High socio-economic status linked to dental wear in children


GOLD COAST, Australia: High socioeconomic status has often been associated with better health outcomes. However, according to a global study of 30 countries, wealth may also predispose people to oral ailments such as cavities and tooth wear, as children with high family incomes benefit from increased access to health benefits. sugary or acidic drinks such as carbonated drinks, energy drinks and packaged juices.

Dr Khaled Ahmed, head of internationalization and lecturer in prosthodontics at the Gold Coast Griffith University School of Medicine and Dentistry, is the study’s principal investigator. He has been interested in tooth wear for a long time since 2007, while doing postdoctoral training at the School of Dental Sciences at Newcastle University in the UK. “It was my first attempt at full oral rehabilitation from severe tooth wear. It took over 16 months, but the pronounced dental transformation and the patient’s confidence and satisfaction with their appearance was both overwhelming and heartwarming, ”he told Dental Tribune International.

Principal author Dr Khaled Ahmed. (Photo: Khaled Ahmed)

He then chose tooth wear as a research topic for his doctorate while teaching at Glasgow University School of Dentistry and was a member of one of the first research groups to use digital dentistry to monitor clinically the progression of tooth wear in patients. Nowadays, he remains curious about the subject and continues to research. He explained, “My interest in tooth wear has not waned over the years, and as a dental problem it continues to intrigue me. It demonstrates how the impact of lifestyle factors such as diet, wealth, underlying medical and mental health issues, oral hygiene practices, habits, hobbies and professions can manifest themselves in dental terms over many years.

Socio-economic status and tooth wear: is there a correlation?

In the study, Dr Ahmed and his fellow researchers at Griffith University and the National Dental Research Institute of Singapore sought to examine the link between socioeconomic status and tooth wear in children and the adults. In total, they analyzed 65 studies involving 64,000 participants and found that children who attend private schools or have high family incomes are more susceptible to tooth wear than those from lower socioeconomic backgrounds. In addition, they reported that increased access to soft drink, energy drinks and packaged juices increased the risk of cavities in wealthy countries, predisposing their populations to a higher risk of erosion.

The study also found that adolescents whose parents had higher levels of education and wealth and who attended private schools had a higher prevalence of dental wear, while adults with higher education had a higher prevalence of dental wear. reduced risk of developing tooth wear.

Discussing the results, Dr Ahmed noted that he found it fascinating to see how socioeconomic status and wealth on a global scale can determine the risk of tooth wear based on age, whether childhood or adulthood. He explained that several studies have already sought to investigate the link, but have yielded conflicting results.

Speaking about the research, he commented, “Identifying these studies, synthesizing and analyzing them, and then merging the results to discern a global connection was a daunting task. However, he noted that the effort was well worth it, as the study is the first definitive claim of wealth as a risk factor in children from high socioeconomic status families, the reverse being true for adults. “When we embarked on this research project, we had an open-minded approach. Nonetheless, I had an idea that this might be the result, ”Dr Ahmed said.

The impact of diet on children’s teeth

According to the researchers, the study makes three main recommendations. First, with regard to public policy initiatives, Dr Ahmed believes that the confirmed link between tooth wear and wealth supports a mandate to review access to acidic foods such as soft drinks and packaged fruit juices. While some of them contain little or no sugar, they are still harmful to oral health due to their acid content.

“Wealth does not translate into better oral health in the absence of awareness and systematic access to dental care”

Second, from a pedagogical point of view, the study shows a strong need to raise public awareness of the impact of diet on children’s teeth. This includes not only sugary foods, but also acidic foods. “Wealth does not translate into better oral health in the absence of awareness and systematic access to dental care,” noted Dr Ahmed.

Finally, from a professional point of view, dental health professionals should perform oral health exams for tooth wear in patients and include socioeconomic status as a risk factor. As Dr Ahmed said: “Early diagnosis and management can prevent long-term irreversible damage to the dentition that will be difficult to treat later due to its biological and financial cost. “

A journey to healthy teeth

Besides socioeconomic status, other major factors including the experience of cavities, fluoridation, access to dental care, education, oral hygiene practices and obesity have already been linked. tooth wear. Even though some countries become more aware of the harmful effect of sugar on oral health and offer dietary, low-sugar or sugar-free alternatives to sugary drinks, which remain acidic. However, Dr Ahmed believes that the introduction of a sugar tax, which has been imposed in countries such as South Africa, Australia, United Kingdom and Singapore, is a step in the right direction, especially when combined with awareness campaigns and advertising regulations. However, the extent of its effect remains to be seen.

The study, entitled “Tooth wear and socioeconomic status in childhood and adulthood: results from a systematic review and meta-analysis of observational studies», Was published online on September 30, 2021 in the Dentistry journal, before inclusion in an issue.

Acid drinks
Oral hygiene
Sugary drinks