Impact of diet on tooth erosion

Data sources: PubMed, Web of Science, Scopus, Science Direct, EBSHost, Scientific Electronic Library online (SciELO).

Study selection: Population-based cross-sectional and longitudinal studies assessing tooth erosion and diet, conducted in children and adolescents between eight and 19 years reporting on the permanent dentition were considered.

Data extraction and synthesis: Studies were selected independently by two reviewers and standard data items extracted. Study quality was assessed using the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) statement and Newcastle-Ottawa Quality Assessment Scale (NOS). The pooled effect of dietary habits on tooth erosion occurrence was calculated using a fixed and a random model (OR and 95%CI).

Results: Thirteen studies involving a total of 16,661 children were included. Eleven of the studies were cross-sectional and two longitudinal. Dietary habits data were mainly obtained from brief dietary assessments (69.2%) with food amount (weighed or estimated) and food frequency questionnaires used less commonly (15.4%). Most dietary assessments were self-administered (84.6%), assessed diet on a single occasion (61.5%) and required recalls of a week or more days or usual behaviours (46.2%). Meta-analyses were carried out for carbonated/soft drinks, sports drinks, milk-based drinks, yogurt, confectionery and snacks and acidic natural fruit drinks. Higher consumption of carbonated drinks or acid snacks/sweets and for acid fruit juices increased the odds for tooth erosion, while higher intake of milk and yogurt reduced the odds of erosion (see table).

Conclusions: The evidence indicated that some dietary habits (soft drinks, acidic snacks/sweets and acidic fruit juices) increased the odds for erosion occurrence, while milk or yogurt produced a protective effect. Methodological issues were shown to partly explain the heterogeneity of the data for some dietary products.