Approximal caries and sugar consumption in Icelandic teenagers

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.

Dental erosion in Icelandic teenagers in relation to dietary and lifestyle factors

“…This was a multiplechoice design similar to questionnaires the authors had used previously for studies on diet and dental caries (8,9), but modified for studying tooth erosion. The questionnaire aimed at determining the amount and frequency of consumption of acidic drinks and fruits and asked specifically about the consumption of these with meals and between meals the previous day (see Table 3).…”

“…There was a clear implication from this study that dental erosion among young people in Iceland was largely a result of excess consumption of acidic soft drinks, and was more pronounced in subjects who in addition had a low salivary buffer capacity. Previous studies on dental caries among preschool children (8) and teenagers (9) in Iceland had been able to link dietary and some`lifestyle' factors to caries prevalence and incidence. Such links are not generally found in populations where caries levels are relatively low, as is the case in most Western countries (10), but findings in Iceland have been consistent, largely because the populations studied varied considerably in their patterns of consumption of refined carbohydrate (9).…”

“…Previous studies on dental caries among preschool children (8) and teenagers (9) in Iceland had been able to link dietary and some`lifestyle' factors to caries prevalence and incidence. Such links are not generally found in populations where caries levels are relatively low, as is the case in most Western countries (10), but findings in Iceland have been consistent, largely because the populations studied varied considerably in their patterns of consumption of refined carbohydrate (9). It was therefore thought appropriate to examine a population of Icelandic children with respect to dental erosion, dietary, salivary and lifestyle factors using methods that had previously been found useful in examining dental caries in Icelandic populations.…”

Food transitions in the 20th–21st century

“…But in comparisons between high-and low-consumption populations, associations between sugar consumption and the incidence of caries are high (r 0X7 to 0.8) 67,68 . Thus, although dietary sugar is the main determinant of a population's incidence of caries, measures of sugar intake in industrialised countries generally fail to identify high risk individuals; the level of consumption is too high, and moreover the variation in sugar consumption within populations is too low, to show any measurable effect on caries incidence 69,70 . Burt et al 40 pointed out that some of the older studies have failed to demonstrate a correlation between amount or frequency of sugar intake and dental caries activity.…”

Effect on Caries of Restricting Sugars Intake

“…However, it has been suggested that fluoride retards the development of cavitation lesions to a later age (Sheiham, 2001). Evidence from a number of identified studies shows that, despite the protection offered by fluoride, the relationship between sugars and dental caries remains (Rugg-Gunn et al, 1984;Burt et al, 1988;Marthaler, 1990;Holt, 1991;Sivaneswaran and Barnard, 1993;Künzel and Fischer, 1997;Arnadottir et al, 1998;Leite, 1999;Rodrigues et al, 1999;Ruottinen et al, 2004;Masson et al, 2010). Moreover, many parts of the world do not benefit from fluoride exposure.…”