{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:49:15Z","timestamp":1792514955773,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:00:00Z","timestamp":1699056000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T00:00:00Z","timestamp":1699056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009827","name":"Alexandria University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009827","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Competitive swimmers spend considerable time practicing their sport. Prolonged exposure to chlorinated water can alter salivary parameters and might compromise oral health. This study aimed to determine erosive tooth wear status and its related risk factors among competitive swimmers as compared to non-swimmers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>A cross-sectional study consisting of 180 athletes (90 competitive swimmers versus 90 competitive rowers \u201cnon-swimmers\u201d) was conducted. Participants were interviewed on the common erosion risk factors. The Basic Erosive Wear Examination system was used to assess the status of erosive tooth wear. Stimulated saliva sample was collected before and after a training session and pool pH was evaluated using pH strips for 7 days. Data were analyzed using descriptive statistics and multivariable analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The prevalence of dental erosion was significantly higher among competitive swimmers (60%) with higher BEWE scores compared to non-swimmers (25.6%). The salivary flow rate was reduced significantly after training sessions in both groups while salivary pH increased among swimmers. Evaluation of pool water revealed a continuous reduction in the pH level, reaching a very acidic pH level of 3.24.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Erosive tooth wear is more prevalent among competitive swimmers. Years of practice and regular consumption of acidic drinks increase the odds of developing erosive lesions. A high incidence of erosive lesions may be attributed to a reduction in swimming pool pH level. Salivary parameters showed variations between groups after training sessions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00784-023-05367-7","type":"journal-article","created":{"date-parts":[[2023,11,4]],"date-time":"2023-11-04T08:02:42Z","timestamp":1699084962000},"page":"7777-7785","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Erosive tooth wear and salivary parameters among competitive swimmers and non-swimmers in Egypt: a cross-sectional study"],"prefix":"10.1007","volume":"27","author":[{"given":"Hams H.","family":"Abdelrahman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Ammar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed G","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa","family":"Essam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Amer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,4]]},"reference":[{"key":"5367_CR1","doi-asserted-by":"publisher","first-page":"ZE21","DOI":"10.7860\/JCDR\/2017\/25866.10110","volume":"11","author":"RM Baiju","year":"2017","unstructured":"Baiju RM, Peter E, Varghese NO, Sivaram R (2017) Oral health and quality of life: current concepts. J Clin Diagn Res 11:ZE21\u2013ZE26. https:\/\/doi.org\/10.7860\/JCDR\/2017\/25866.10110","journal-title":"J Clin Diagn Res"},{"key":"5367_CR2","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1038\/s41405-021-00078-1","volume":"7","author":"C Opazo-Garc\u00eda","year":"2021","unstructured":"Opazo-Garc\u00eda C, Moya-Salazar J, Chicoma-Flores K, Contreras-Pulache H (2021) Oral health problems in high-performance athletes at 2019 Pan American Games in Lima: a descriptive study. BDJ Open 7:21. https:\/\/doi.org\/10.1038\/s41405-021-00078-1","journal-title":"BDJ Open"},{"key":"5367_CR3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s40368-017-0317-5","volume":"19","author":"M Skalsky Jarkander","year":"2018","unstructured":"Skalsky Jarkander M, Grindefjord M, Carlstedt K (2018) Dental erosion, prevalence and risk factors among a group of adolescents in Stockholm County. Eur Arch Paediatr Dent 19:23\u201331. https:\/\/doi.org\/10.1007\/s40368-017-0317-5","journal-title":"Eur Arch Paediatr Dent"},{"key":"5367_CR4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1159\/000503308","volume":"54","author":"N Schlueter","year":"2020","unstructured":"Schlueter N, Amaechi BT, Bartlett D et al (2020) Terminology of erosive tooth wear: consensus report of a workshop organized by the ORCA and the cariology research group of the IADR. Caries Res 54:2\u20136. https:\/\/doi.org\/10.1159\/000503308","journal-title":"Caries Res"},{"key":"5367_CR5","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/sj.ebd.6401164","volume":"17","author":"D Richards","year":"2016","unstructured":"Richards D (2016) Impact of diet on tooth erosion. Evid Based Dent 17:40. https:\/\/doi.org\/10.1038\/sj.ebd.6401164","journal-title":"Evid Based Dent"},{"key":"5367_CR6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1123\/ijare.2014-0041","volume":"8","author":"NV Las Vegas","year":"2014","unstructured":"Department of Environmental and Occupational Health at the University of Nevada, Las Vegas, Las Vegas NV, Pharr JR, Irwin C, Irwin R (2014) Parental factors that influence swimming in children and adolescents. IJARE 8:368\u2013381. https:\/\/doi.org\/10.1123\/ijare.2014-0041","journal-title":"IJARE"},{"key":"5367_CR7","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1080\/17461391.2014.922621","volume":"15","author":"A Garc\u00eda-Ramos","year":"2015","unstructured":"Garc\u00eda-Ramos A, Feriche B, Calder\u00f3n C et al (2015) Training load quantification in elite swimmers using a modified version of the training impulse method. Eur J Sport Sci 15:85\u201393. https:\/\/doi.org\/10.1080\/17461391.2014.922621","journal-title":"Eur J Sport Sci"},{"key":"5367_CR8","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/j.ijheh.2017.01.005","volume":"220","author":"T Manasfi","year":"2017","unstructured":"Manasfi T, Coulomb B, Boudenne JL (2017) Occurrence, origin, and toxicity of disinfection byproducts in chlorinated swimming pools: an overview. Int J Hyg Environ Health 220:591\u2013603. https:\/\/doi.org\/10.1016\/j.ijheh.2017.01.005","journal-title":"Int J Hyg Environ Health"},{"key":"5367_CR9","doi-asserted-by":"publisher","first-page":"3257","DOI":"10.1111\/all.15014","volume":"76","author":"M Couto","year":"2021","unstructured":"Couto M, Bernard A, Delgado L et al (2021) Health effects of exposure to chlorination by-products in swimming pools. Allergy 76:3257\u20133275. https:\/\/doi.org\/10.1111\/all.15014","journal-title":"Allergy"},{"key":"5367_CR10","unstructured":"Water Treatment and Testing | Healthy Swimming | Healthy Water | CDC. https:\/\/www.cdc.gov\/healthywater\/swimming\/residential\/disinfection-testing.html. Accessed 4 May 2023"},{"key":"5367_CR11","doi-asserted-by":"publisher","first-page":"465","DOI":"10.2166\/wh.2013.156","volume":"11","author":"KMS Hansen","year":"2013","unstructured":"Hansen KMS, Albrechtsen H-J, Andersen HR (2013) Optimal pH in chlorinated swimming pools - balancing formation of by-products. J Water Health 11:465\u2013472. https:\/\/doi.org\/10.2166\/wh.2013.156","journal-title":"J Water Health"},{"key":"5367_CR12","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.jds.2011.05.001","volume":"6","author":"P Benjakul","year":"2011","unstructured":"Benjakul P, Chuenarrom C (2011) Association of dental enamel loss with the pH and titratable acidity of beverages. J Dent Sci 6:129\u2013133. https:\/\/doi.org\/10.1016\/j.jds.2011.05.001","journal-title":"J Dent Sci"},{"key":"5367_CR13","doi-asserted-by":"publisher","first-page":"34760","DOI":"10.1038\/srep34760","volume":"6","author":"T Baumann","year":"2016","unstructured":"Baumann T, Kozik J, Lussi A, Carvalho TS (2016) Erosion protection conferred by whole human saliva, dialysed saliva, and artificial saliva. Sci Rep 6:34760. https:\/\/doi.org\/10.1038\/srep34760","journal-title":"Sci Rep"},{"key":"5367_CR14","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1016\/j.archoralbio.2015.07.012","volume":"60","author":"AJM Ligtenberg","year":"2015","unstructured":"Ligtenberg AJM, Brand HS, van den Keijbus PAM, Veerman ECI (2015) The effect of physical exercise on salivary secretion of MUC5B, amylase and lysozyme. Arch Oral Biol 60:1639\u20131644. https:\/\/doi.org\/10.1016\/j.archoralbio.2015.07.012","journal-title":"Arch Oral Biol"},{"key":"5367_CR15","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.jds.2020.10.007","volume":"16","author":"DD Chawhuaveang","year":"2021","unstructured":"Chawhuaveang DD, Yu OY, Yin IX et al (2021) Acquired salivary pellicle and oral diseases: a literature review. J Dent Sci 16:523\u2013529. https:\/\/doi.org\/10.1016\/j.jds.2020.10.007","journal-title":"J Dent Sci"},{"key":"5367_CR16","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1093\/oxfordjournals.aje.a114283","volume":"123","author":"BS Centerwall","year":"1986","unstructured":"Centerwall BS, Armstrong CW, Funkhouser LS, Elzay RP (1986) Erosion of dental enamel among competitive swimmers at a gas-chlorinated swimming pool. Am J Epidemiol 123:641\u2013647. https:\/\/doi.org\/10.1093\/oxfordjournals.aje.a114283","journal-title":"Am J Epidemiol"},{"key":"5367_CR17","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/s00784-012-0720-6","volume":"17","author":"J Buczkowska-Radli\u0144ska","year":"2013","unstructured":"Buczkowska-Radli\u0144ska J, \u0141agocka R, Kaczmarek W et al (2013) Prevalence of dental erosion in adolescent competitive swimmers exposed to gas-chlorinated swimming pool water. Clin Oral Investig 17:579\u2013583. https:\/\/doi.org\/10.1007\/s00784-012-0720-6","journal-title":"Clin Oral Investig"},{"issue":"Suppl 1","key":"5367_CR18","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1007\/s00784-007-0181-5","volume":"12","author":"D Bartlett","year":"2008","unstructured":"Bartlett D, Ganss C, Lussi A (2008) Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs. Clin Oral Investig 12(Suppl 1):S65\u2013S68. https:\/\/doi.org\/10.1007\/s00784-007-0181-5","journal-title":"Clin Oral Investig"},{"key":"5367_CR19","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1472-6831-12-8","volume":"12","author":"A Mulic","year":"2012","unstructured":"Mulic A, Tveit AB, Songe D et al (2012) Dental erosive wear and salivary flow rate in physically active young adults. BMC Oral Health 12:8. https:\/\/doi.org\/10.1186\/1472-6831-12-8","journal-title":"BMC Oral Health"},{"key":"5367_CR20","doi-asserted-by":"publisher","unstructured":"Srivastava S, Saha S, Kumari M, Mohd S (2016) Effect of probiotic curd on salivary pH and Streptococcus mutans: A Double Blind Parallel Randomized Controlled Trial. J Clin Diagn Res 10:ZC13-6. https:\/\/doi.org\/10.7860\/JCDR\/2016\/15530.7178","DOI":"10.7860\/JCDR\/2016\/15530.7178"},{"key":"5367_CR21","unstructured":"Dental Erosion and Its Clinical Management | SpringerLink. https:\/\/link.springer.com\/book\/10.1007\/978-3-319-13993-7. Accessed 4 May 2023"},{"key":"5367_CR22","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1590\/1678-775720150324","volume":"24","author":"S D\u2019Ercole","year":"2016","unstructured":"D\u2019Ercole S, Tieri M, Martinelli D, Tripodi D (2016) The effect of swimming on oral health status: competitive versus non-competitive athletes. J Appl Oral Sci 24:107\u2013113. https:\/\/doi.org\/10.1590\/1678-775720150324","journal-title":"J Appl Oral Sci"},{"key":"5367_CR23","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1080\/02640414.2011.640705","volume":"30","author":"K Kojima","year":"2012","unstructured":"Kojima K, Jamison PL, Stager JM (2012) Multi-age-grouping paradigm for young swimmers. J Sports Sci 30:313\u2013320. https:\/\/doi.org\/10.1080\/02640414.2011.640705","journal-title":"J Sports Sci"},{"key":"5367_CR24","first-page":"81","volume":"56","author":"W Kaczmarek","year":"2010","unstructured":"Kaczmarek W (2010) The status of mineralized dental tissues in young competitive swimmers. Ann Acad Med Stetin 56:81\u201386","journal-title":"Ann Acad Med Stetin"},{"key":"5367_CR25","first-page":"207","volume":"12","author":"WA Bretz","year":"2013","unstructured":"Bretz WA, Carrilho MR (2013) Salivary parameters of competitive swimmers at gas-chlorinated swimming-pools. J Sports Sci Med 12:207\u2013208","journal-title":"J Sports Sci Med"},{"key":"5367_CR26","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.archoralbio.2017.03.001","volume":"79","author":"TM da Silva Ventura","year":"2017","unstructured":"da Silva Ventura TM, Cassiano LD, de Silva CM et al (2017) The proteomic profile of the acquired enamel pellicle according to its location in the dental arches. Arch Oral Biol 79:20\u201329. https:\/\/doi.org\/10.1016\/j.archoralbio.2017.03.001","journal-title":"Arch Oral Biol"},{"key":"5367_CR27","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/1550-2783-10-49","volume":"10","author":"M Tanabe","year":"2013","unstructured":"Tanabe M, Takahashi T, Shimoyama K et al (2013) Effects of rehydration and food consumption on salivary flow, pH and buffering capacity in young adult volunteers during ergometer exercise. J Int Soc Sports Nutr 10:49. https:\/\/doi.org\/10.1186\/1550-2783-10-49","journal-title":"J Int Soc Sports Nutr"},{"key":"5367_CR28","doi-asserted-by":"publisher","first-page":"269","DOI":"10.2334\/josnusd.17-0183","volume":"60","author":"M Tanabe-Ikegawa","year":"2018","unstructured":"Tanabe-Ikegawa M, Takahashi T, Churei H et al (2018) Interactive effect of rehydration with diluted sports drink and water gargling on salivary flow, pH, and buffering capacity during ergometer exercise in young adult volunteers. J Oral Sci 60:269\u2013277. https:\/\/doi.org\/10.2334\/josnusd.17-0183","journal-title":"J Oral Sci"},{"key":"5367_CR29","doi-asserted-by":"publisher","unstructured":"Ntovas P, Loumprinis N, Maniatakos P et al (2022) The effects of physical exercise on saliva composition: a comprehensive review. Dent J 10. https:\/\/doi.org\/10.3390\/dj10010007","DOI":"10.3390\/dj10010007"},{"key":"5367_CR30","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1080\/07853890.2018.1561981","volume":"51","author":"J Andr\u00e9","year":"2019","unstructured":"Andr\u00e9 J, Marta C, Cristina M et al (2019) The effect of endurance training in salivary flow and pH. Ann Med 51:139\u2013139. https:\/\/doi.org\/10.1080\/07853890.2018.1561981","journal-title":"Ann Med"},{"key":"5367_CR31","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.5037\/jomr.2014.5206","volume":"5","author":"A Zebrauskas","year":"2014","unstructured":"Zebrauskas A, Birskute R, Maciulskiene V (2014) Prevalence of dental erosion among the young regular swimmers in Kaunas, Lithuania. J Oral Maxillofac Res 5:e6. https:\/\/doi.org\/10.5037\/jomr.2014.5206","journal-title":"J Oral Maxillofac Res"},{"key":"5367_CR32","doi-asserted-by":"publisher","first-page":"390","DOI":"10.4103\/ijcm.IJCM_213_19","volume":"44","author":"KA Rao","year":"2019","unstructured":"Rao KA, Thomas S, Kumar JK, Narayan V (2019) Prevalence of dentinal hypersensitivity and dental erosion among competitive swimmers, Kerala, India. Indian J Community Med 44:390\u2013393. https:\/\/doi.org\/10.4103\/ijcm.IJCM_213_19","journal-title":"Indian J Community Med"},{"key":"5367_CR33","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1016\/j.jdent.2017.10.002","volume":"67","author":"S O\u2019Toole","year":"2017","unstructured":"O\u2019Toole S, Bartlett D (2017) The relationship between dentine hypersensitivity, dietary acid intake and erosive tooth wear. J Dent 67:84\u201387. https:\/\/doi.org\/10.1016\/j.jdent.2017.10.002","journal-title":"J Dent"},{"key":"5367_CR34","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s41894-017-0018-9","volume":"2","author":"JA Kaidonis","year":"2018","unstructured":"Kaidonis JA, Anastassiadis PM, Lekkas D et al (2018) Prevention and control of dental erosion by professionally applied treatment. Clin Dent Rev 2:5. https:\/\/doi.org\/10.1007\/s41894-017-0018-9","journal-title":"Clin Dent Rev"},{"key":"5367_CR35","doi-asserted-by":"publisher","first-page":"104945","DOI":"10.1016\/j.archoralbio.2020.104945","volume":"120","author":"RF Zanatta","year":"2020","unstructured":"Zanatta RF, Caneppele TMF, Scaramucci T et al (2020) Protective effect of fluorides on erosion and erosion\/abrasion in enamel: a systematic review and meta-analysis of randomized in situ trials. Arch Oral Biol 120:104945. https:\/\/doi.org\/10.1016\/j.archoralbio.2020.104945","journal-title":"Arch Oral Biol"}],"container-title":["Clinical Oral Investigations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05367-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00784-023-05367-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00784-023-05367-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T04:38:26Z","timestamp":1702355906000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00784-023-05367-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,4]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["5367"],"URL":"https:\/\/doi.org\/10.1007\/s00784-023-05367-7","relation":{},"ISSN":["1436-3771"],"issn-type":[{"value":"1436-3771","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,4]]},"assertion":[{"value":"13 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The research was conducted in accordance with the declaration of Helsinki for human research. This study was reviewed and approved by the ethics committee at the faculty of dentistry at Alexandria University, Egypt. Informed parental and participant consent was obtained prior to participation. Participation was voluntary and participant withdrawal was possible at any stage of the research without justification.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent for publication was provided by the parents and participants to be photographed for scientific purposes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}