Evaluating Knowledge, Attitudes and Practices regarding Dental Erosion among Tunisian Dental Partitioners.

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Published Jan 22, 2026
https://doi.org/10.62438/tunismed.v103i11.5638
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Vol. 103 No. 11 (2025): Tunis Med Nov 2025

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Linda Ayedi
Fixed Prosthetic Department, Dental Clinic of Monastir, Faculty of Dental Medicine of Monastir, University of Monastir, Monastir, Tunisia.
Hanen Boukhris
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.
Taha Yessine
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.
Cyrine Jebali
Fixed Prosthetic Department, Dental Clinic of Monastir, Faculty of Dental Medicine of Monastir, University of Monastir, Monastir, Tunisia.
Sihem Hajjeji
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.
Nouha Mghirbi
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.
Hayet Hajjemi
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.
Souha Ben Youssef
Department of Dental Medicine, Farhat Hached University Hospital, Faculty of Dental Medicine, University of Monastir, Sousse, Tunisia.

Abstract

Introduction. Dental erosion is characterized by the irreversible loss of tooth structure due to non-bacterial acids. Despite its prevalence, the level of awareness and understanding among dental practitioners remains unclear, particularly in Tunisia.


Aim. This study aimed to assess the Knowledge, Attitudes, and Practices of dental practitioners in Tunisia regarding the causes, risk factors, symptoms, and management of dental erosion.


Methods. A cross-sectional, descriptive, observational and analytical study conducted over 12 months (January 2024 to January 2025) among dental practitioners in Sousse, Tunisia, working in both public and private sectors. The target population included licensed private dentists, hospital-university practitioners, dental residents, and thesis-level dental students, selected through convenience sampling across dental offices and university hospitals. Data were collected using a structured, self-administered 21-question online questionnaire developed from literature and expert input, and validated through a pilot study. The survey assessed demographic data, theoretical knowledge, attitudes through clinical case scenarios, and professional practices regarding dental erosion. Statistical analysis was conducted using SPSS version 19, employing descriptive statistics, t-tests, Chi-square tests, ANOVA, Fisher’s exact test, and Pearson correlation, with significance set at p < 0.05.


Results. The study revealed a significant lack of knowledge among dental practitioners regarding the etiology, symptoms, and prevalence of dental erosion, as indicated by statistically significant p values. Furthermore, the majority of practitioners demonstrated an inadequate attitude towards dental erosion management, with 64.40% showing insufficient understanding or approach in clinical scenarios. Additionally, most practitioners neither implemented preventive measures nor utilized ...( Abstract truncated at 250 words).

Keywords:

Attitudes, Dentists, Health Knowledge, Practice, Tooth Erosion

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Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. - Hermont AP, Oliveira PA, Martins CC, Paiva SM, Pordeus IA, Auad SM. Tooth erosion and eating disorders: a systematic review and meta-analysis. PLoS One. 2014;9:e111123.
  2. - Tulek A, Mulic A, Runningen M, Lillemo J, Utheim TP, Khan Q, Sehic A. Genetic aspects of dental erosive wear and dental caries. Int J Dent. 2021;2021:5566733.
  3. - Pace F, Pallotta S, Tonini M, Vakil N, Bianchi Porro G. Systematic review: gastro-oesophageal reflux disease and dental lesions. Aliment Pharmacol Ther. 2008;27:1179–86.
  4. - Schlueter N, Luka B. Erosive tooth wear—a review on global prevalence and on its prevalence in risk groups. Br Dent J. 2018;224:364–70.
  5. - Naim S, Spagnuolo G, Osman E, Mahdi SS, Battineni G, Qasim SSB, Cernera M, Rifai H, Jaafar N, Maalouf E, et al. Quantitative measurements of the depth of enamel demineralization before and after bleach: an in vitro study. BiomedRes Int. 2022;2022:2805343.
  6. - Schmidt J, Huang B. Awareness and knowledge of dental erosion and its association with beverage consumption: a multidisciplinary survey. BMC Oral Health. 2022;22:35.
  7. - Malekzadeh M, Nosrati M, Maleki D. Assessment of dental students’ knowledge of tooth wear: diagnosis, prevalence and treatment. J DentomaxillofacRadiol Pathol Surg. 2018;7:123–8.
  8. - Schmidt J, Huang B. Awareness and knowledge of dental erosion and its association with beverage consumption: a multidisciplinary survey. BMC Oral Health. 2022;22:35.
  9. - Barret JP, Nygren G, Carmona A, et al. Dental erosion: prevalence, risk factors and management. Eur J Oral Sci. 2009;117(5):567–76.
  10. - Piotrowski B, Schlueter N, Cieslik-Biskup J, et al. Prevalence and risk factors for dental erosion in children and adolescents: a systematic review and meta-analysis. Eur J Oral Sci. 2018;128(1–2):1–17.
  11. - Lavigne AM, Ganssler A, Roulet JP, et al. Impact of dental erosion on quality of life in young adults. J Clin Exp Dent. 2016;8(6):e409–14.
  12. - Yap AK, Galloway JL, Amaechi BU. Dental erosion: a review of the causes, clinical characteristics, and management. J Contemp Dent. 2014;5(2):129–37.
  13. - Tsakos G, Koutris S, Potamianos P, et al. Dental erosion: a comprehensive review of its management and prevention. Int J Dent. 2016;2016:1–13.
  14. - Chouchene F, Djait A, Masmoudi F, et al. Pediatricians' knowledge, attitude, and practice toward early childhood caries in Tunisia. J South Asian Assoc Pediatr Dent. 2020;8(1):45–50.
  15. - Amaechi BU. Dental erosion: trends in prevalence, risk factors, and management strategies. J Clin Exp Dent. 2022;14(3):317–23.
  16. - Cieslik-Biskup J, Schlueter N, Fazal N, et al. Dental erosion in children and adolescents: global prevalence, risk factors and management recommendations. Eur Arch Paediatr Dent. 2023;24(1):1–17.
  17. - Tsmilek A, Michalikova D, Poliansky O, et al. Dental erosion: a review of diagnostic methods, risk factors, and treatment modalities. Int J Dent. 2022;2022:1–12.
  18. - Yap AK, Chuang SK, Luo W, et al. Management of non-carious tooth wear: a review of the literature. Int J Dent. 2022;2022:1–15.
  19. - Silva-Soares M, Figueiredo R, Romeu A, et al. Dental erosion in children and adolescents: a systematic review of management strategies. Clin Oral Res. 2023;30(3):317–34.
  20. - Bartlett DW. The role of erosion in tooth wear: etiology, prevention and management. Int Dent J. 2013;55(4 Suppl 1):277–83.
  21. - Lussi A, Carvalho TS. Erosive tooth wear: From diagnosis to therapy. Monogr Oral Sci. 2018;28:184–90.
  22. - Bonanomi M. Management of dental erosion: A review of current approaches and recommendations. IAPD Foundational Articles and Consensus Recommendations: Management of Dental Erosion, 2020.
  23. - Mohammed A, Dusara K. What is the role of topical fluoride application in preventing dental erosion? Evid Based Dent. 2013;14:59–62.
  24. - Lussi A, Carvalho TS. Erosive tooth wear: a multifactorial condition of growing concern and increasing knowledge. Monogr Oral Sci. 2014;25:1–15.
  25. - Wiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials—fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dental Materials: Official Publication of the Academy of Dental Materials. 2007;23(3):343–362.
  26. - da Silva BM, Rios D, Foratori-Junior GA, Magalhães AC, Buzalaf MAR, Peres SCS, Honório HM. Effect of fluoride group on dental erosion associated or not with abrasion in human enamel: a systematic review with network meta-analysis. Arch Oral Biol. 2022;144:105568.
  27. - Aranguiz V, Lara JS, Marro ML, O’Toole S, Ramirez V, Bartlett D. Recommendations and guidelines for dentists using the Basic Erosive Wear Examination index (BEWE). Br Dent J. 2020;228:153–7.
  28. - Bartlett D, Dattani S, Mills I, Pitts N, Rattan R, Rochford D, et al. Monitoring erosive tooth wear: BEWE, a simple tool to protect patients and the profession. Br Dent J. 2019;226:930–2.
  29. - Meurman JH, ten Cate JM. Pathogenesis and modifying factors of dental erosion. Eur J Oral Sci. 1996;104(2 Pt 2):199–206.
  30. - Loomans B, Opdam N, Attin T, Bartlett D, Edelhoff D, Frankenberger R, et al. Severe tooth wear: European consensus statement on management guidelines. J Adhes Dent. 2017;19:111–9.
  31. - Vailati F, Belser UC. Full mouth adhesive rehabilitation of a severely eroded dentition: the three step technique. Part I. Eur J Esthet Dent. 2008;1:58–72.
  32. - Sartawi S, Salim NA, Taim D. Awareness and treatment decisions on tooth wear among Jordanian dentists and prosthodontists: a cross-sectional survey study. Int J Dent. 2020;2020:8861266.
  33. - Marinho VS, Geraldes RF, Romito AR, Marchesan M, Mauloa MA. Prevalence and risk factors for dental erosion in Brazilian adults. Caries Res. 2016;50(2):189–96.