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Preventive and Therapeutic Effects of Plant-Derived Compounds on Tooth Erosion: A Systematic Review and Meta-Analysis
Mahtab Memarpour1, Neda Afzali Baghdadabadi1, Golnoush Farzinnia2
1Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Objectives:
Tooth erosion is the nonbacterial and irreversible pathological dissolution of enamel and dentin, and is primarily influenced by lifestyle. This systematic review and meta-analysis aimed to evaluate the preventive and therapeutic effects of plant-derived compounds on tooth erosion using evidence from in vitro and in situ studies.
Materials And Methods:
The review was registered in PROSPERO (CRD42023493906) and search was performed in PubMed, Scopus, ISI Web of Science, and Embase databases until July 5, 2025. In vitro and in situ original studies that investigated the effects of plant-based interventions on dental erosion, with a control group, were included. In vivo studies and those plants combined with non-plant substances were excluded. Risk of bias was assessed using the QUIN tool. Meta-analyses were performed when appropriate. Mechanical and ultrastructure assessments used to evaluate surface loss, hardness, and morphological changes were also reviewed.
Results:
Out of 1119 studies, 38 studies met the inclusion criteria; 22 studies assessed preventive effects, and 18 assessed the therapeutic effects, and one study that evaluated both the effects. Most studies had a medium risk of bias. Meta-analysis showed that quercetin as a preventive measure, significantly reduced dentin loss by 4.95 µm with high heterogeneity (I2 = 98%). For therapeutic measures, green tea reduced dentin loss by 0.89 µm, whereas epigallocatechin-3-gallate (EGCG) did not significantly decrease dentin loss. The two analyses were heterogeneous (I2 = 99%). Quercetin significantly decreased dentin loss by 4.19 µm with low heterogeneity (I2 = 0%).
Conclusions:
Plants with polyphenols may modify the pellicle layer ultrastructure to protect teeth from erosion. Quercetin (the most common flavonoid in fruit and vegetables) has preventive and therapeutic effects on dentin erosion. Green tea (because of its elevated catechin content) has therapeutic effects on dentin erosion.
