Sugar and oral health

Moynihan (2016) emphasizes the prevalence of dental caries in the world (affecting ≤80% of the world's population) and highlights that almost a quarter of adults in the U.S. have untreated caries (tooth decay). It is important to note that dietary free sugars is the most prominent risk factor for dental caries, which is why the World Health Organization (WHO) has issued guidelines on the recommended intake of free sugars. As per their recommendations, people are advised to at least consume ≤10% of total energy intake as free sugars, and to reduce this percentage to <5% to protect dental health throughout life. These recommendations are based on a systematic review of the literature on sugar intake and dental caries risk, that initially found that limiting free sugars to ≤10% of energy reduced dental caries but did not eliminate them. Since caries are a lifelong, progressive disease, even low levels in children are of concern. Therefore, the systematic review then explored more studies that indicated lower incidences of dental caries in subjects consuming less than 5% of their energy intake as free sugars. Recommendations published by the WHO are generally used by policy makers as a benchmark and as a driving force for policy change. [NPID: sugar, oral health, tooth decay, WHO, free sugars, dental caries, policy change]

While the process of tooth decay (dental caries) is said to be influenced by diet, Blostein et al. (2020) hypothesize that dietary patterns may be important predictors of caries. This study collected the data of 4467 people (18+ years old) in the U.S. that participated in the 2013-2014 National Health and Nutrition Examination Survey. 24-hour dietary recalls allowed the respondents’ diets to be divided into 3 dietary patterns, while their previous caries experiences were also recorded. Although the 18-30 and >30 age groups possessed similar dietary patterns, the prevalence of decayed, missing and filled teeth (DMFT) scores>0 and the median DMFT scores were higher in those older individuals (>30 years old). Furthermore, no dietary habit was associated with higher prevalence or severity of dental caries experience. Whereas the prevalence of DMFT>0 among those over 30 years old tended to rise as the intakes of sugar-sweetened beverages and sandwiches increased. In fact, there was a 6% higher incidence of dental caries experience in those individuals in the quartile with the highest level of sugar-sweetened beverage and sandwich consumption, compared to those in the lowest quartile. To summarize the results, dietary patterns were related to prevalence of dental caries experience, with varying risk depending on age. Although food groups high in sugar were linked with caries prevalence and severity, this study concluded that more prominent relationships were with the overall diet. [NPID: sugar, oral health, tooth decay, dental caries, sugar-sweetened beverages, SSB, sandwiches]

Too short to summarize. See link.

In this 2020 study, 1,111 Scottish children were recruited and assessed on their sugar-sweetened beverage intakes and the number of dental cavities found. The overall objective was to find an association between early (during the first year of life) and subsequent consumption of sugar-sweetened drinks with caries trajectories. The children were examined annually from 12 months old to 48 months, with their parents reporting sugar-sweetened beverage (SSB) consumption. SSB intake was then divided into 2 components: the initial intake level; and the deviation from that value over time. Also, dental caries were clinically determined every year. According to the analysis models employed, the number of caries discovered grew as SSB intake and the deviation from the initial SSB intake increased. By the time the children were followed up for the fourth time, the predicted mean difference in decayed, missing, and filled tooth surfaces between kids with low and high initial sugar-sweetened beverage consumption was 1.73. In addition, the difference observed between children with low and high deviation from their initial SSB intake was 1.17. These data highlight that Scottish children tended to experience more dental caries after being introduced to sugar-sweetened drinks during the first year of their lives. Furthermore, these findings back up the current recommendations to avoid giving sugar to very young children. [NPID: sugar, oral health, tooth decay, SSB, sugar-sweetened beverages, cavities, Scotland, young children]