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Occlusal problems, mental health issues and non-carious cervical lesions


Non-carious cervical lesions (NCCLs) are characterized by a loss of hard dental tissue near the cement–enamel junction with multifactorial etiology. The aim of this study was to demonstrate that occlusal factors as attrition, malocclusion, and bruxism, and mental disorders as depression, stress, and anxiety are involved in the etiology of NCCLs. Salivary samples and clinical data of 340 individuals selected from 6,112 participants were obtained from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository project. The affected group was formed by individuals with NCCL (34 females, 34 males, mean age 55.34 years). In addition, the comparison group was formed by individuals without NCCL (136 females, 136 males, mean age 55.14 years). Eleven single-nucleotide polymorphisms (SNPs) previously associated with mental disorders were genotyped and tested for association with NCCLs. When all occlusal factors were combined there was found a significant association with NCCL (p = 0.000001/adjusted OR 4.38, 95% CI 2.50–7.69). Attrition (OR 3.56, 95% CI 2.00–6.32) and malocclusion (OR 5.09, 95% CI 1.65–15.68) as separate variables showed statistically significant associations with NCCL. There was a significant difference in stress history between the two groups (OR 2.17, 95% CI 1.08–4.39). No associations between NCCLs and the SNPs selected were found. However, when the occlusal factors were analyzed as covariates, associations were found between bruxism and seven of the selected SNPs. Our results suggest that occlusal factors might be associated with NCCLs.

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This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001.

Author information




BLN: Research conception and design, acquisition of data, analysis and interpretation of data, drafting the manuscript. ARV: Manuscript review, agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MB: Contributions to conception and design, acquisition, analysis and interpretation of genetic data. SAI: Analysis and interpretation of data. EMS: Research conception and design, drafting the manuscript, final approval of the version to be published.

Corresponding author

Correspondence to Evelise M. Souza.

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The authors declare that they have no conflict of interest.

Ethical approval

Data for the study were obtained from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA repository project. The study protocol was approved by the University of Pittsburgh Institutional Review Board.

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Informed consent was obtained from all individual participants included in the study.

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Nascimento, B.L., Vieira, A.R., Bezamat, M. et al. Occlusal problems, mental health issues and non-carious cervical lesions. Odontology (2021).

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  • Dental occlusion
  • Bruxism
  • Depression
  • Anxiety
  • Polymorphism genetic