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Tooth surface loss associated with unshelled sunflower seed consumption: a scoping review
Suresh Kandagal Veerabhadrappa1,2, Srinivas Sulugodu Ramachandra3, Seema Yadav4
1Department of Oral Diagnostic Sciences, Faculty of Dentistry, SEGi University, Kota Damansara, Petaling Jaya, Selangor, Malaysia.
Objectives:
The consumption of unshelled sunflower seeds (USS) is a common, culturally embedded dietary habit in many parts of the world. However, the dental findings associated with this practice have not been comprehensively synthesised. This scoping review aimed to map the available evidence on the reported dental findings associated with USS consumption and to identify gaps in existing literature.
Materials And Methods:
Following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines, a comprehensive search of PubMed, MEDLINE, Scopus, Embase, Web of Science, and Google Scholar was conducted for studies published from inception to August 2026. Eligibility was based on the Population, Concept, and Context(PCC) framework. English-language peer-reviewed cross-sectional studies, case series, case reports, and narrative reviews reporting dental findings associated with USS consumption were included and descriptively synthesized.
Results:
Eight articles (two cross-sectional studies, three case reports, two case series, and one narrative review with a previously unpublished case) met the inclusion criteria. Tooth surface loss (TSL), presenting as characteristic incisal notching of the anterior teeth was the primary finding associated among the included studies. Infrequently reported findings included incisal fractures, dentinal hypersensitivity, gingival recession, widening of the periodontal ligament space, and localized inflammatory peri-implant disease associated with food impaction. Temporomandibular joint (TMJ) symptoms and masticatory muscle tenderness were reported only in a single case series.
Conclusion:
USS consumption may be associated with TSL, commonly presenting as characteristic incisal notching of the anterior teeth. Reported periodontal and TMJ findings can be considered as exploratory observations. Although TSL has been reported in association with USS consumption, the current evidence is insufficient to establish a causal relationship. Further epidemiological and longitudinal studies are needed to clarify these associations and determine the prevalence, progression, and clinical significance of the reported oral findings.