Tooth Erosion Association with Obesity: Findings from a Brazilian Survey in Schoolchildren

Mabel Miluska Suca Salas, Fabiana Vargas-Ferreira, Gustavo Giacomelli Nascimento, Marie-Charlotte Huysmanns, Flávio Fernando Demarco


Objective: To evaluate a possible association between tooth erosion and weight status in Brazilian schoolchildren. Material and Methods: 1211 children aged 8-12-year-old from public and private schools in Southern Brazil were selected by a two-stage cluster method. Oral conditions were assessed by six trained and calibrated examiners. Tooth erosion assessment was determined by using the O´Sullivan index. Anthropometric measures were taken in order to obtain the body mass index. Socio-demographic and behavioral data were collected using questionnaires in children and parents. Multivariate Poisson regression model considering the cluster sample was used for data analysis (Prevalence ratio - PR; 95% Confidence Interval - CI). Results: Tooth erosion was observed in 25.1% of the children. Obesity and overweight prevalence was 34.6%. In the multivariate adjusted model, tooth erosion was associated with children from private schools (PR 1.68; 95%CI 1.05-2.68) and higher frequency of physical activity weekly (PR 1.48; 95%CI 1.04-2.09), whereas dental crowding in both arches was considered a protective effect (PR 0.55; 95%CI 0.34-0.89). In the stratified analysis regarding the type of school, children from private schools presented a positive association between tooth erosion and obesity (PR 3.26; 95%CI 1.38-7.69). Conclusion: Tooth erosion was not associated with obesity in the total sample. Socioeconomic differences seem to influence the relationship tooth erosion and obesity.


Tooth Erosion; Obesity; Child; Adolescent; Prevalence

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Caterson ID, Gill TP. Obesity: epidemiology and possible prevention. Best Pract Res Clin Endocrinol Metab 2002; 16 (4):595-610.

de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92(5):1257-64. doi: 10.3945/ajcn.2010.29786.

Colosia AD, Palencia R, Khan S. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes 2013; 6:327-38. doi: 10.2147/DMSO.S51325.

Goettems ML, Schuch HS, Hallal PC, Torriani DD, Demarco FF. Nutritional status and physical activity level as risk factor for traumatic dental injuries occurrence: a systematic review. Dental Traumatol 2014; 30(4):251-8. doi: 10.1111/edt.12102.

Nascimento GG, Seerig LM, Vargas-Ferreira F, Correa FO, Leite FR, Demarco FF. Are obesity and overweight associated with gingivitis occurrence in Brazilian schoolchildren? J Clin Periodontol 2013; 40(12):1072-8. doi: 10.1111/jcpe.12163.

Frary CD, Johnson RK, Wang MQ. Children and adolescents' choices of foods and beverages high in added sugars are associated with intakes of key nutrients and food groups. J Adolesc Health 2004; 34(1):56-63.

Dugmore CR, Rock WP. A multifactorial analysis of factors associated with dental erosion. Br Dent J 2004; 196(5):283-6. doi:10.1038/sj.bdj.4811041.

El Aidi H, Bronkhorst EM, Huysmans MC and Truin GJ. Multifactorial analysis of factors associated with the incidence and progression of erosive tooth wear. Caries Res 2011; 45 (3): 303-12. doi: 10.1159/000328671.

Al-Dlaigan YH, Shaw L, Smith A. Dental erosion in a group of British 14-year-old schoolchildren. Part II: Influence of dietary intake. Br Dent J 2001; 190(5):258-61. doi: 10.1038/sj.bdj.4800943a.

Peres KG, Armenio MF, Peres MA, Traebert J, De Lacerda JT. Dental erosion in 12-year-old schoolchildren: a cross-sectional study in Southern Brazil. Int J Paediatr Dent 2005; 15(4):249-55. doi: 10.1111/j.1365-263X.2005.00643.x.

Sharma A, Sharma K, Mathur KP. Growth pattern and prevalence of obesity in affluent schoolchildren of Delhi. Public Health Nutr 2007; 10(5):485-91. doi: 10.1017/S1368980007223894.

McGuire J, Szabo A, Jackson S, Bradley TG, Okunseri C. Erosive tooth wear among children in the United States: relationship to race/ethnicity and obesity. Int J Paediatr Dent 2009; 19(2):91-98. doi: 10.1111/j.1365-263X.2008.00952.x.

Tong HJ, Rudolf MC, Muyombwe T, Duggal MS, Balmer R. An investigation into the dental health of children with obesity: an analysis of dental erosion and caries status. Eur Arch Paediatr Dent 2014; 15 (3):203-10. doi: 10.1007/s40368-013-0100-1.

Goettems ML, Correa MB, Vargas-Ferreira F, Torriani DD, Marques M, Domingues MR, Hallal PC, Demarco FF. Methods and logistics of a multidisciplinary survey of schoolchildren from Pelotas, in the Southern Region of Brazil. Cad Saude Publica 2013; 29(5):867-78. doi: 10.1590/S0102-311X2013000500005.

Vargas-Ferreira F, Praetzel JR, Ardenghi TM. Prevalence of tooth erosion and associated factors in 11-14-year-old Brazilian schoolchildren. J Public Health Dent 2011; 71(1):6-12. doi: 10.1111/j.1752-7325.2010.00194.x.

O’Sullivan EA. A new index for the measurement of erosion in children. Eur J Paediatr Dent 2000; 1(2):69-74.

World, Health and Organization. Oral health surveys - basic methods. 4th. ed. Geneva, 1997.

Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320(7244):1240-3. doi: 10.1136/bmj.320.7244.1240.

Auad SM, Waterhouse PJ, Nunn JH, Steen N, Moynihan PJ. Dental erosion amongst 13- and 14-year-old Brazilian schoolchildren. Int Dent J 2007; 57(3):161-7. doi: 10.1111/j.1875-595X.2007.tb00119.x.

El-Sayed AM, Scarborough P and Galea S. Socioeconomic inequalities in childhood obesity in the United Kingdom: a systematic review of the literature. Obes Facts 2012; 5(5):671-92. doi: 10.1159/000343611.

Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health 2007; 97(4):667-75. doi: 10.2105/AJPH.2005.083782.

IBGE. Pesquisa Nacional de Saúde do Escolar. Rio de Janeiro: Brazilian Institute of Geographic and Statistics, 2009.

Diniz MB, Lussi A. Dental erosion in pediatric dentistry: What is the clinical relevance? Braz Res Pediatr Dent Integ Clinic 2017; 17(1):1-2. doi: 10.4034/PBOCI.2017.171.ed.