Even with regular visits to the dentist, affluent children are more likely to experience tooth decay, according to the first meta-analysis of its kind.
The systematic review suggests the corrosive effects of soda, juices, and energy drinks have eaten away at some of the privileges provided by wealth and education.
Across 65 studies from 30 countries, including more than 60,000 individuals from age 6 to 79, researchers found a link between socioeconomic status and tooth wear.
Among adolescents who attend private school and whose parents have higher levels of education and income, tooth wear appears to be significantly worse.
That might sound strange at first, especially since teens from more affluent families are more likely to have access to regular dental care, but given how closely diet is tied to socioeconomic status, it does make sense.
“Fizzy drinks, energy drinks and packaged juices are in many countries available to the affluent. And despite a focus on sugar, such as the implementation of a sugar tax in the UK, the diet/low-sugar/sugar-free alternatives remain acidic,” explains Khaled Ahmed, who researches dentistry and oral health at Griffith University in Australia.
“These dietary habits may predispose children of all socio-economic levels to erosive risk, but those from a ‘high’ [socioeconomic] area may be more frequently exposed than their counterparts due to increased access as a result of affluence in low- and middle-income countries.”
Of course, the vast majority of people experience some level of tooth wear over the course of their lives, but the rate at which teeth erode, wear down and chip away depends on a whole bunch of factors that can ebb and flow with time and age.
Some children with a low socioeconomic status, for instance, might not show tooth wear initially, but as they grow older and continue to use their teeth day in and day out, tooth wear might become a problem.
In nations where acidic foods – like hibiscus, citrus, tamarind and baobab – are eaten frequently, for example, tooth wear seems to be significantly worse. Yet diet isn’t the only factor at play.
In the current meta-analysis, higher-educated adults were also less likely to develop pathological tooth wear over time. Not only does this bracket of the population tend to eat healthier, they also generally maintain better oral hygiene practices.
In addition, more affluent individuals are less likely to experience other health issues, like reflux disorder and diabetes, which can further complicate dental hygiene and care.
“Adults with lower socioeconomic status were more likely to have tooth wear due to poor diet, underlying medical conditions such as acid reflux, eating disorders or stress and depression as well as limited access to dental care,” says Ahmed.
“Wealthier adults not only have a lower risk but also improved access to dental treatment resulting in early identification and intervention.”
But not all dental practices that are popular today are necessarily good for the longevity of our chompers.
Multiple studies in the meta-analysis found certain brushing habits, like using an electric toothbrush or a hard-bristle brush, were linked to greater tooth wear in adults and not less, like you’d expect.
This suggests we need to better communicate healthy dental practices to the population, although more thorough first-hand research is needed. Most studies on tooth wear included in the meta-analysis were based in high-income countries. Only seven papers came from nations with lower relative incomes.
What’s more, the majority of studies included in the review gathered data predominantly from adolescents, which means the results might not capture the full extent of tooth wear and tear as we age.
Measuring tooth wear is also tricky business, with many studies using different evaluations, making them challenging to compare.
That said, the current review is a good assessment of current research on tooth wear and its connection to education, income, and social standing. The findings suggest a person’s socioeconomic status could very well act as a strong risk factor for dental complications later in life.
Future epidemiological studies will need to explore this connection in further detail, so we can figure out why the association exists and who is most at risk in the long run.
After all, protecting the teeth we already have is the healthiest and cheapest option.
The study was published in the Journal of Dentistry.