Type and timing of dietary acid intake and tooth wear among American adults

Objectives: To explore the interrelationship between type and timing of dietary acid intake and tooth wear among American adults. Methods: This study used data from 3,586 adults, aged 18 years and older, who participated in the National Health and Nutrition Examination Survey (NHANES) 2003-04. Information on four types of acidic food and beverages (fruits, fruit juices, alcoholic drinks, and soft drinks) and timing of consumption (meals versus snacks, defined according to percentage of total energy intake, self-reported eating occasion, and time of day) was extracted from two 24-hour dietary recalls. The association of the type and timing of dietary acid intake with the number of surfaces with moderate-to-severe tooth wear was assessed in Hurdle models to account for the excess zero counts and over-dispersion. Models were adjusted for socio-demographic factors, acid reflux medication, and dental insurance coverage. Results: The daily intake of soft drinks was associated with tooth wear, while those of fruits, fruit juices, and alcoholic drinks were not. The consumption of soft drinks with meals was the only factor consistently associated with tooth wean irrespective of the method used to define meals versus snacks. The above associations were found with the number of surfaces with tooth wear (among those with the condition), but not with the odds of having tooth wear (among all participants). Conclusion: The consumption of soft drinks with meals was associated with moderate-to-severe tooth wear among American adults. Other acidic foods and beverages were not associated with tooth wear, regardless of their timing of consumption.