Are dental patients able to perceive erosive tooth wear on anterior teeth? An internet-based survey assessing awareness and related action

Micah B. Goldfarb, Anderson T. Hara, Adam T. Hirsh, Joana C. Carvalho, Gerardo Maupomé

Research output: Contribution to journalArticle


Background: Erosive tooth wear (ETW) is irreversible loss of dental hard tissue. The authors examined patients’ ability to recognize ETW relative to sound teeth and teeth with caries. Methods: Using Amazon's crowdsourcing service, the authors recruited participants (N = 623) to view standardized images of buccal surfaces of teeth (sound, ETW, or caries). Participants reported whether a dental condition existed (yes or no), likelihood to seek care, and esthetic attractiveness for teeth with no, initial, moderate, or severe signs of ETW or caries. Results: Dental patients showed poor recognition of cases of ETW, especially compared with sound and caries-affected teeth at each level of severity. Patients were less likely to schedule a dental appointment for care or treatment of teeth with ETW than for teeth with caries at each level of severity. Patients also found ETW more esthetically attractive than caries at each level of severity and found initial ETW more attractive than sound teeth. Conclusions: Dental patients struggle to recognize ETW, in general and compared with caries, at each level of severity and particularly for early stages of ETW. These recognition difficulties likely arise, in part, from tooth esthetic attractiveness standards (smooth and shiny teeth look more esthetic), possibly leading to lack of appropriate care-seeking behavior. Practical Implications: This internet-based tool may be used to assess dental patients’ awareness and ability to recognize cases of ETW. Improved patient awareness might lead to seeking professional care to prevent or delay ETW progression.

Original languageEnglish (US)
Pages (from-to)10-15
Number of pages6
JournalJournal of the American Dental Association
Issue number1
StatePublished - Jan 2020



  • Erosive tooth wear
  • care-seeking behavior
  • caries, patient perceptions
  • oral health

ASJC Scopus subject areas

  • Dentistry(all)

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