Relationship between noncarious cervical lesions, cervical dentin hypersensitivity, gingival recession, and associated risk factors: A cross-sectional study

Abstract

Objectives: The aim of this study was to evaluate the risk factors associated with noncarious cervical lesions (NCCLs), cervical dentin hypersensitivity (CDH), and gingival recession (GR), besides the relationship among these conditions in a specific Brazilian sample population.

Methods: 185 patients who attended the "Ambulatory Program for Rehabilitation of Patients with Noncarious Cervical Lesions and Cervical Dentin Hypersensitivity" were evaluated, and 5180 teeth were analyzed. The subjects filled out a form and a calibrated examiner performed the clinical exams to determine the presence of NCCLs, CDH, and GR. NCCLs were classified according to their morphology and depth, CDH levels were evaluated according to air stimuli response, and GRs were categorized according to Miller's classification. The association of the risk factors with NCCLs, CDH, and GR was determined with the Mann-Whitney U test and multiple linear regression. For the correlations, the Spearman test was used with a 95%-confidence level.

Results: The NCCLs, CDH, and GR distributions within the study were 88.1%, 89.1%, and 59.4%, respectively. Maxillary premolars were the most affected by all three conditions. A positive correlation was found between age, NCCLs, and GR; between NCCLs and CDH; CDH and GR; GR and NCCLs. Age, gender, oral hygiene, gastroesophageal diseases, and occlusal trauma were significantly associated with the presence of all three conditions.

Conclusions: The NCCLs and GR distributions increased with age; NCCLs, CDH, and GR had positive correlation; the lesions' depth and morphology contributed to high levels of sensitivity and severity of recessions; age, gender, gastric disease, and occlusal trauma were relevant factors for the occurrence of NCCLs, CDH, and GR.

Clinical significance: The increasing distribution of NCCLs, CDH, and GR is closely associated with people's lifestyles. Thus, it is important for the clinicians to recognize the etiological factors and their most relevant associations to prevent and control such alterations, in order to improve the population's quality of life.

Keywords: Cervical dentin hypersensitivity; Cross-sectional studies; Epidemiology; Gingival recession; Non-carious cervical lesions; Prevalence.