WEAK EVIDENCE SUGGESTS VEGETARIAN DIETS MAY BE ASSOCIATED WITH AN INCREASED RISK OF DENTAL EROSION

Teresa A. Marshall

doi:10.1016/j.jebdp.2020.101524

Subjects or Study Selection Four electronic databases (PubMed, EMBASE, Web of Science, and CINAHL) were searched for experimental or observational studies in adults or children pertinent to the association between following a vegetarian diet and oral health, tooth disease, periodontal disease, or gingival disease. Selection criteria were not articulated, yet are presumed to include studies a) comparing subjects following a vegetarian versus a nonvegetarian diet, and b) measuring noncarious cervical lesions (NCCL), dental caries, and tooth loss. Key Study Factor Subjects following any type of vegetarian diet void of meat, poultry, or fish were compared with subjects following nonvegetarian diets that included meat, poultry, or fish. Main Outcome Measure Three oral health outcomes of interest were investigated: 1) NCCL, including dental erosion, abrasion, and cervical buccal defects, 2) caries defined as decayed, missing, or filled teeth or surfaces or the presence of dental caries, lesions, or white spots, and 3) the number missing or present teeth or edentulousness. Main Results Twenty-one articles reporting 18 different studies from initial 321 articles were considered in final analysis. Using the Newcastle-Ottawa Scale, three articles reporting two studies were considered to be of fair quality; the remaining articles were considered of poor quality due to limited sample sizes, limited nonresponder information, comparability of study groups, or consideration of statistical testing. Eleven studies reported on NCCL using six different definitions; five of these studies showed a significantly higher prevalence of NCCL and tooth wear in vegetarians than in nonvegetarians. One study in children and five studies in adults that reported dental erosion were included in initial meta-analysis; considerable heterogeneity was noted. After restricting analysis to studies in adults and removing a study having an extreme confidence interval (8.89-3141.82), the prevalence of tooth erosion was notably higher in individuals following a vegetarian diet compared with those following a nonvegetarian diet (pooled OR = 2.56; 95% CI: 1.77-3.71) with no observed heterogeneity. Eleven studies reported on dental caries, with results of four studies included in meta-analysis. One study considered lacto-ovo vegetarians separate from other vegetarians, whereas another study considered 12- to 15-year-olds separately; these subgroups were included in the initial meta-analysis. The final meta-analysis considered only adults and excluded lacto-ovo vegetarians, and suggested an insignificant difference between mean DMFT scores (-0.10; 95% CI: -0.32-0.13) of individuals following a vegetarian diet compared with those following a nonvegetarian diet. Seven studies reporting on the number of teeth present showed inconsistent differences in those subjects following a vegetarian diet compared with a nonvegetarian diet. Conclusions Following a vegetarian diet may increase risk of dental erosion.

WEAK EVIDENCE SUGGESTS VEGETARIAN DIETS MAY BE ASSOCIATED WITH AN INCREASED RISK OF DENTAL EROSION

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