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

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 (p(adj.)<0.001; OR=1.30, 95 % CI: 1.16-1.44), regurgitation (p(adj.)=0.033; OR=2.27, 95 % CI: 1.41-3.65), digestive disorders (p(adj.)<0.001; OR=1.81, 95 % CI: 1.48-2.21), consumption of acidic foods (p(adj.)=0.033; OR=2.40, 95 % CI: 1.44-4.00), seasoning sauces (p(adj.)=0.003; OR=1.28, 95 % CI: 1.13-1.44), nutritional supplements (p(adj.)=0.019; OR=1.73, 95 % CI: 1.28-2.35), and carbonated drinks (p(adj.)=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.