© 2008 The Authors Journal compilation © 2008 BSPD, IAPD and Blackwell Publishing Ltd 353 DOI: 10.1111/j.1365-263X.2008.00919.x Blackwell Publishing Ltd Diet and dental erosion in young people in south-east Brazil PAULA J. WATERHOUSE 1 , SHEYLA M. AUAD 1,4 , JUNE H. NUNN 2 , IAN N. STEEN 3 & PAULA J. MOYNIHAN 1 1 The School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK, 2 The Dental School, Trinity College, Dublin, Ireland, 3 The Centre for Health Services Research, Newcastle University, Newcastle upon Tyne, UK, 4 Federal University of Minas Gerais, Belo Horizonte, Brazil International Journal of Paediatric Dentistry 2008; 18: 353– 360 Background. The regular consumption of acidic foods and drinks may be associated with dental erosion, and soft drink consumption appears to be increasing both in developed and developing countries. Dentists are aware that an acidic diet can contribute to the development of erosion; however, there may be confusion within the profession concerning the general health message of eating five portions of fruits and vegetables each day. Objective. The aim of this study was to investigate associations between dental erosion and the con- sumption of acidic foods and beverages in school- children in south-east Brazil. The objective was to gather information, by means of a dietary question- naire, on frequency of intake and patterns of consumption of acidic foods and drinks in a group of schoolchildren. The hypothesis was that the expe- rience of dental erosion among the study sample was associated with the frequency and pattern of con- sumption of soft drinks, fruit juices, fruits, and yogurt. Methods. A cross-sectional study was conducted in Três Corações, south-east Brazil. A sample of 458 schoolchildren, mean age 13.8 (SD 0.39) years, completed the study. Information about potential dietary risk factors for dental erosion was collected through a questionnaire survey completed by the schoolchildren. For the dental examinations, the subjects were examined for dental erosion in a school room. Associations between dental erosion and the variables under study were investigated through processes of bivariate and multivariate analyses. The statistical significance level was set at 5%. Results. Analysis of the questionnaire surveys showed that the frequency of consumption of sugared carbonated drinks was the only variable independently associated with the erosive process, with subjects who had a daily consumption of such drinks having a greater likelihood of having erosion (P = 0.015, odds ratio 1.752, 95% confidence interval 1.116 –2.750). Conclusions. Of all tested factors in this sample of schoolchildren the consumption of sugared carbon- ated drinks is most associated with dental erosion. Introduction There is a growing body of evidence to suggest that acidic foods and soft drinks may be important in the development of erosion 1 . Within the dental profession generally, there is awareness that an acidic diet may cause erosion; however, confusion could exist when professionals are called upon to provide dietary advice to individual patients because, in the UK, the government is promoting the con- sumption of at least five portions of fruits and vegetables per day for children and adults 2 . This could lead to conflicting advice from dental practitioners who may recommend to a patient, at risk of developing erosion, that they should reduce their fruit intake because of its acidic nature. Added to this, the availability of acidic drinks, particularly carbonated ones, is increasing both in developed and developing countries 3,4 . In Brazil, 12.2 billion litres of carbonated drinks were sold in 2004, compared with the 6.4 billion litres sold in 1994 5 . The impact of an acidic diet has been studied widely, and results suggest an association with erosion 6–15 . Early case reports suggested that unusual patterns of consumption of fruits cause erosion 16,17 . A European-based epidemiological study has associated citrus fruit consumption with erosion 18 . However, other work has failed to find an association between fruit consumption and erosion 19 . An increasing number of studies suggest a more important role of soft drinks Correspondence to: Paula Jane Waterhouse, The School of Dental Sciences, Framlington Place, Newcastle upon Tyne NE2 4BW, UK. E-mail: p.j.waterhouse@ncl.ac.uk