Non-carious cervical lesions: How common are they in adults?


Non-carious cervical lesions have been defined as tooth loss at the cementoenamel junction that is not related to bacteria.  There is debate regarding their aetiology which is considered to be multifactorial involving attrition, abrasion and erosion.  There is also variation in their classification and diagnosis and wide variation in reported prevalence rates.

The main aim of this review is to estimate the worldwide prevalence of non-carious cervical lesions (NCCLs) in the adult population.


Searches were conducted in the PubMed/Medline and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Cross-sectional studies conducted in adults ≥ 16 years of age reporting the prevalence of NCCLs diagnosed by dental care professionals and published in English were considered. Two reviewers independently screened and selected studies and extracted data. Methodological quality was assessed using the Joanna Briggs Institute’s checklist for analytical cross-sectional studies. An overall weighted mean prevalence percentage was calculated.


  • 24 studies involving 14,628 patients were included.
  • Age range of the populations studied ranged from 16 to 75 years.
  • Most studies used visual or tactile clinical examination.
  • 7 studies were considered to have a high risk of bias, 5 substantial risk, 8 moderate risk and 4 a low risk of bias.
  • Meta-analysis was not conducted due to study heterogeneity.
  • NCCL prevalence ranged from 9.1% – 93%.
  • Weighted mean prevalence of NCCLs among the whole studied population = 46.7 % (95 %CI; 38.2 to 55.3 %).
  • Populations older than 30 years had a higher weighted prevalence (53 %) than those younger than 30 years (43 %).
  • South America had the highest reported prevalence of NCCLs (69%), the United States the lowest (19%).
  • 54% of the general population had NCCLs compared with 44% in dental populations.


The authors concluded: –

The worldwide prevalence of NCCLs among adults is 46.7 % and higher in older populations than younger ones. The established index also supports the rise in prevalence when compared to visual and tactile clinical examination. South America has the highest prevalence of NCCLs among different geographical regions, and general populations are more inclined to present these lesions than specific ones.


The reviewers followed the PRISMA and MOOSE guidelines when undertaking this review, two major databases were searched although the restriction in English language articles may have resulted in the exclusion of some relevant studies. Of the included studies 12 were considered to be at high or substantial risk of bias which needs to be taken into consideration when interpreting the findings. Another issue is the definition and diagnosis of NCCLs as differing definitions may contribute to the variation in reported prevalence between the included studies. This is discussed in the review and one of the recommendations is that a standard index needs to be developed to facilitate comparison of results in the future.


Primary Paper

Teixeira DNR, Thomas RZ, Soares PV, Cune MS, Gresnigt MMM, Slot DE. Prevalence of noncarious cervical lesions among adults: A systematic review [published online ahead of print, 2020 Jan 30]. J Dent. 2020;103285. doi:10.1016/j.jdent.2020.103285

Picture credits

By Funkynatsuki – Own work, CC BY-SA 4.0



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