Vegetarian diet and its possible influence on dental health: A systematic literature review.

Kirsten P J Smits,Stefan Listl,Milica Jevdjevic

doi:10.1111/cdoe.12498

Abstract

ObjectivesPeople following a vegetarian diet could be more prone to oral health problems than people following a nonvegetarian diet. The aim of this systematic review was to examine the possible impacts of following a vegetarian diet on dental hard tissues, focusing on caries development, dental erosion and number of natural teeth.MethodsPubMed, EMBASE, Web of Science and CINAHL were searched systematically up until 17 April 2019. Original studies comparing dental health (exclusively focusing on dental hard tissues) in vegetarians and nonvegetarians were selected. Study characteristics and outcome data were extracted, and the quality of the studies was assessed using the Newcastle‐Ottawa Scale. When a dental health characteristic was reported in three or more papers in a comparable way, a meta‐analysis was performed.ResultsTwenty‐one papers reporting on 18 studies were included in this review. In meta‐analyses, the vegetarian diet was associated with a higher risk for dental erosion (odds ratio: 2.40 [95% confidence interval: 1.24, 4.66]; P = .009) and a lower decayed, missing and filled teeth (DMFT) score (mean difference: −0.15 [95% confidence interval: −0.29, −0.02]; P = .023), although the quality of most included studies was poor and the findings for DMFT score became insignificant when only studies on adults were included in the meta‐analysis. A meta‐analysis for the other dental characteristics was not possible due to the limited number of eligible studies. There was inconsistent evidence for a link between following a vegetarian diet and dental caries or the number of natural teeth.ConclusionsWithin the limitations of the present study, the findings suggest that following a vegetarian diet may be associated with a greater risk of dental erosion.

Highlights

We focused on noncarious/cervical lesions (NCCL), dental caries and number of natural teeth
The findings showed a significantly higher risk of the presence of dental erosion in vegetarians than in nonvegetarians (odds ratio (OR): 2.40 [95%confidence intervals (CI): 1.24, 4.66]; P = .009; I2 = 72.7%; Figure 2A)
There was a significantly lower mean DMFT score in vegetarians than in non‐ vegetarians

Summary

| METHODS

We were interested in observational or intervention studies com‐ paring a vegetarian diet with a nonvegetarian diet in terms of dental health outcomes. The data were systematically extracted from the included papers This included information on the aim, design of study, setting, number of vegetarian and nonvegetarian participants and their characteristics if reported (age, gender and duration of vegetarian diet), dental health outcome, statistical analysis and key study results. One paper focused on children, while the other five included adults Despite these differences, the findings showed a significantly higher risk of the presence of dental erosion in vegetarians than in nonvegetarians (odds ratio (OR): 2.40 [95%CI: 1.24, 4.66]; P = .009; I2 = 72.7%; Figure 2A). A sensitivity analysis including only adults showed a lower and nonsignificant effect (mean difference: −0.10 [95%CI: −0.32, 0.13]; P = .418; I2 = 37.8%; Figure 3B) Both funnel plots showed no signs of publication bias (Appendix S7). One study showed that vegetarians had a higher level of edentulousness than nonvegetarians

| DISCUSSION

| Strengths and limitations

Findings

CONFLICT OF INTEREST