Effect on Caries of Restricting Sugars Intake

Abstract

A systematic review of studies in humans was conducted to update evidence on the association between the amount of sugars intake and dental caries and on the effect of restricting sugars intake to < 10% and < 5% energy (E) on caries to inform the updating of World Health Organization guidelines on sugars consumption. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Wanfang, and South African Department of Health. Eligible studies reported the absolute amount of sugars and dental caries, measured as prevalence, incidence, or severity. The review was conducted and reported in accordance with the PRISMA statement, and the evidence was assessed according to GRADE Working Group guidelines. From 5,990 papers identified, 55 studies were eligible -3 intervention, 8 cohort, 20 population, and 24 cross-sectional. Data variability limited meta-analysis. Of the studies, 42 out of 50 of those in children and 5 out of 5 in adults reported at least one positive association between sugars and caries. There is evidence of moderate quality showing that caries is lower when free-sugars intake is < 10% E. With the < 5% E cutoff, a significant relationship was observed, but the evidence was judged to be of very low quality. The findings are relevant to minimizing caries risk throughout the life course.

A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake

“…The widescale use of fluoride toothpaste is a reasonable explanation for the decline in children’s caries in many countries since the 1970s, yet what then becomes relatively evident is that caries becomes more prominent in adolescents and adults [4, 21]. …”

Dental Caries Status and Caries Risk Factors in Students Ages 12–14 Years in Zhejiang, China

“…In our study, only 41% of students brushed their teeth twice daily, and 91.9% of participants had no idea whether the toothpaste they use contain fluoride or not. Limiting sugars to 5% of energy intake is beneficial to minimize the risk of dental caries [33]. The change in oral hygiene behavior and diet represents the strategy to modify or eliminate the causes of dental caries.…”

Constructing public health policies in post crisis countries: lessons to learn from the associations between free-sugars consumption and diabetes, obesity and dental caries before, during and after sanctions in Iraq

“…Systematic reviews have largely identified consistent evidence supporting a relationship between the amount of sugar intake and the development of type-2 diabetes (Ruxton et al 2010), overweight and obesity (Te Morenga et al 2013), and dental caries (Moynihan and Kelly 2014; Sheiham and James 2014a) across different age groups. For every increase of 150 kcal sugar/person/day, there is a 1.1 % increased prevalence of type-2 diabetes.…”

“…Free sugars, a determinant and common risk factor across the aforementioned NCDs (Ruxton et al 2010; Te Morenga et al 2013; Moynihan and Kelly 2014), are defined as monosaccharides and disaccharides added to foods by the manufacturers, cooks or consumers and sugars naturally present in honey, syrups, fruit juices and fruit concentrates (World Health Organization and Food Agriculture Organization 2002). Currently, many countries in the Middle East are suffering from crises relate to political conflicts and economic sanctions.…”