooth wear symptoms, most
of the volunteers (53.57%) answered that they do
not possess the knowledge of it. However, other
volunteers reported to believe that the sensation
of pain or sensitivity when drinking hot and
cold beverages or eating acidic or sweet foods
(28.57%), teeth with thinner edges (19.64%),
with fractures on the dental edges (10.7%),
yellow teeth (7.14%) or smoother and shinier
dental surfaces (1.78%) are symptoms caused
by erosive tooth wear (Figure 3). In order to
confront the symptoms of the erosive tooth wear,
a great number of professionals (71.42%) stated
that they would go to a dental appointment,
some professionals would brush their teeth
more often (25%), have regular dental revisions
(19.64%), decrease their acids intake (10.7%),
change toothpaste (10.7%), brush their teeth
immediately after eating something (8.92%),
decrease their intake of beverages or foods that
cause sensitivity (5.36%) and use dental oss,
do dental prophylaxis and a tooth whitening
(3.57%).
About the treatment of erosive tooth wear,
most professionals believe that brushing their
teeth immediately after eating something
(37.5%) or increasing the frequency of teeth
brushing (33.92%) is the most appropriate.
Others did not know or had difculty to answer
this question (30.35%) and only one professional
believes that brushing their teeth harder is ideal,
while 12.5% believed that none of the proposed
options was suitable as a treatment for erosive
tooth wear (Figure 4).
When they were asked if the wine tasting
can cause any effect on teeth, most participants
(82.14%) answered that there is a relationship
between wine and dental changes (Figure 5).
About the changes that may occur, 13 reported
“teeth darkening”, 11 reported “tooth sensitivity”,
8 reported “presence of dental stains”, 7 reported
“yellow teeth”, 5 reported “erosive tooth wear”,
3 reported “presence of dental calculus”, 2 people
reported “corrosion”, one volunteer related
“aesthetic problems” and another volunteer
“temporary darkening”.
Almost all participants (96.42%) reported
having had dental caries or having had their
teeth restored at some time of their lives. When
they compare their current dental condition
Figure 1. Number of dental appointments per year by professional
wine tasters.
Figure 2. Professional wine tasters responded if they have ever
heard about erosive tooth wear.
Figure 3. Professional wine tasters responded what are the
symptoms of erosive tooth wear.
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Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
to when they were younger, participants
reported that their teeth are more yellowed
(48.2%) and more sensitive and painful when
drinking cold or hot liquid or eating acidic
and/or sweet foods (32.14%). Furthermore,
other participants answered that their teeth
currently have fractures on the dental edges
(30.35%), thinner dental edges (25%) and
more brightness and smoothness (5.36%). Only
14.28% of the volunteers reported not having
noticed any of the situations listed (Figure 6).
In the second part of the rst questionnaire,
participants received a brief explanation about
the signs and symptoms of erosive tooth wear.
Regarding them, some participants (30.35%)
do not know or do not remember the age when
they first noticed these signs and symptoms.
Others noticed that the rst symptoms appeared
between 31 and 40 years old (23.21%), 21 and
30 years old (16.07%), 20 years old or younger
(8.92%), between 41 and 55 years old (7.14%)
and 14.28% did not answer this question.
Regarding signs and symptoms, when
the professionals were asked if they were
currently presenting the following conditions,
the percentage of answers were yellowed
teeth (46.4%), with fractures on the dental
edges (39.28%), with thinner dental edges
(33 9%), reduced in size due to erosive tooth
wear (23.21%) or smoother and brighter tooth
(5.36%). Only three professionals are not
concerned with these signs and symptoms.
Most professionals (82.14%) reported to
have three daily meals (breakfast, lunch and
dinner) and 12.5% two meals (lunch and dinner).
Among these main meals, they also reported
eating snacks, fruits, desserts, or drinking other
types of beverages, besides water or tea, once or
twice a day (35.78%), three or four times a day
(32.14%), ve or six times a day (19.64%) and
more than seven times a day (7.13%). When they
are not working, all participants reported daily
wine consumption, fruit juice (87.5%), sparkling
wine (85.7%), citrus fruits (75%) and soft drinks
(25%) (Figure 3).
Regarding their health condition, two
participants reported: “reasonable”, “good” or
“very good” (96.4%). Most professionals (78.6%)
reported not having a systemic disease or using
continuous medication (64.3%). None of them
reported to have bulimia, but two reported
alcoholism disease and rumination syndrome.
Gastroesophageal reux disease was reported by
seven professionals.
The professional wine tasters hold in median
three wine tasting sessions per week lasting in
median one hour and 30 minutes each. Almost
all participants (87.48%) have been working as
professional wine tasters for at least 10 years
(median working time 19.4 years). After wine
tasting, almost half (46.42%) do not perform
any type of oral hygiene, others rinse with water
Figure 6. Professional wine tasters responded about self-perceived
dental changes over time.
Figure 4. Professional wine tasters responded what are treatment
options for erosive tooth wear.
Figure 5. Professional wine tasters responded if the wine tasting
may affect their teeth.
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Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
(44.64%) or brush with toothpaste (14.2%).
The alternatives in the question regarding the
use of fluoride mouthwash, dental floss and
brushing without toothpaste were marked by one
participant each (Figure 3).
No significant correlation was observed
between gender of the professional with
the following variables: frequency of dental
appointments, rinsing water after wine tastings,
using mouthwash, oral hygiene frequency and
performing oral hygiene after wine tastings
(p > 0.05) (Table 1). Regarding the use of
mouthwashes during oral hygiene, it was
observed that younger professionals (< 41 years
old) usually use them more frequently than
older professionals (p = 0.039). However, no
significant correlation was observed between
age and frequency of dental appointments, if the
professional has heard about erosive tooth wear,
rinsing water after wine tastings, oral hygiene
frequency and performing oral hygiene after wine
tastings (p > 0.05) (Table 2).
DISCUSSION
In the last years, according to OIV statistical,
the global consumption of wine has been increased
and, particularly in Brazil, there is no study to
date, which assessed knowledge and attitudes
of wine tasters. The questionnaires applied in
this study addressed questions regarding the
perception of signs and symptoms that may
be related to erosive tooth wear. However, it
was not the aim of this study to evaluate the
prevalence of erosive tooth wear in professional
wine tasters. In the literature, this relationship
is already reported in studies that show a higher
prevalence of erosive tooth wear in professional
wine tasters [3-5,14].
In our sample, the median working time was
19.4 years. Previous studies have already reported
the relationship between prevalence and severity
of erosive tooth wear lesions with the number of
years exerting the profession [3,5,18]. Besides,
the wine tasters reported to do in average three
wine tasting sessions per week. However, when
they are not working the consumption of other
acidic substances is also high. All participants
reported consuming wine daily and fruit juice
consumption was reported by 87.5%, as well as
sparkling wines (85.7%) and citrus fruits (75%).
A similar result was found in a study conducted
in Sweden with 14 professional wine tasters with
erosive tooth wear, in which, after the analysis of
their 7-day food plan, the authors noted that 12 of
them reported consuming citric fruits and wine
during dinner every day [5]. Thus, professional
wine tasters are often exposed to the action
Table 1 - Relationship between gender and oral hygiene habits
Frequency of dental
appointments
Rinse water after
wine tastings
Use mouthwash
Oral hygiene
frequency
Perform oral
hygiene after
wine tastings
1x/year
2x/year or
more
Yes No Yes No
Up to 2x/
day
3x/day or
more
Yes No
Female 28 19 20 10 16 31 18 29 23 24
Male 6 3 11 15 1 8 1 8 6 3
Total 34 22 31 25 17 39 19 37 29 27
Homogeneous variables (p > 0.05). Fisher’s exact test.
Table 2 - Relationship between age, oral hygiene habits and if the professional wine taster have heard about erosive tooth wear
Frequency of
dental
appointments
Have you ever
heard about
erosive tooth
wear?
Rinse water
after wine
tastings
Use mouthwash*
Oral hygiene
frequency
Perform oral
hygiene after
wine tastings
1x/year
2x/year
or more
Yes No Yes No Yes No Yes No Yes No
< 41 years 22 13 17 18 20 10 14 21 12 23 18 17
≥ 42 years 12 9 12 9 11 15 3 18 7 14 11 10
Total 34 22 29 27 31 25 17 39 19 37 29 27
*Statistically significant p = 0.039. Other homogeneous variables (p> 0.05). Fisher’s exact test.
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Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
of non-bacterial acids in the oral cavity, even
when they are not working leading their dental
surfaces, when in prolonged contact with low pH
substances, to erosive tooth wear [2].
In our study, the professionals reported
that wine tasting sessions usually last one hour
and 30 minutes and they taste different types of
wines. In a study in Norway, it was found that
tasters usually taste 20 to 40 wines per session.
Each wine is held in the mouth for about six
seconds and during this time the wines are
rinsed to stimulate the taste buds before they
are swallowed or expelled [4]. This long and
frequent exposure to low-pH beverages increases
the probability of erosive tooth wear compared
to rapidly swallowed beverages [27].
The majority of wine tasters reported to go
regularly to the dentist (55.35% once a year and
37.49% twice or more) and more than half of the
sample reported to believe that wine tasting could
have some effect on teeth (82.14%), heard about
erosive tooth wear (51.78%) and observed dental
changes in themselves over time. However, these
conditions did not mean knowledge about erosive
tooth wear, since most volunteers (53.57%)
reported not to know the symptoms of erosive
tooth wear and that the most reported treatment
options as being the increasing of the frequency
of brushing (33.92%) and brushing the teeth
immediately after eating some acidic food or
drink (37.5%). However, in the literature, the
ideal time to tooth brush after the consumption
of acidic substances is controversially discussed.
In the literature, some studies indicate that
saliva minimizes erosive tooth wear due to its
capacity for tamponade, remineralization and
acquired pellicle formation [28,29]. The acquired
pellicle would be able to protect dental tissues
by acting as a barrier, preventing direct contact
between acids and the tooth surface [30]. Thus,
some authors recommend that patients at high
risk for erosive tooth wear wait 30 to 60 minutes
to perform tooth brushing after eating acidic
foods or beverages [9]. However, there are
in situ
studies that have not found a signicant effect
of saliva on demineralization processes [31,32].
Thus, it is currently discussed in the literature
to delay tooth brushing after ingesting acidic
substances is not as effective preventive measure
as it is usually recommended, because the
demineralized dental surface with the effect of
acids will be eroded by soft tissue action (tongue,
cheek or occlusal contacts), even in the absence
of brushing [33,34]. However, regardless of
when tooth brushing will be performed, the
recommendation is to always do it with a soft or
extra-soft toothbrush and uoride toothpaste [35].
Sugar-free chewing gum may also be indicated
because it increases salivary ow and collaborates
with tissue remineralization [36].
After the wine tastings, part of the
professionals (46.42%) said they do not realize
oral hygiene and another portion (44.64%)
reported rinse their mouth with water. After
consume of low pH substances is recommended
to rinse their mouth with water because the water
contributes to the neutralization of acids in the
oral cavity [36]. Therefore, all professional wine
tasters should be encouraged to develop this
habit after tasting. Our ndings suggest that in
older professionals this encouragement should be
done even more closely, as these tasters were less
likely to adopt the preventive habits, considering
that the use of mouthwash was reported less
frequently by them (p = 0.039).
Fluoride toothpastes, fluoride varnishes,
uoride gels and uoride solutions have been
reported as preventive strategies because
the fluoride is able to increase the enamel
resistance to acid dissolution [37]. Although
erosive tooth wear is an aggressive process, the
knowledge about the best strategy for uoride
application to prevent or control the process
is still debated [35]. Thus, different fluoride
formulations and different commercial vehicles
are being studied for a more effective preventive
action. In the literature,
in situ
studies have
already shown the benecial of stannous uoride
toothpastes and mouthwashes in reducing tissue
loss involved in erosive processes [38,39].
Besides, an
in vitro
study compared toothpastes
with 1.100ppm and 5.000ppm sodium uoride
and indicated an additional preventive action of
26% and 53% respectively when compared to
placebo toothpaste [40]. However, the systematic
reviews currently available in the literature also
indicate the low evidence of the use of uorides,
delivered as varnishes, dentifrices and other
remineralizing agents, for the prevention and
management of erosive tooth wear [41].
Our outcomes, as well as in other studies in
literature, evidence a general lack of knowledge
among professionals regarding erosive tooth
wear. Thus, it is necessary to discuss that these
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Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
findings may indicate that there is a lack of
awareness among dentists about the diagnosis
and etiological factors associated with the
erosive tooth wear, as well as the transmission
of knowledge from professional to patient.
A previous study reported that seven of nine wine
tasters with erosive tooth wear and had gone to
the dentist in a short time were not informed
about the presence of this condition, although
in ve of them the lesions already compromised
dentine tissue [4]. Besides that, other study
reported that only one of 19 professional wine
tasters had been informed by his dentist that the
erosive lesions would probably be associated with
occupational exposure [5]. In fact, the diagnosis
and identication of etiological factors are not so
simple to do, considering that erosive tooth wear
involves a series of additional modifying factors
and usually occurs simultaneously with dental
abrasion and attrition [30]. However, the dentist
should be aware of these changes when dealing
with professionals who are exposed to various
occupational risks, considering that management
and non-progression of the condition become
more difcult to achieve.
This discussion about the oral health of
professionals, although important, has been little
studied [1]. Professional wine tasters are a risk
group to develop erosive tooth wear, but they
do not have a clear understanding about the
process. Knowledge in oral health is considered
an essential prerequisite for health-related
behavior. People who are able to assimilate
health knowledge have a greater sense of
personal control over their oral health and are
more likely to adopt self-care practices [42].
Thus, it is important to increase the knowledge
production with this theme to implement more
effective programs aimed to professionals’ health.
Therefore, although our sample is limited, our
results seek to stimulate the development of
further studies in this important area of oral
health care, which is sometimes neglected.
Therefore, dentists must be aware of the
occupational risks that certain professionals
are submitted. Thus, preventive strategies
focused on different population groups can be
properly addressed during the management
of these patients. To the non-advancement
and/or prevention of erosive tooth wear in
professional wine tasters is important that the
dentist identies these professionals and explains
to them about the occupational risk that they are
submitted. Dietary advice, uoride application
and encouragement of proper oral hygiene with
the use of soft toothbrush, controlled brushing
force and uoridated toothpaste are preventive
measures that may be adopted.
CONCLUSIONS
Oral health education is fundamental to
help the population understand the diseases
and changes that affect their oral cavities.
Comprehensive knowledge of different risk and
protective factors is an essential prerequisite for
proper prevention and control measures.
Professional wine tasters are part of a group
more likely to develop erosive tooth wear. These
professionals reported high ingestion of acidic
substances, even when they are not working.
However, while the majority go to the dentist at
least once a year and have heard about erosive
tooth wear, knowledge about this condition is
still limited among these professionals.
Author’s Contributions
BPO, NMS, NCS, TMOV: Conceptualization.
BPO, NMS, NCS, TMOV: Methodology. BPO,
NMS, NCS, TMOV: Software. BPO, NMS, NCS,
TMOV: Formal Analysis. BPO, NMS, NCS, TMOV:
Investigation. BPO, NMS, NCS, TMOV: Resources.
BPO, NMS, NCS, TMOV: Data Curation. BPO:
Writing – Original Draft Preparation. BPO, NMS,
NCS, TMOV: Writing – Review & Editing.
MARB, JAR: Supervision. MARB, JAR:
Project Administration.
Conict of Interest
No conicts of interest declared concerning
the publication of this article.
Funding
The authors declare that no nancial support
was received.
Regulatory Statement
This study was conducted in accordance with
all the provisions of the local human subjects
oversight committee guidelines and policies of:
9
Braz Dent Sci 2023 Jan/Mar;26(1): e3517
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
Local Human Research and Ethics Committee.
The approval code for this study is: 2.024.551.
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professional wine tasters: a cross-sectional study
Oliveira BP et al.
Knowledge and attitudes related to erosive tooth wear of professional wine tasters: a cross-sectional study
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Knowledge and attitudes related to erosive tooth wear of
professional wine tasters: a cross-sectional study
Date submitted: 2022 May 20
Accept submission: 2022 Aug 09
Bethania Paludo de Oliveira
(Corresponding address)
Universidade Federal do Rio Grande do Sul, Departamento de Cirurgia e Ortopedia,
Faculdade de Odontologia, Porto Alegre, RS, Brasil.
Email address: be.p.o@hotmail.com
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