Sugar Consumption and Caries Risk: A Systematic Review

Abstract

This systematic review addresses the question: In the modern age of extensive fluoride exposure, do individuals with a high level of sugar intake experience greater caries severity relative to those with a lower level of intake? The MEDLINE and EMBASE databases were searched for English-language papers published between 1980 and 2000 using a search expression developed in conjunction with an experienced librarian. There were 809 papers located in the initial search. A review of titles and abstracts to identify clearly irrelevant papers reduced this number to 134. Two readers each read one half of these papers, and application of predetermined inclusion/exclusion criteria reduced this number of papers to sixty-nine. Criteria were established for scoring the quality of each of these papers on evidence tables. The maximum score for each paper was 100; the sixty-nine papers rated scored between 12 and 79. Final judgment of results was limited to those thirty-six papers that scored 55 or higher on the evidence tables and that reported studies carried out in countries where there is moderate-to-extensive fluoride exposure. Results showed that only two papers found a strong relationship between sugar consumption and caries development, sixteen found a moderate relationship, and eighteen found weak-to-no relationship. It was concluded that the relationship between sugar consumption and caries is much weaker in the modern age of fluoride exposure than it used to be.

Oral health messages for the Australian public. Findings of a national consensus workshop#

“…Four major reviews of the relationship between diet and dental caries have been published since 2001 3–6 . The findings from these reviews were not consistent.…”

A content analysis of oral health messages in Australian mass media

“…Only 1.5% of ‘incidents’ depicted mentioned the word fluoride. There were no mentions of the sugar/caries relationship . The predominant focus of product placement (advertisements) focused on diabetes and periodontal links to oral health.…”

“Setting the scene in early childhood” – an MID approach for life

“…The causal relationship between dietary sugars and dental caries is well established, despite becoming weaker since widespread exposure to fluoride became available . Hence, diet counselling is still an important part of any prevention program .…”

“…The frequency of dietary sugars appears to be an important factor in the development of dental caries and cariogenic foods should be restricted to mealtimes . Dietary control measures have most benefit to children at high caries risk, while offering less benefit to those considered at low risk with adequate saliva, optimal exposure to fluoride and who practice adequate oral hygiene measures …”