Dental erosion: incidence worldwide remains unclear

Dental erosion can been defined as the irreversible loss of tooth tissue by chemical processes not involving bacteria. There is concern that the levels of erosion are rising are erosion rates of between 7% to 95% have been reported in some populations of children and adolescents.

The aim of this review was to estimate the prevalence of dental erosion in permanent teeth of children and adolescents.

Methods

Searches were conducted in the PubMed/ Medline, ISI Web of Knowledge, Scopus, Scientific Electronic Library online (SciELO), Latin American and Caribbean Health Sciences (LILACS) databases. There were no language limits. Cross-sectional and prospective longitudinal studies in children and adolescents aged between 8 and 19 years with permanent teeth reporting the prevalence rate or data that allowed the calculation of prevalence rates of tooth erosion were considered. Two reviewers independently selected studies

Results

22 studies involving a total 23,012 children and adolescents of were included. Individual study samples varied in size form 200 to 3812.
20 studies were cross-sectional and 2 prospective cohorts.
The estimated combined prevalence of dental erosion in permanent teeth of children and adolescents was 30.4% (95%CI 23.8–37.0)
Rates ranged from 7.2% to 74.0%.

Conclusions

This study found a great variability in prevalence rates of dental erosion in permanent teeth of children and adolescents worldwide. Results suggest that the type of index used for clinical detection of dental erosion plays an important role in this variability.

Commentary

While this review has used a range of databases to identify studies for inclusion it is not clear how or whether the quality of the included studies was rated. STROBE which aims to Strengthenthe Reporting of Observational studies in Epidemiology was mentioned was mentioned as a method of determining quality but no further details are provided. As the authors noted there was considerable heterogeneity between the studies and much of this could be related to the range of indices used for measurement. Sample size may have had an impact on prevalence and the authors indicated that a meta-regression suggested that studies with sample sizes small than 1000 presented different rates from those with more than 1000 patients. While some erosion is to be expected as part of normal ageing the increases being seen in younger population could be a cause for concern. However in order to compare it both within and across population we need to agree a common valid and easily recordable index that can be used in a wide range of populations to enable ready and repeatable comparisons to assess the true extent of this problem.