International Journal of Paediatric Dentistry 2001; 11: 430–439 430 © 2001 BSPD and IAPD Blackwell Science Ltd The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi Arabia M. I. AL-MALIK, R. D. HOLT & R. BEDI Department of Transcultural Oral Health, Eastman Dental Institute, University College London, UK Summary. Objectives. The aim of this study was to investigate the possible association between dental erosion and caries, and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and questionnaire survey was carried out at a number of kindergartens. Sample and methods. A sample of 987 children (2–5-year-olds) was drawn from 17 kind- ergartens. Clinical examinations were carried out under standardized conditions by a trained and calibrated examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires distributed to the parents through the schools. These were completed before the dental examination. Results. Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child was a baby, were all related to erosion. Con- sumption of carbonated drinks and fruit syrups was also related to caries but they were part of a larger number of significant factors including socio-demographic measures and oral hygiene practices. Conclusions. There was no clear relationship between erosion and social class, or between erosion and oral hygiene practices; the reverse was true for caries. Dietary factors relating to both erosion and caries and/or rampant caries were found in this sample of children. Introduction Dental erosion and dental caries both arise from acid attack on dental enamel. Caries result from acid produced by bacteria being held against the tooth surface; this results in localized lesions [1]. The disease demonstrates a characteristic pattern of attack in the dentition, having a predilection for sites of plaque accumulation. In contrast, erosive lesions are caused by acid repeatedly ‘washing’ the enamel surface; they are often shallow and most often affect teeth and sites that are consistently free of plaque [1,2]. Erosion has been regarded as multifactorial in aetiology, as have caries. Both intrinsic and extrinsic sources of acid are able to contribute to erosion. The process may be affected by a number of determinants, including life-style, which affects the frequency of acid consumption, and oral hygiene practices, which may promote the removal of weakened, demineral- ized enamel [3]. Previous studies have linked a wide variety of foods and drinks to erosion in children and adults [4 – 7]. The majority of these were either experimental investigations or case-studies confined to one or a small number of reported cases. There appears to Correspondence: Dr Ruth Holt, Eastman Dental Institute, Transcultural Oral Health Department, 256 Gray’s Inn Road London, WC1 8LD, UK. E-mail: r.holt@eastman.ucl.ac.uk