Richards Derek
Department of Public Health, NHS Forth Valley and Centre for Evidence-based Dentistry, DHSRU, University of Dundee, Scotland.
Evid Based Dent. 2016 Jun;17(2):40. doi: 10.1038/sj.ebd.6401164.
Data sourcesPubMed, Web of Science, Scopus, Science Direct, EBSHost, Scientific Electronic Library online (SciELO).Study selectionPopulation-based cross-sectional and longitudinal studies assessing tooth erosion and diet, conducted in children and adolescents between eight and 19 years reporting on the permanent dentition were considered.Data extraction and synthesisStudies were selected independently by two reviewers and standard data items extracted. Study quality was assessed using the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) statement and Newcastle-Ottawa Quality Assessment Scale (NOS). The pooled effect of dietary habits on tooth erosion occurrence was calculated using a fixed and a random model (OR and 95%CI).ResultsThirteen studies involving a total of 16,661 children were included. Eleven of the studies were cross-sectional and two longitudinal. Dietary habits data were mainly obtained from brief dietary assessments (69.2%) with food amount (weighed or estimated) and food frequency questionnaires used less commonly (15.4%). Most dietary assessments were self-administered (84.6%), assessed diet on a single occasion (61.5%) and required recalls of a week or more days or usual behaviours (46.2%). Meta-analyses were carried out for carbonated/soft drinks, sports drinks, milk-based drinks, yogurt, confectionery and snacks and acidic natural fruit drinks. Higher consumption of carbonated drinks or acid snacks/sweets and for acid fruit juices increased the odds for tooth erosion, while higher intake of milk and yogurt reduced the odds of erosion (see table).ConclusionsThe evidence indicated that some dietary habits (soft drinks, acidic snacks/sweets and acidic fruit juices) increased the odds for erosion occurrence, while milk or yogurt produced a protective effect. Methodological issues were shown to partly explain the heterogeneity of the data for some dietary products.
数据来源
PubMed、科学网、Scopus、Science Direct、EBSHost、科学电子图书馆在线数据库(SciELO)。
研究选择
纳入以人群为基础的横断面和纵向研究,这些研究评估了8至19岁儿童和青少年恒牙列的牙齿侵蚀与饮食情况。
数据提取与综合分析
由两名审阅者独立选择研究,并提取标准数据项。使用STROBE(加强流行病学观察性研究报告)声明和纽卡斯尔-渥太华质量评估量表(NOS)评估研究质量。使用固定模型和随机模型(比值比及95%置信区间)计算饮食习惯对牙齿侵蚀发生的合并效应。
结果
共纳入13项研究,涉及16,661名儿童。其中11项为横断面研究,2项为纵向研究。饮食习惯数据主要通过简短饮食评估获得(69.2%),较少使用食物量(称重或估算)和食物频率问卷(15.4%)。大多数饮食评估采用自行填写的方式(84.6%),单次评估饮食情况(61.5%),且需要回忆一周或更长时间的饮食或日常行为(46.2%)。对碳酸饮料/软饮料、运动饮料、乳类饮品、酸奶、糖果和零食以及酸性天然果汁进行了荟萃分析。碳酸饮料、酸性零食/甜食以及酸性果汁的摄入量增加会增加牙齿侵蚀的几率,而牛奶和酸奶摄入量增加则会降低侵蚀几率(见表)。
结论
证据表明,某些饮食习惯(软饮料、酸性零食/甜食和酸性果汁)会增加牙齿侵蚀的几率,而牛奶或酸奶具有保护作用。方法学问题在一定程度上解释了某些饮食产品数据的异质性。