Sugar Consumption and Changes in Dental Caries from Childhood to Adolescence

Abstract

There are no prospective studies investigating the effects of sugar-related feeding practices on changes in dental caries from early childhood to young adulthood. The aim of this study was to assess whether sugar-related feeding practices affect dental caries between the ages of 6 and 18 y. This birth cohort study was initiated in 1993 in Pelotas, Brazil. There were 3 dental clinical assessments; at ages 6 y (n = 359), 12 y (n = 339), and 18 y (n = 307). Sugar-related feeding practices were assessed at ages 4, 15, and 18 y. Covariates included sex and life course variables, such as family income, breast-feeding, mother's education, regularity of dental visit, and child's toothbrushing habits. Group-based trajectory analysis was performed to characterize trajectories of time-varying independent variables that had at least 3 time points. We fitted a generalized linear mixed model assuming negative binomial distribution with log link function on 3-time repeated dental caries assessments. One in 5 participants was classified as "high" sugar consumers, and nearly 40% were "upward consumers." "Low consumers" accounted for >40% of the sample. High and upward sugar consumers had higher dental caries prevalence and mean DMFT in all cohort waves when compared with low sugar consumers. Caries occurred at a relatively constant rate over the period of study, but in all sugar consumption groups, the increment of dental caries was slightly higher between ages 6 and 12 y than between 12 and 18 y. Adjusted analysis showed that dental caries increment ratio between ages 6 and 18 y was 20% and 66% higher in upward and high sugar consumer groups as compared with low consumers. The higher the sugar consumption along the life course, the higher the dental caries increment. Even the low level of sugar consumption was related to dental caries, despite the use of fluoride.

Ethnic Disparities in Dental Caries among Six-Year-Old Children in the Netherlands

“…However, the current study also shows that ethnic disparities in dental caries are not fully explained by mother's education and household income. Generally, the dental literature proposes 3 hypotheses that might explain the association: bad oral hygiene, unhealthy dietary habits with high and frequent sugar consumption, and genetic factors [Vanobbergen et al, 2001;Morrison et al, 2016;Peres et al, 2016]. In our results, in disagreement with Vanobbergen et al [2001], oral health behaviour did not contribute to the differences in caries prevalence between the ethnic groups.…”

“…Within the scope of our study, we were not able to investigate sugar consumption. Still, we strongly suggest it is a possible mechanism behind the association [Sohn et al, 2006;Johansson et al, 2010;Peres et al, 2016]. The literature is not conclusive, but ethnic minority groups tend to have higher sugar consumption compared to native Dutch [Verrips et al, 1993;de Boer et al, 2015].…”

Untreated Dental Caries Is Associated with Reports of Verbal Bullying in Children 8-10 Years Old

“…They observed that in a sample of 13,486 children and adolescents aged between 6 and 18 years from Iran, consumption of fast foods and sugary drinks was associated with victims of violent behavior, bullying, anxiety, and depression [Zahedi et al, 2014]. The consumption of this type of food, frequently associated with other factors, can lead to the appearance of signs of caries disease [Sheiham and James, 2015;Peres et al, 2016].…”

Effect of Fluoride Concentration on Reduction of Enamel Demineralization According to the Cariogenic Challenge

“…Working on caries process, reducing demineralization and enhancing remineralization, fluoride is clearly effective to slow down the progression of caries lesions but it does not avoid the disease (4,5). Epidemiological surveys have shown in children and adults the effect of sugars on caries and the limited effect of fluoride on its control (6,7).…”