Sugar intake above international recommendations and oral disease burden: A population‐based study

Abstract

ObjectiveTo evaluate the association between added sugar intake above the daily limit for the risk of noncommunicable diseases (NCDs) and the Chronic Oral Disease Burden in adolescents.MethodsThis was a population‐based study using cross‐sectional data nested to RPS Cohorts Consortium, São Luís, Brazil, from the 18–19‐year‐old follow‐up (n = 2515). High consumption of added sugars was estimated according to the limits of the World Health Organization guidelines (WHO) (≥5% of total energy/day) and the American Heart Association statement (AHA) (≥25 g/day). The Chronic Oral Disease Burden was a latent variable (number of decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing). Models were adjusted for Socioeconomic Status, sex, obesity, and plaque index and analyzed through structural equation modeling.ResultsAdolescents had high sugar consumption according to the WHO (78.6%) and AHA (81.4%) recommendations. High sugar intake, according to WHO (SC = 0.096; p = 0.007) and AHA (SC = 0.056; p = 0.027), was associated with a heavier Chronic Oral Disease Burden. Even half of the recommended dose was sufficient to affect some oral disease indicators.ConclusionSugar intake over international statements to prevent NCDs is associated with higher Chronic Oral Disease Burden among adolescents.

Sugar‐sweetened beverage consumption and periodontitis among adults: A population‐based cross‐sectional study

“…In this study, SSB consumption was assessed in various ways because there is no clear consensus on the threshold at which behaviour becomes a risk factor, and studies tend to use arbitrary cut‐off points (Carmo et al, 2018; Song et al, 2016). International health organizations have offered guidelines defining cut‐off points in terms of the percentage of total daily energy from added sugar, ranging from 5% to 10%, for preventing NCDs (World Health Organization, 2015), but these recommended amounts do not protect against periodontitis (Ladeira et al, 2022).…”

Obesity, Insulin Resistance, Caries, and Periodontitis: Syndemic Framework

“…In epidemiological studies, we have used the Chronic Oral Disease Burden as a latent variable to analyze the correlation between caries and periodontitis indicators [ 4 , 19 , 29 ]. We draw attention to the fact that the Chronic Oral Disease Burden is not a diagnostic tool to be used in the clinical setting; instead, it is an epidemiological approach for understanding why the indicators of caries and periodontitis group through life and investigating their common risk factors [ 4 , 19 , 29 ].…”

“…In epidemiological studies, we have used the Chronic Oral Disease Burden as a latent variable to analyze the correlation between caries and periodontitis indicators [ 4 , 19 , 29 ]. We draw attention to the fact that the Chronic Oral Disease Burden is not a diagnostic tool to be used in the clinical setting; instead, it is an epidemiological approach for understanding why the indicators of caries and periodontitis group through life and investigating their common risk factors [ 4 , 19 , 29 ]. In addition, this latent variable allows us to analyze the periodontal indicators in a continuous manner, dispensing cut-off points to determine case definition, which persists in disagreement and remains challenging in younger populations [ 32 , 33 ].…”

“…Chronic Oral Disease Burden was estimated from the shared variance of the indicators: (a) the number of teeth with carious lesions, (b) VPI, (c) the number of teeth with BoP, (d) the number of teeth with PPD ≥4 mm, and (e) the number of teeth with CAL ≥3 mm [ 4 , 19 , 29 ].…”