High Socioeconomic Status May Be Risk Factor for Tooth Wear

woman holding her jaw in pain

woman holding jaw in pain
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Obviously, consuming soft drinks and other sweetened beverages, including energy drinks and fruit juices, increases the risk for dental caries. But a recent study conducted by researchers from Australia’s Griffith University and the National Dental Research Institute in Singapore confirms that while easy access to such beverages does exacerbate tooth decay, additional factors also play a role.1

The study, which researchers say is the first comprehensive review to investigate a link between socioeconomic status and tooth wear, was recently published in the Journal of Dentistry. For the study, researchers collected data from 30 countries across the globe, comprising 65 studies and 63,893 participants. Findings indicate a strong association between higher socioeconomic status, sugary drink consumption, and tooth wear in the permanent dentition of both children and adults.1 


One of the study’s authors, Khaled Ahmed, PhD, BDS, of the Griffith University School of Medicine and Dentistry, defines tooth wear as “… a condition that results in progressive and irreversible wearing down of teeth over time making them unsightly, more sensitive, and affecting a person’s ability to chew food.” He notes that while the sugar contained in fizzy drinks, energy drinks, and packaged juices is a major risk factor, diet, low-sugar, and sugar-free alternatives are also acidic. Acidic foods and drinks are associated with tooth wear.2

According to Ahmed, though such dietary habits may predispose children of all socioeconomic levels to erosive risk, those from higher socioeconomic areas may be more frequently exposed than their counterparts. This is due to increased access of soft drinks and other sugary and acidic beverages due to affluence. This, he says, results in tooth wear among children of high socioeconomic status that stems from the erosive nature of their diets.2

Yet, affluence has its benefits. The study results show a positive association between tooth wear and education, family income, and private school attendance in the case of adolescents. However, parents with higher levels of education and greater wealth had less risk of developing tooth wear. This is, no doubt, at least partly due to ready access to oral healthcare, including early intervention.1

In contrast, adults with lower socioeconomic status were more likely to exhibit tooth wear. Reasons for this include poor diet; underlying medical conditionals such as acid reflux, eating disorders, stress, and depression; and limited access to dental care and early intervention.


The authors conclude that to mitigate the ravages of tooth wear, education is vital. Parents, public health officials, and oral health professionals need to understand the causes of tooth wear in order to formulate effective detection, intervention, and management strategies. For that reason, socioeconomic status should be included as part of the routine screening and risk assessment for tooth wear.1

Says Ahmed, “Early screening of individuals at risk, as part of routine risk assessment that considers socioeconomic status as a risk factor based on the patient’s age, will enhance the cost-effectiveness and success of dental treatment.”2


  1. Entezami S, Glazer Peres KG, Huihua L, Zahra’a A, Hijazia M, Ahmedd KE. Tooth wear and socioeconomic status in childhood and adulthood: findings from a systematic review and meta-analysis of observational studies. J Dent. 2021;115:103827.
  2. Griffith University. Children From Wealthy Backgrounds at Greater Risk of Tooth Wear. Medical Xpress. Click here.
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