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Schulze A, Busse M. Sports Diet and Oral Health in Athletes: A Comprehensive Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:319. [PMID: 38399605 PMCID: PMC10890155 DOI: 10.3390/medicina60020319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20-84%, dental erosion 42-59%, gingivitis 58-77%, and periodontal disease 15-41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes' dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes' health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.
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Affiliation(s)
- Antina Schulze
- General Outpatient Clinic of Sports Medicine, University of Leipzig, 04103 Leipzig, Germany;
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Hajishafiee M, Kapellas K, Listl S, Pattamatta M, Gkekas A, Moynihan P. Effect of sugar-sweetened beverage taxation on sugars intake and dental caries: an umbrella review of a global perspective. BMC Public Health 2023; 23:986. [PMID: 37237341 DOI: 10.1186/s12889-023-15884-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND As part of the Global Strategy on Oral health, the World Health Organization (WHO) is exploring cost-effective interventions for oral health, including taxation on sugar-sweetened beverages (SSBs). To inform this process, this umbrella review aimed to identify the best available estimates pertaining to the impact of SSB taxation on the reduction of sugars intake, and the sugars-caries dose-response, such that estimates of the impact of SSB taxation on averting dental caries in both high (HIC) and low and middle (LMIC) countries be available. METHODS The questions addressed were: (1) what are the effects of SSB taxation on consumption of SSBs and (2) sugars? (3) What is the effect on caries of decreasing sugars? and (4) what is the likely impact of a 20% volumetric SSB tax on the number of active caries prevented over 10 years? Data sources included PubMed, Embase, Web of Science, Scopus, CINAHL, Dentistry and Oral Sciences Source, Cochrane Library, Joanna Briggs Institute (JBI) Systematic Review Register, and PROSPERO. The review was conducted with reference to JBI guidelines. The quality of included systematic reviews was assessed using AMSTAR to identify best evidence. RESULTS From 419 systematic reviews identified for questions 1 & 2, and 103 for question 3, 48 (Questions 1 & 2) and 21 (Question 3) underwent full text screening, yielding 14 and five included reviews respectively. Best available data indicated a 10% tax would reduce SSB intake by 10.0% (95% CI: -5.0, 14.7%) in HIC and by 9% (range -6.0 to 12.0%) in LMIC, and that a 20% tax would reduce free sugars intake on average by 4.0 g/d in LMIC and 4.4 g/d in HIC. Based on best available dose response data, this could reduce the number of teeth with caries per adults (HIC and LMIC) by 0.03 and caries occurrence in children by 2.7% (LMIC) and 2.9% (HIC), over a 10-year period. CONCLUSION Best available data suggest a 20% volumetric SSB tax would have a modest impact on prevalence and severity of dental caries in both HIC and LMIC.
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Affiliation(s)
| | - Kostas Kapellas
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Stefan Listl
- Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Madhuri Pattamatta
- Department of Dentistry - Quality and Safety of Oral Health Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Athanasios Gkekas
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Paula Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
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Liu L, Ma F, Liu Q, Yu X, Zeng X. Association Between the SLC2A2 Gene rs1499821 Polymorphism and Caries Susceptibility. Genet Test Mol Biomarkers 2023; 27:149-156. [PMID: 37257183 DOI: 10.1089/gtmb.2022.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Objectives: This study was designed to analyze the association between the SLC2A2 rs1499821 polymorphism and caries susceptibility in the Chinese Han, Zhuang, and Baikuyao populations. Materials and Methods: The present case-control study included 1067 12-year-old children: 481 with caries (142 Han, 166 Zhuang and 173 Baikuyao) and 586 who were caries-free (135 Han, 178 Zhuang and 273 Baikuyao). Questionnaires about diet and oral habits were obtained from all subjects. All of the children received dental examinations and DNA collection. The SLC2A2 rs1499821 SNP was genotyped using the SNPscan technique. Results: The rs1499821 T polymorphism was significantly associated with caries susceptibility in both the Han population and the combined populations of the three ethnic subgroups. SLC2A2 rs1499821 was associated with caries susceptibility in the dominant model in the Han (p = 0.045) population and the combined (p = 0.038) group. The CT+TT genotypes at rs1499821 were associated with a higher risk of caries in the Han (OR = 1.69, adjusted 95% CI: 1.01-2.81) and combined (OR = 1.33, adjusted 95% CI: 1.02-1.74) populations. In both Han (p = 0.009) and the combined populations (p = 0.004), there were statistically significant associations between the frequency of sweet food intake and dental caries. However, the rs1499821 polymorphisms did not associate with the frequency of sweet food intake in these ethnic subgroups. Conclusion: In the Han population, the SLC2A2 rs1499821 T allele and the frequency of sweet food intake may be regarded as risk factors for caries susceptibility. The SLC2A2 rs1499821 T allele had no association with the frequency of sweet food intake in any of the three ethnic groups.
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Affiliation(s)
- Li Liu
- Guangxi Medical University College of Stomatology, Nanning, China
| | - Fei Ma
- Guangxi Medical University College of Stomatology, Nanning, China
| | - Qiulin Liu
- Guangxi Medical University College of Stomatology, Nanning, China
| | - Xueting Yu
- Guangxi Medical University College of Stomatology, Nanning, China
| | - Xiaojuan Zeng
- Guangxi Medical University College of Stomatology, Nanning, China
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst KI, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Naska A, Peláez C, Pentieva K, Siani A, Thies F, Tsabouri S, Adan R, Emmett P, Galli C, Kersting M, Moynihan P, Tappy L, Ciccolallo L, de Sesmaisons‐Lecarré A, Fabiani L, Horvath Z, Martino L, Muñoz Guajardo I, Valtueña Martínez S, Vinceti M. Tolerable upper intake level for dietary sugars. EFSA J 2022; 20:e07074. [PMID: 35251356 PMCID: PMC8884083 DOI: 10.2903/j.efsa.2022.7074] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Following a request from five European Nordic countries, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was tasked to provide scientific advice on a tolerable upper intake level (UL) or a safe level of intake for dietary (total/added/free) sugars based on available data on chronic metabolic diseases, pregnancy-related endpoints and dental caries. Specific sugar types (fructose) and sources of sugars were also addressed. The intake of dietary sugars is a well-established hazard in relation to dental caries in humans. Based on a systematic review of the literature, prospective cohort studies do not support a positive relationship between the intake of dietary sugars, in isocaloric exchange with other macronutrients, and any of the chronic metabolic diseases or pregnancy-related endpoints assessed. Based on randomised control trials on surrogate disease endpoints, there is evidence for a positive and causal relationship between the intake of added/free sugars and risk of some chronic metabolic diseases: The level of certainty is moderate for obesity and dyslipidaemia (> 50-75% probability), low for non-alcoholic fatty liver disease and type 2 diabetes (> 15-50% probability) and very low for hypertension (0-15% probability). Health effects of added vs. free sugars could not be compared. A level of sugars intake at which the risk of dental caries/chronic metabolic diseases is not increased could not be identified over the range of observed intakes, and thus, a UL or a safe level of intake could not be set. Based on available data and related uncertainties, the intake of added and free sugars should be as low as possible in the context of a nutritionally adequate diet. Decreasing the intake of added and free sugars would decrease the intake of total sugars to a similar extent. This opinion can assist EU Member States in setting national goals/recommendations.
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Kumar D, Gandhi K, Maywad S, Malhotra R, Ahuja S, Kapoor R. Prevalence and Correlation of Dental Caries with its Specific Risk Factors in 5-15-year-old School-going Children in Urban Population of Ghaziabad. Int J Clin Pediatr Dent 2020; 13:72-78. [PMID: 32581484 PMCID: PMC7299897 DOI: 10.5005/jp-journals-10005-1714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dental caries is a rapidly emerging oral health problem amid the children with differing prevalence rate in different states of India. The data available from Ghaziabad city regarding dental caries are scarce; therefore, the study was conducted in 5–15-year school-going children in urban population of Ghaziabad.
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Affiliation(s)
- Dipanshu Kumar
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Kapil Gandhi
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Shraddha Maywad
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Ritika Malhotra
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Shilpa Ahuja
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
| | - Rishabh Kapoor
- Department of Pedodontics and Preventive Dentistry, Inderprastha Dental College and Hospital, Ghaziabad, Uttar Pradesh, India
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Sehdev B, Muruts L, Ganji KK. Prevalence of Tooth Decay and Associated Factors Among Ethiopian Patients. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abbass MMS, AbuBakr N, Radwan IA, Rady D, El Moshy S, Ramadan M, Ahmed A, Al Jawaldeh A. The potential impact of age, gender, body mass index, socioeconomic status and dietary habits on the prevalence of dental caries among Egyptian adults: a cross-sectional study. F1000Res 2019; 8:243. [PMID: 30906540 PMCID: PMC6426081 DOI: 10.12688/f1000research.17892.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Dental caries is a major public health problem and the most widespread chronic disease to affect individuals throughout their lifetime. Little information exists about the prevalence of dental caries among Egyptian adults. Therefore, this study investigated the dental caries experience among Egyptian adults in correlation with different risk factors. Methods: A total of 359 Egyptian adults (age range, 18-74 years) were examined over a period of 3 months, starting on the 15
th of November 2017 until the 13
th of January 2018. Socio-demographic data, brushing frequency, body mass index (BMI) and eating habits were recorded and collected using a questionnaire. Dental examination was performed using the Decayed, Missing and Filled tooth (DMFT) index. Results: In total, 86.63% of participants had dental caries experience. Of the participants, 60.45%, 48.47% and 55.43% had at least one decayed, missing and filled tooth, respectively. The mean number of decayed, missing, filled or DMFT for the whole sample were 2.4±3.6, 1.98±3.99, 1.79±2.45, 6.09±5.7, respectively. Decayed teeth were inversely correlated with socio-economic status (SES), education level, brushing frequency and milk consumption and positively correlated with grains, junk food and soda drinks consumption. Missing teeth were inversely correlated with SES, education level and brushing frequency, while positively correlated with age, BMI and caffeinated drink consumption. Conversely, filled teeth were positively correlated with age, BMI, SES and education level, while negatively correlated with grains and sugars in drinks. Conclusion: The present study clarifies that age, BMI, SES, education level and brushing frequency are risk factors significantly associated with dental caries prevalence amongst Egyptian adults. Egyptian adults' dietary habits might lead to obesity, which indirectly causes dental caries rather than directly as in children.
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Affiliation(s)
- Marwa M S Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermeen AbuBakr
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mohamed Ramadan
- Specialized Dental Hospital, Armed Forces Medical Complex, Cairo, Egypt
| | - Attera Ahmed
- Independent Researcher, Research door, Limerick, County Limerick, Ireland
| | - Ayoub Al Jawaldeh
- Nutrition Unit, World Health Organization Office for Eastern Mediterranean Region, Cairo, Egypt
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Forde H, Solomon-Moore E. A Qualitative Study to Understand the Potential Efficacy of an Information-Based Sugar Reduction Intervention among Low Socioeconomic Individuals in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E413. [PMID: 30709042 PMCID: PMC6388364 DOI: 10.3390/ijerph16030413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/04/2019] [Accepted: 01/30/2019] [Indexed: 02/08/2023]
Abstract
Sugar consumption in the UK consistently exceeds recommendations, despite the association it has with poor health outcomes. Low socioeconomic groups are most likely to over-consume sugar, which could exacerbate existing health disparities. Various interventions attempt to reduce the amount of sugar consumed, but their effectiveness is still unclear. This study qualitatively explored the sugar consumption behaviours of individuals experiencing food poverty, and examined how an information-based sugar reduction intervention might influence these behaviours. Eight clients and six volunteers from a food bank in Bristol (UK) completed semi-structured, one-to-one interviews that were thematically analysed. Food bank clients appeared to heavily consume sugar, with little understanding of the associated health effects and limited awareness of the intervention. Consumption behaviours were particularly influenced by personal and psychological factors, such as mental health; in addition to social factors, like familial behaviours and food access issues. It emerged that food bank clients' often-challenging personal circumstances were likely to promote their sugar consumption. Making intervention materials visually appealing and easily comprehendible were found to be important for improving an intervention's reception. Recommendations were developed to improve the efficacy of similar information-based sugar reduction interventions among socioeconomically deprived groups.
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Affiliation(s)
- Hannah Forde
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK.
| | - Emma Solomon-Moore
- Department for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK.
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Li LW, Wong HM, Gandhi A, McGrath CP. Caries-related risk factors of obesity among 18-year-old adolescents in Hong Kong: a cross-sectional study nested in a cohort study. BMC Oral Health 2018; 18:188. [PMID: 30458813 PMCID: PMC6247777 DOI: 10.1186/s12903-018-0657-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Socio-economic status, health awareness, and dietary habits have been reported as common risk factors of dental caries and obesity. The present study aimed to explore shared mediators between caries and obesity and to estimate the effects of caries-related factors on adiposity. METHODS This was a cross-sectional study among adolescents aged 18 years. The study was nested in a population-representative cohort of Chinese in Hong Kong. The number of decayed, missing, and filled permanent teeth (DMFT) was recorded during the oral examinations. Body Mass Index (BMI), Waist Circumference (WC), Waist-Hip-Ratio (WHR), Waist-Height-Ratio (WHtR), and Triceps Skinfold Thickness (TRSKF) were used as adiposity indices. Data on socio-economic status, oral health behavior (tooth brushing habit, use of fluoride toothpaste, dental flossing habit, and mouth rinse habit), and dietary record (frequency and amount of different food) were collected through self-completed questionnaires. Chi-square tests and binary logistic regressions were used for analysis. RESULTS Three hundred eighty-three participants were included. The mean (standard deviation, SD) of BMI, WC, WHR, WHtR, TRSKF, and DMFT were 21.26 (3.72), 69.11 (9.25), 0.77 (0.06), 0.42 (0.05), 15.72 (6.33), and 2.06 (2.43), respectively. Males were more likely to be overweight/obese than females. Various factors including gender, parental employment status, mouth rinse habit, frequency and amount of meat intake, frequency of oil intake, use of fluoride toothpaste, and DMFT were found significant (p < 0.05) in different final models of adiposity status. CONCLUSIONS More mediators should be included in future research to elucidate mechanism of the association between caries and obesity.
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Affiliation(s)
- Ling-Wei Li
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Hai Ming Wong
- Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, 2/F Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China
| | - Akanksha Gandhi
- Food and Nutritional Science, School of Biological Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Colman Patrick McGrath
- Periodontology & Public health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Karjalainen S, Tolvanen M, Pienihäkkinen K, Söderling E, Lagström H, Simell O, Niinikoski H. High sucrose intake at 3 years of age is associated with increased salivary counts of mutans streptococci and lactobacilli, and with increased caries rate from 3 to 16 years of age. Caries Res 2016; 49:125-32. [PMID: 25756173 DOI: 10.1159/000369358] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed to study the long-term associations between sucrose intake (SI), selected representatives of the cariogenic oral flora, and the dental health of children from 3 to 16 years of age. METHODS At 7 months of age 1,062 infants (540 intervention; 522 controls) were included in the prospective, randomised STRIP-project aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis when they become adults. At 3 years of age, every fifth child was invited (n = 178) to an oral sub-study, and 148 (78 boys) children attended. A restudy was conducted on 135 children aged 6, 127 aged 9, 114 aged 12 and 88 aged 16. SI using 4-day food records, plate-cultured mutans streptococci (MS), salivary lactobacilli (LB) and yeasts using commercial kits (Orion Diagnostica, Espoo Finland), toothbrushing frequency using fluoridated toothpaste and dental health expressed as d 3 mft/D 3 MFT were regularly recorded. RESULTS The SI of children whose intake was ≥ 10 E% (high SI) at 3 years remained high throughout the entire follow-up (p < 0.001, GLM for repeated measures) period, and they had higher salivary MS and LB counts (p = 0.024 and p = 0.068, respectively, GLM) than their counterparts whose SI was below 10 E% (low SI). No differences in toothbrushing habits were found between the high and low SI-groups. Caries-survival was strongly associated with low 6-year-counts of MS (p = 0.008, Cox regression analysis), and the d 3 mft/D 3 MFTscores of the high SI-group were higher than those of the low SI-group (p = 0.046, GLM). CONCLUSIONS High SI at 3 years was associated with high MS-counts ( ≥ 10 5 cfu/ml) and with a high risk for caries.
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FDI policy statement on dietary free sugars and dental caries: Adopted by the FDI General Assembly: 24 September 2015, Bangkok, Thailand. Int Dent J 2016; 66:9-10. [PMID: 26803942 DOI: 10.1111/idj.12232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bernabé E, Vehkalahti MM, Sheiham A, Lundqvist A, Suominen AL. The Shape of the Dose-Response Relationship between Sugars and Caries in Adults. J Dent Res 2015; 95:167-72. [PMID: 26553884 DOI: 10.1177/0022034515616572] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dental caries is considered a diet-mediated disease, as sugars are essential in the caries process. However, some gaps in knowledge about the sugars-caries relationship still need addressing. This longitudinal study aimed to explore 1) the shape of the dose-response association between sugars intake and caries in adults, 2) the relative contribution of frequency and amount of sugars intake to caries levels, and 3) whether the association between sugars intake and caries varies by exposure to fluoride toothpaste. We used data from 1,702 dentate adults who participated in at least 2 of 3 surveys in Finland (Health 2000, 2004/05 Follow-up Study of Adults' Oral Health, and Health 2011). Frequency and amount of sugars intake were measured with a validated food frequency questionnaire. The DMFT index was the repeated outcome measure. Data were analyzed with fractional polynomials and linear mixed effects models. None of the 43 fractional polynomials tested provided a better fit to the data than the simpler linear model. In a mutually adjusted linear mixed effects model, the amount of, but not the frequency of, sugars intake was significantly associated with DMFT throughout the follow-up period. Furthermore, the longitudinal association between amount of sugars intake and DMFT was weaker in adults who used fluoride toothpaste daily than in those using it less often than daily. The findings of this longitudinal study among Finnish adults suggest a linear dose-response relationship between sugars and caries, with amount of intake being more important than frequency of ingestion. Also, daily use of fluoride toothpaste reduced but did not eliminate the association between amount of sugars intake and dental caries.
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Affiliation(s)
- E Bernabé
- King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Division of Population and Patient Health, London, UK
| | - M M Vehkalahti
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - A Sheiham
- Department of Epidemiology and Public Health, University College London, London, UK
| | - A Lundqvist
- National Institute for Health and Welfare, Helsinki, Finland
| | - A L Suominen
- National Institute for Health and Welfare, Helsinki, Finland Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
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Polymorphisms in sweet taste genes (TAS1R2 and GLUT2), sweet liking, and dental caries prevalence in an adult Italian population. GENES AND NUTRITION 2015; 10:485. [PMID: 26268603 DOI: 10.1007/s12263-015-0485-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
The aim of the study was to assess the relationship between sweet taste genes and dental caries prevalence in a large sample of adults. In addition, the association between sweet liking and sugar intake with dental caries was investigated. Caries was measured by the decayed, missing, filled teeth (DMFT) index in 647 Caucasian subjects (285 males and 362 females, aged 18-65 years), coming from six villages in northeastern Italy. Sweet liking was assessed using a 9-point scale, and the mean of the liking given by each individual to specific sweet food and beverages was used to create a sweet liking score. Simple sugar consumption was estimated by a dietary history interview, considering both added sugars and sugar present naturally in foods. Our study confirmed that polymorphisms in TAS1R2 and GLUT2 genes are related to DMFT index. In particular, GG homozygous individuals for rs3935570 in TAS1R2 gene (p value = 0.0117) and GG homozygous individuals for rs1499821 in GLUT2 gene (p value = 0.0273) showed higher DMFT levels compared to both heterozygous and homozygous for the alternative allele. Furthermore, while the relationship sugar intake-DMFT did not achieve statistical significance (p value = 0.075), a significant association was identified between sweet liking and DMFT (p value = 0.004), independent of other variables. Our study showed that sweet taste genetic factors contribute to caries prevalence and highlighted the role of sweet liking as a predictor of caries risk. Therefore, these results may open new perspectives for individual risk identification and implementation of target preventive strategies, such as identifying high-risk patients before caries development.
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Doichinova L, Bakardjiev P, Peneva M. Assessment of food habits in children aged 6-12 years and the risk of caries. BIOTECHNOL BIOTEC EQ 2014; 29:200-204. [PMID: 26019634 PMCID: PMC4433830 DOI: 10.1080/13102818.2014.989180] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 11/12/2014] [Indexed: 11/05/2022] Open
Abstract
Food is necessary for the proper growth and development of children. The excessive intake of low-molecular carbohydrates constitutes a serious health issue, which has an unfavourable impact on the dental health status. The aim of this study was to assess the food habits in healthy children aged 6–12 years and the effect on their oral risk profile. The study included 100 children. The assessment of their nutrition was done with the help of a seven-day reproduction of the food intake and a survey used to determine their underlying food habits and preferences. The results revealed unbalanced nutrition of the children and increased intake of simple sugar, which will increase the risk of development of dental caries. The observed high levels of DMFT (number of decayed, missing and filled teeth) in 54% of the children is a logical result of the frequent intake of sugary foods and beverages for a long period of time, as this will increase the acid production by microorganisms in dental plaque, which is one of the leading etiologic factors for the development of caries. It is necessary for dentists to administer control over the carbohydrate intake and the food habits of children, as well as to encourage non-cariogenic diet in order to keep their good oral health.
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Affiliation(s)
- Liliya Doichinova
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia , Sofia , Bulgaria
| | - Peter Bakardjiev
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia , Sofia , Bulgaria
| | - Milena Peneva
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia , Sofia , Bulgaria
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Sheiham A, James WPT. A new understanding of the relationship between sugars, dental caries and fluoride use: implications for limits on sugars consumption. Public Health Nutr 2014; 17:2176-84. [PMID: 24892213 PMCID: PMC10282617 DOI: 10.1017/s136898001400113x] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/07/2014] [Accepted: 05/02/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the quantitative relationship between sugar intake and the progressive development of dental caries. DESIGN A critical in-depth review of international studies was conducted. Methods included reassessing relevant studies from the most recent systematic review on the relationship between levels of sugars and dental caries. Reanalysis of dose-response relationships between dietary sugars and caries incidence in teeth with different levels of caries susceptibility in children was done using data from Japanese studies conducted by Takeuchi and co-workers. SETTING Global, with emphasis on marked differences in both national sugar intake and fluoride use and preferably where one factor such as sugar intake changed progressively without changes in other factors over a decade or more. SUBJECTS Children aged 6 years or more and adults. RESULTS Caries occurred in both resistant and susceptible teeth of children when sugar intakes were only 2-3 % of energy intake, provided that the teeth had been exposed to sugars for >3 years. Despite increased enamel resistance after tooth eruption, there was a progressive linear increase in caries throughout life, explaining the higher rates of caries in adults than in children. Fluoride affects progression of caries development but there still is a pandemic prevalence of caries in populations worldwide. CONCLUSIONS Previous analyses based on children have misled public health analyses on sugars. The recommendation that sugar intakes should be ≤10 % of energy intake is no longer acceptable. The much greater adult burden of dental caries highlights the need for very low sugar intakes throughout life, e.g. 2-3 % of energy intake, whether or not fluoride intake is optimum.
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Affiliation(s)
- Aubrey Sheiham
- Department of Epidemiology & Public Health, University College London, 1‐19 Torrington Place, London WC1E 6BT, UK
| | - W Philip T James
- London School of Hygiene and Tropical Medicine, London, UK, and World Obesity, London, UK
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Gupta P, Gupta N, Pawar AP, Birajdar SS, Natt AS, Singh HP. Role of sugar and sugar substitutes in dental caries: a review. ISRN DENTISTRY 2013; 2013:519421. [PMID: 24490079 PMCID: PMC3893787 DOI: 10.1155/2013/519421] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/06/2013] [Indexed: 11/17/2022]
Abstract
Dental caries is a chronic disease which can affect us at any age. The term "caries" denotes both the disease process and its consequences, that is, the damage caused by the disease process. Dental caries has a multifactorial aetiology in which there is interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. The role of sugar (and other fermentable carbohydrates such as highly refined flour) as a risk factor in the initiation and progression of dental caries is overwhelming. Whether this initial demineralization proceeds to clinically detectable caries or whether the lesion is remineralized by plaque minerals depends on a number of factors, of which the amount and frequency of further sugars consumption are of utmost importance. This paper reviews the role of sugar and sugar substitutes in dental caries.
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Affiliation(s)
- Prahlad Gupta
- Department of Public Health Dentistry, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Nidhi Gupta
- Department of Prosthodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab 151203, India
| | - Atish Prakash Pawar
- Department of Oral Pathology, Aditya Dental College, Beed, Maharashtra 431122, India
| | | | - Amanpreet Singh Natt
- Department of Orthodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Harkanwal Preet Singh
- Department of Oral Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
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Guido JA, Martinez Mier EA, Soto A, Eggertsson H, Sanders BJ, Jones JE, Weddell JA, Villanueva Cruz I, Anton de la Concha JL. Caries prevalence and its association with brushing habits, water availability, and the intake of sugared beverages. Int J Paediatr Dent 2011; 21:432-40. [PMID: 21718372 DOI: 10.1111/j.1365-263x.2011.01146.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND. With Dental Caries being the most common disease amongst children in the world today, there is a need to fully understand risk factors that may be related to caries prevalence and how they could be best addressed. AIM. The aim of this study was to evaluate soda, juice, sugared-beverage intake, brushing habits, and community water source availability as they relate to the prevalence of both noncavitated and cavitated caries lesions in small rural villages in Mexico. DESIGN. The International Caries Detection and Assessment System (ICDAS) was used in children from small, isolated, villages in Mexico. Risk factors were assessed via questionnaires. RESULTS. Caries prevalence in the villages was very high, ranging from 94.7% to 100% of the children studied. The mean number of surfaces with lesions per child (D1MFS + d1mfs) having scores ≥1 (noncavitated and cavitated) ranged from 15.4 ± 11.1 to 26.6 ± 15.2. Many of the children reported drinking beverages containing sugar. CONCLUSIONS. Drinking sugared beverages, poor oral hygiene habits, and lack of access to tap water were identified as risk factor for caries in this sample of residents of rural Mexico.
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[The importance of health education in prevention of oral health in children]. ACTA ACUST UNITED AC 2008; 61:65-70. [PMID: 18798477 DOI: 10.2298/mpns0802065i] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED HEALTH EDUCATION: The aim of education is to impart knowledge on the causes of disease and decay of the teeth and periodontium, on the ways and possibilities of disease prevention and adequate treatment; to point out to the necessity of proper nutrition, regular and proper oral hygiene, proper use of fluoride products as well as to the significance of regular check-ups with a dentist. NUTRITION Frequent intake of carbohydrates leads to a higher prevalence of caries. Taking into consideration that it is neither obtainable nor recommendable to completely eliminate glucoses from the nutrition components, it is necessary to advice parents and children to take glucose (if possible) only along with the regular meal when the saliva flow is increased. ORAL HYGIENE In order to establish oral hygiene as an important prophylactic measure influencing successful protection of oral health of the whole population, it is necessary to inform as many people as possible about oral hygiene effectiveness and its necessity in preventing oral and dental diseases; to develop the habits of regular oral hygiene maintenance in the youngest children as well as to refer them to the use of most adequate paraphernalia and agents for performing the daily oral hygiene procedures. FLUORIDE PROPHYLAXIS Undoubtedly, fluoride is currently the most efficient agent for the prevention of dental pathology. The anticaries efficacy of fluoride is a consequence of the cumulative effect of several different mechanisms. They can occur on the dental surface or directly influence the mineral phase in the enamel. Each dental hygiene preventive program must include the content about the use of fluoride as the basic prophylactic measure. It is recommended to be the sum of the combined effect of systemic (endogenic) and local (exogenic) application. CONCLUSION Regarding high prevalence of caries in children, the issue of prophylaxis is of great significance and current interest. In that respect, health education should point out to the significance of proper nutrition, regular oral hygiene and fluoride prophylaxis, all aimed at preventing dental diseases. It is certain that parents must take an active part in these activities both as educators and controllers of the proposed measures.
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Maserejian NN, Tavares MA, Hayes C, Soncini JA, Trachtenberg FL. Prospective study of 5-year caries increment among children receiving comprehensive dental care in the New England children's amalgam trial. Community Dent Oral Epidemiol 2008; 37:9-18. [PMID: 18782333 DOI: 10.1111/j.1600-0528.2008.00437.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To measure the 5-year caries increment among high-risk children during their participation in the New England Children's Amalgam Trial (NECAT), and to evaluate sociodemographic factors that may account for any observed disparities. METHODS NECAT recruited 534 children aged 6-10 with at least two decayed posterior occlusal surfaces from urban Boston and rural Maine. After restoration of baseline caries and application of sealants to sound surfaces, NECAT continued to provide free comprehensive semiannual dental care to participants. The net caries increment of children who completed the 5-year follow-up (n = 429) was calculated and predictors of caries increment were investigated using multivariate negative binomial models. RESULTS The majority of children (89%) experienced new caries by the end of the 5-year follow-up. Almost half (45%) had at least one newly decayed surface by the first annual visit. At year 5, the mean number of new decayed teeth was 4.5 +/- 3.6 (range 0-25) and surfaces was 6.9 +/- 6.5 (range 0-48). Time trends showed a noticeably higher increment rate among older children and young teenagers. Multivariate models showed that age (P < 0.001), number of baseline carious surfaces (P < 0.001), and toothbrushing frequency (<1/day versus >or=2/day, P = 0.04) were associated with caries increment. Only 48 children (11%) did not develop new caries. CONCLUSIONS Despite the receipt of comprehensive semiannual dental care, the vast majority of these high-risk children continued to develop new caries within 5 years. While disparities were observed by age, extent of prior decay, and toothbrushing frequency, no other sociodemographic factors were associated with caries increment, suggesting that the dental care provided during the trial reduced sociodemographic disparities in prior caries experience that were observed at baseline.
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Abstract
AbstractOral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks.Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride.It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is <15–20kg/yr (~6–10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.
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Affiliation(s)
- Paula Moynihan
- WHO Collaborating Centre for Nutrition and Oral Health, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
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Bruno-Ambrosius K, Swanholm G, Twetman S. Eating habits, smoking and toothbrushing in relation to dental caries: a 3-year study in Swedish female teenagers. Int J Paediatr Dent 2005; 15:190-6. [PMID: 15854115 DOI: 10.1111/j.1365-263x.2005.00621.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of the present study were to describe eating, toothbrushing and smoking habits in a cohort of Swedish female adolescents, and to relate the findings to dental caries increment. DESIGN The research took the form of a longitudinal study. SUBJECTS AND METHODS The study sample consisted of a cohort of 162 girls under regular dental care, aged 12 years at baseline, who were followed for 3 years, from the sixth to the ninth grade. Eating, oral cleaning and smoking habits were self-reported three times per year through a questionnaire, and caries data at baseline and after 3 years were collected from dental records. RESULTS The results showed significantly (P < 0.05) impaired eating habits during the study period and that adherence to regular main meals diminished. In the eighth grade, one-third of the girls skipped breakfast before school and only 50% had their free school lunch daily. The omission of breakfast and irregular main meals, as well as smoking were significantly associated with caries (decayed, missed and filled surfaces) increment in the eighth grade (odds ratio = 4.1-4.9, P < 0.05). Snacks, light meals, soft drinks and sweets were already frequently consumed at baseline and continued to be so over the years. Although > 95% of subjects reported that they brushed their teeth at least once a day, approximately 20% did not do it every evening, and this figure remained stable over the study period. However, snacks, soft drinks and sweets, and toothbrushing habits had no significant influence on caries development. CONCLUSION Dietary advice for caries prevention in adolescent girls should focus on the importance of retaining regular main meals, and especially, not skipping breakfast.
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Abstract
A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.
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Affiliation(s)
- Riva Touger-Decker
- University of Medicine & Dentistry of New Jersey, School of Health Related Professions, New Jersey Dental School, Newark 07107, USA.
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23
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Campain AC, Morgan MV, Evans RW, Ugoni A, Adams GG, Conn JA, Watson MJ. Sugar-starch combinations in food and the relationship to dental caries in low-risk adolescents. Eur J Oral Sci 2003; 111:316-25. [PMID: 12887397 DOI: 10.1034/j.1600-0722.2003.00056.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this 2-year prospective cohort study was to determine whether food-level sugar-starch combinations are predictors of dental caries in a low-risk adolescent population. A total of 645 subjects, aged 12-13 yr at baseline, were recruited from 25 secondary colleges in the north-west region of metropolitan Melbourne, Australia. Examinations to record dental caries status were conducted annually. Dental caries was diagnosed according to the criteria of the World Health Organization. Dietary information was collected by four, continuous 4-d records. Demographic data was collected by parental self-administered questionnaire. A total of 504 subjects provided complete information for analysis. Approximately 37% of subjects experienced an increment in caries. In the multivariate model, only the low sugar-high starch food group was a significant predictor of caries increment on all surfaces and pit and fissure surfaces. For both these surfaces, significant interactions with starch at low sugar and across those clusters with a maximum proportion of sugar and/or starch (that is, high sugar-low starch, medium sugar-medium starch and high sugar-low starch) were found. Sugar-starch interactions may be predictive of caries risk in a low-risk adolescent population. Changing patterns of food consumption and the widespread exposure to various fluoride vehicles are possibly altering the diet-dental caries dynamic that once existed.
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Mariri BP, Levy SM, Warren JJ, Bergus GR, Marshall TA, Broffitt B. Medically administered antibiotics, dietary habits, fluoride intake and dental caries experience in the primary dentition. Community Dent Oral Epidemiol 2003; 31:40-51. [PMID: 12542431 DOI: 10.1034/j.1600-0528.2003.00019.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Dental caries continues to be a major public health problem in the US and other nations, particularly among younger children. Unfortunately, understanding of factors contributing to caries in this age group is incomplete and further studies are necessary. The purpose of this study was to assess factors related to extensive caries experience among children aged 4-7 years, including antibiotic use, dietary patterns, fluoride intakes, and tooth brushing habits. METHODS The case-control study was nested within a longitudinal cohort study of children's oral health. The larger cohort study collected data on fluoride intakes and behavioral factors, including antibiotic use and dietary patterns of children periodically from birth. A single dental examination was completed for each child at a time between the ages of 4-7 years. A case-control design was used to compare children with severe caries experience (6 or greater dmfs) to those with no caries experience. Cases (n = 39) included all who met the criteria and had sufficient longitudinal data (n = 39) while a control group was selected to have comparable mean age, exam dates, and an equal number of boys and girls. RESULTS Backward elimination logistic regression controlling for demographic variables showed severe caries experience to be related to greater regular pop/other sugared beverage intake, greater frequency of starch foods, and greater frequency of eating occasions. Mother's education and fluoride intake from water were inversely related to severe caries experience. Antibiotic use was generally higher in the control group, but was not significantly different than in the severe caries group. CONCLUSIONS Although we cannot rule out the possibility that antibiotics may be associated with increased or decreased caries risk, our data suggest that they play only a minor role in caries prevention compared to fluoride. Dietary sugar continues to be a significant risk factor for caries in the primary dentition.
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Affiliation(s)
- Boipelo P Mariri
- Department of Preventive and Community Dentistry, College of Dentistry, 200 Hawkins Drive #01105 PFP, The University of Iowa, Iowa City, IA 52242, USA
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25
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Abstract
This paper aims to provide dental health professionals with practical advice to pass on to patients about diet and dental health. Sugars are the most important dietary factor contributing to dental caries. Different foods carry different dental health risks; those containing non-milk, extrinsic sugars are potentially the most damaging. In the UK, sugared soft drinks and confectionery contribute approximately 50% to total intake of non-milk extrinsic sugars. Patients should be encouraged to reduce the frequency of intake of sugary foods. Intake of acidic foods and drinks contributes to dental erosion and consumption of such foods should also be limited. Dietary advice to dental patients should be positive and personalized if possible and can be in line with dietary recommendations for general health. These are to increase the consumption of starchy staple foods (eg bread, potatoes and unsweetened cereals), vegetables and fruit and to reduce the consumption of sugary and fatty foods.
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Affiliation(s)
- P J Moynihan
- School of Dental Sciences, University of Newcastle, Newcastle upon Tyne.
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Sayegh A, Dini EL, Holt RD, Bedi R. Food and drink consumption, sociodemographic factors and dental caries in 4-5-year-old children in Amman, Jordan. Br Dent J 2002; 193:37-42. [PMID: 12171204 DOI: 10.1038/sj.bdj.4801478] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate the association between type of food and drink consumption, sociodemographic factors and prevalence and severity of caries in 4-5-year-old Jordanian children. METHOD Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman. Clinical examinations were carried out by one examiner. Mothers completed a questionnaire relating to sociodemographic factors and food and drink consumption. RESULTS Snack foods were consumed by a high percentage of children. Amongst the most popular 'high in NME sugar snacks', confectionery was reported to be regularly consumed by 76% and biscuits and cakes by 71% of them. More than 50% had carbonated drinks. Children from a lower social class, attending a kindergarten with lower tuition fees had more dessert, squashes and more teas with sugar. When all variables were considered, consumption of confectionery was independently associated with caries prevalence and consumption of teas with sugar was independently associated with caries severity. CONCLUSION The types of foods and drinks consumed as snacks by young Jordanian children were similar to those of Western countries. In the absence of more widespread oral health promotion measures and in the presence of high prevalence and severity of caries,the oral health of Jordanian children is a matter of concern.
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Abstract
Over the last three decades the condition of the teeth of children has improved tremendously. This has generally been attributed to the increased use of fluoride toothpaste. During this period the total amount of sugars disappearing into the population per capita has hardly changed. This suggests that the relationship between diet and caries has to be reassessed, which provokes different opinions among dental experts. Some suggest a maximum threshold level for the daily amount of sugars to prevent caries. Others propose that in general the amount of sugars eaten is not an important determinant of caries experience. The scientific evidence for the various opinions on the role of diet in caries development will be discussed. It is concluded that the role of diet is not so much related to the diet itself but to the individual behaviour of people. Where oral hygiene and fluoride supplementation are adequate, the diet has become a lesser factor in caries prevention. However, those diets may cause caries when there is too little fluoride. It is a mistake to classify a diet as cariogenic it may be potentially cariogenic. When one wants to decrease this potency, one should modify those factors that are actually controlling it, which is, in most cases, the topical presence of fluoride and not the composition of the diet. A model is proposed to guide caries prevention. The (insufficient) use of fluoride, (insufficient) oral hygiene and (insufficient) clearance by saliva form a window of risk. The total burden of cariogenic food that can be seen through the window constitutes the actual caries risk.
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Affiliation(s)
- C van Loveren
- Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands.
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Abstract
Dental caries is a highly prevalent chronic disease and its consequences cause a lot of pain and suffering. Sugars, particularly sucrose, are the most important dietary aetiological cause of caries. Both the frequency of consumption and total amount of sugars is important in the aetiology of caries. The evidence establishing sugars as an aetiological factor in dental caries is overwhelming. The foundation of this lies in the multiplicity of studies rather than the power of any one. That statement by the British Nutrition Foundation's Task Force on Oral Health, Diet and Other Factors, sums up the relationship between sugars and caries in Europe. There is no evidence that sugars naturally incorporated in the cellular structure of foods (intrinsic sugars) or lactose in milk or milk products (milk sugars) have adverse effects on health. Foods rich in starch, without the addition of sugars, play a small role in coronal dental caries. The intake of extrinsic sugars beyond four times a day leads to an increase risk of dental caries. The current dose-response relationship between caries and extrinsic sugars suggests that the sugars levels above 60 g/person/day for teenagers and adults increases the rate of caries. For pre-school and young children the intakes should be proportional to those for teenagers; about 30 g/person/day for pre-school children. Fluoride, particularly in toothpastes, is a very important preventive agent against dental caries. Toothbrushing without fluorides has little effect on caries. As additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people, the main strategy to further reduce the levels of caries, is reducing the frequency of sugars intakes in the diet. Dental erosion rates are considered to be increasing. The aetiology is acids in foods and drinks and to a much lesser extent from regurgitation.
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Affiliation(s)
- A Sheiham
- Department of Epidemiology and Public Health, University College London, UK.
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Rodrigues CS, Sheiham A. The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: a longitudinal study. Int J Paediatr Dent 2000; 10:47-55. [PMID: 11310126 DOI: 10.1046/j.1365-263x.2000.00165.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the effects of dietary guidelines on sugar and sugar intake at day nurseries, and other potential risk factors on dental caries in two groups of low socio-economic nursery schoolchildren. DESIGN Nursery based, longitudinal study. SETTING Metropolitan area of Recife, north-eastern Brazil. SAMPLE AND METHODS The study population comprised 510, 3-year-old low socio-economic nursery schoolchildren. Sugar intake at the nursery was based upon a weighed inventory method during 2 non-consecutive days. Parents answered a questionnaire. RESULTS Children attending nurseries not adopting guidelines on reduction of sugar intake had a higher caries risk, with an odds ratio of 3.6 compared to those attending nurseries with guidelines. A higher caries increment was related to higher daily frequency and weight of sugar intake at nursery, overall daily frequency of sugar intake (sugar intake at home plus nursery), past caries experience, use of fluoride, and habits related to toothbrushing. Children having more than 32.6 g of sugar daily at nursery were 2.99 times more likely to have high caries increment than those having less than that amount. CONCLUSIONS Sugar intake at nursery and the adoption of guidelines on sugar were associated with lower caries increment in low income nursery schoolchildren. A number of modifiable factors such as a higher daily frequency and weight of sugar intake at nursery, use of fluoride and habits related to toothbrushing were strongly related to caries increment.
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Affiliation(s)
- C S Rodrigues
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
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Smallridge J. UK National Clinical Guidelines in Paediatric Dentistry. Management of the stained fissure in the first permanent molar. Int J Paediatr Dent 2000; 10:79-83. [PMID: 11310131 DOI: 10.1046/j.1365-263x.2000.00160.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arnadóttir IB, Rozier RG, Saemundsson SR, Sigurjóns H, Holbrook WP. Approximal caries and sugar consumption in Icelandic teenagers. Community Dent Oral Epidemiol 1998; 26:115-21. [PMID: 9645405 DOI: 10.1111/j.1600-0528.1998.tb01937.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study, conducted in 1994, was to examine the association between approximal caries and sugar consumption in teenagers residing in three fluoride-deficient areas in Iceland while controlling for a number of behavioral, residential and microbiological factors. One hundred and fifty subjects (mean age 14 years) selected from the Icelandic Nutritional Survey (INS) were examined radiographically and they completed questionnaires about sugar consumption frequency. Total grams of sugar intake were obtained from the INS for each subject. Caries experience on approximal surfaces, diagnosed from radiographs, was used as the dependent variable in the analyses. Altogether 45.2% of subjects were caries free on approximal surfaces. The overall sample was found to have a mean DFS on approximal surfaces of 2.73 (s=4.36) per subject. Average daily total sugar intake was 170 g per subject and the mean number of sugar-eating occasions between meals was 5.32 (s=6.29) per subject. The regression model indicated that the frequency of between-meal sugar consumption was associated with approximal caries, with frequency of candy consumption being the most important of the sugar variables. In multivariate analysis, no relationship was found between dental caries and total daily intake of sugar, although a significant relationship between total sugar consumption and presence of caries was seen in bivariate analysis. Between-meal consumption of sugar remains a risk factor for the occurrence of dental caries, especially in populations with moderate-to-high levels of dental caries experience.
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Corey GA. Oral Cavity. Fam Med 1998. [DOI: 10.1007/978-1-4757-2947-4_73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bjarnason S, Finnbogason SY, Köhler B, Holbrook WP. Trends in dental health among Icelandic urban children. Eur J Oral Sci 1997; 105:189-95. [PMID: 9249184 DOI: 10.1111/j.1600-0722.1997.tb00200.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Caries experience, oral hygiene and caries-related salivary parameters were recorded in a 20% representative sample of 12-year-old schoolchildren in Reykjavik, Iceland in 1991. The majority of the children was re-examined 3 years later in 1994. Trends in prevalence of caries and salivary bacteria were assessed by comparison with an analogous earlier longitudinal study (1984-87). Mean DFS values for 12-year-olds were 12.1 and 4.1, for 15-year-olds 23.3 and 11.3 in the earlier and later study, respectively. Reduction in DFS was 66% and 52% for the respective age groups. The decline was most pronounced in the group with low caries prevalence. Trends in caries experience were paralleled by salivary bacteria. The mean caries scores and frequency distributions of 15-year-olds in 1994 closely resembled those of 12-year-olds a decade earlier, suggesting a delay rather than a true fall in caries prevalence.
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Affiliation(s)
- S Bjarnason
- Faculty of Odontology, Göteborg University, Sweden.
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