Anamnestic risk factors for erosive tooth wear: Systematic review, mapping, and meta-analysis.

ABSTRACT

OBJECTIVES: Erosive tooth wear is a multifactorial condition. The aim of this systematic review and meta-analysis was to identify key risk factors for erosive tooth wear in permanent dentition. STUDY SELECTION Observational studies reporting anamnestic risk factors for erosive tooth wear. Methodological quality and risk of bias were assessed using the modified Newcastle-Ottawa scale for cross-sectional studies. Risk factors were visually presented in a heatmap, and where possible, random-effects meta-analyses were performed for the odds ratios (ORs) of risk factors. SOURCES Electronic databases (MEDLINE, Embase, Scopus, and Web of Science) and manual searches in February 2023. The protocol was registered in PROSPERO (CRD4202339776). DATA A total of 87 publications reporting on 71 studies were included in the systematic review. The studies examined a variety of anamnestic risk factors (n = 80) that were categorized into ten domains (socio-demographics, socio-economics, general health, oral diseases, medication, oral hygiene, food, beverages, dietary habits, and leisure-related risk factors). Meta-analyses revealed significant associations between erosive tooth wear and male gender (padj.<0.001; OR=1.30, 95 % CI 1.16-1.44), regurgitation (padj.=0.033; OR=2.27, 95 % CI 1.41-3.65), digestive disorders (padj.<0.001; OR=1.81, 95 % CI 1.48-2.21), consumption of acidic foods (padj.=0.033; OR=2.40, 95 % CI 1.44-4.00), seasoning sauces (padj.=0.003; OR=1.28, 95 % CI 1.13-1.44), nutritional supplements (padj.=0.019; OR=1.73, 95 % CI 1.28-2.35), and carbonated drinks (padj.=0.019; OR=1.43, 95 % CI 1.17-1.75). Most included studies exhibited low bias risk. CONCLUSIONS: Observational studies investigated a variety of anamnestic risk factors for erosive tooth wear. Future studies should employ validated questionnaires, particularly considering the most important risk factors. CLINICAL SIGNIFICANCE: Erosive tooth wear is a prevalent condition. Clinicians should concentrate primarily on symptoms of gastroesophageal reflux disease and dietary factors when screening patients at risk for erosive tooth wear.