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The Role of Nutrient Content in Diet in the Etiology of Dental Crowding


BACKGROUND: Malocclusion affects almost two thirds of the American population. While malocclusion is unlikely to cause physical morbidity, crooked teeth pose a burden on quality of life and their treatment supplies a 10 billion-dollar per year orthodontic industry in the United States alone. Yet, it is a recent phenomenon since compared to recent anthropologic past the prevalence of malocclusion has sharply increased. However, there is currently little agreement among experts as to the reason for this change. Genetic theorists speculate that allelic redistributions are to blame. On the contrary, environmental theorists claim dental attrition, airway obstruction, functional habits, caries prevalence, diet consistency, and nutrient content each may contribute to the development of malocclusion. Surprisingly, few studies have been performed examining the influence of dietary nutrient content on the development of dental crowding. Insight gained may over time lead to improved preventative treatment options for malocclusion, increased stability of teeth, the promotion of oral health, and increased access to care.

OBJECTIVE: 1.) To provide a synthesis of studies addressing the contribution of nutrient content in diet and its influence on malocclusion. 2.) To design a study that would examine the effect of diet on the development of malocclusion while considering all potential confounders.

METHODS: A scoping systematic review was performed January of 2016 using PubMed and EMBASE databases. Studies were included if they met the following criteria: 1.) published in English and 2.) assessed diet and its possible relationship to malocclusion. Studies were excluded for the following reasons: 1.) Not published in English, 2.) Limited information on methods, 3.) focuses only on diet consistency and not nutrient content and other known etiologies of malocclusion as discussed already in the introduction or 4.) the full-text article is no longer in print.

RESULTS: After reviewing 1,689 articles found in the PubMed and EMBASE databases, 14 studies met the inclusion criteria and were chosen for analysis in the review. Eleven studies were cross-sectional and 3 were animal studies.

CONCLUSIONS: To date, no studies have measured nutrient content in diet and determined its role in the development of malocclusion while controlling for the following confounding factors: genetics, orofacial habits, attrition, caries, and diet consistency. Such studies are necessary to investigate the association between nutrient content in diet and malocclusion. Further high-quality studies are needed to gain etiological insight. Such knowledge could reduce the incidence and/or severity of dental crowding in the permanent dentition, improve access to public oral health, and reduce the burden of malocclusion on self-confidence and quality of life.

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