Fatores de riscos e parâmetros preventivos do desgaste dentário erosivo consequente a dieta ácida: uma revisão sistemática

Abstract

Premature oral aging syndrome (PEOS), characterized by accelerated loss of tooth structure, causes an individual to have an oral age greater than their chronological age. This has been associated as a main factor with the frequent consumption of acidic foods and beverages, in addition to factors such as gastroesophageal reflux, where frequent exposure to these acids, combined with other factors, leads to erosive dental wear. Factors such as temporomandibular disorders, parafunctional habits, stress, use of abrasive toothpastes, and hard-bristled toothbrushes should be considered, the latter being modifying factors. This is a systematic review investigating the risk factors for erosive dental wear in individuals who excessively ingest acidic substances. The study was conducted following the PRISMA protocol, with searches in databases (PubMed, Ovid (Medline), Scopus, Web of Science, and ProQuest) using MeSH descriptors and free descriptors through the combination of Boolean operators. No language or time restrictions were applied. A total of 7,777 studies were found, and after rigorous screening, four were included. Methodological quality and risk of bias were assessed using the STROBE and Newcastle-Ottawa scales. The studies showed that an acidic diet is strongly associated with erosive tooth wear, especially when consumed between meals or kept in the mouth for a period of time; however, it is not an isolated factor for SEPB. Modifying factors are also associated, since the constant presence of acid in the oral cavity can lead to erosive tooth wear, among other changes. In addition to the extrinsic risk factor—high acid intake—other extrinsic factors, such as habits and occupational factors, are also present. There are intrinsic and idiopathic factors that potentiate the damage caused by erosive wear. Therefore, the study shows that the risk of SEPB is exacerbated by modifying factors, occurring independently or in combination with one another, requiring a multidisciplinary approach to its prevention and treatment. There is a lack of universally validated diagnostic criteria and a need for standardization and greater methodological rigor in studies for SEPB and adherence to guidelines such as NOS and the modified NOS. The methodological quality of the studies differs in the level of detail of the protocols.