ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Increased Risk Of Dental Caries In Children That Consume A Diet High In Fermentable Carbohydrates
Clinical Question Does the risk of dental caries increase in children that consume a diet high in fermentable carbohydrates compared to children that do not consume a diet high in fermentable carbohydrates?
Clinical Bottom Line Children that eat a diet high in fermentable carbohydrates have a significant increase in their dental caries risk compared to children that do not have a diet high in fermentable carbohydrates.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21831127Huew/2012Children 12 years of ageSurvey
Key resultsIn this study, the authors examined the association between dental caries, dental erosion, and dietary factors among school children. Among the 791 children studied, 57.8% of them had dental caries. This study showed a positive correlation between the consumption of fruit-based sugared drinks and an increase in the prevalence of dental caries. The authors concluded that children who drink or eat sugared dietary foods are at greater risk for dental caries.
#2) 21703076Chankanka/2011Children between 5 and 9 years oldCase Control Study
Key resultsThe aim of this study was to identify the reasons for an increased incidence of dental caries (new cavitated lesions) in children. In the children that participated in the study, 37% of them had new cavitated lesions. One conclusion of the study was that the children with a greater caries incidence (new cavitated lesions) had a diet that contained snacks composed mainly of fermentable carbohydrates.
#3) 21718372Guido/2011Children 2- 18 years of ageCross-sectional Survey
Key resultsThe authors evaluated oral hygiene behaviors (brushing habits) and dietary practices to the prevalence of noncavitated and cavitated carious lesions in rural village within the country of Mexico. The dietary variables included soda, juice, and sugar-beverage intake, along with access to fluoridated water. The investigators found that the occurrence of carious lesions seen in these children was very high ranging from 94.7% to 100%. The study concluded that the major risk factors for caries in the sample of children studied were drinking sugared drinks, poor oral hygiene, and a poor access to community fluoridated water.
Evidence Search "Child"[Mesh]) AND "Risk"[Mesh]) AND "Dental Caries"[Mesh]) AND "Diet"[Mesh]) AND "Dietary Carbohydrates"[Mesh]
Comments on
The Evidence
The random sample of children received a dental examination to identify subjects with dental caries and dental erosion. Following the examination, parents completed questionnaires that provided dietary information. “Associations between caries and dietary variables were analyzed through bivariate and multivariate analyses”. It was found that the regularity of consuming fruit-based sugared drinks was found to be positively statistically significant in associated with dental caries (p=0.002). The study done by Chankanka et al. involved the Iowa Fluoride Study cohort, which included children between the ages of 5 and 9 years of age. The children within this study “were mostly Caucasian and of relatively high socioeconomic status”. During the study, dental exams recorded dental caries on both primary and mixed dentition and diet diaries were recorded. The study showed that 37% of the children had new caviated lesions. The mean new cavitated lesions count for the children in the study was 1.17 surfaces with a standard deviation of +/-2.28. Using a multivariable logistic regression analytical method, there were several factors that were significantly associated with new dental caries lesions (p<0.10). One variable that was statistically significantly associated with an increased incidence of dental caries was a “greater processed starch at snack frequency (OR=3.87, p=.07)”. The results from these studies recommended that if a parent wants to reduce their child’s likelihood of getting new dental carious lesions they should help their child reduce the consumption of processes starches as snacks. In Guido et al., was a cross-sectional survey that had the objective to “relate the prevalence of both noncaviated and caviated lesions when assessing soda, juice sugared-beverage intakes, brushing habits, and community water source availability” within villages in Mexico. Their study design included the International Caries Detection and Assessment system (ICDAS) for caries measurement. Risk factors associated to dental caries, including dietary habits, were evaluated using a questionnaire. Some of the factors that related to higher dmfs scores were: “age, drinking soda or milk with sugar, the child brushing their own teeth, and using drinking water (bottled water, filtered water, or some other type of special drinking water)”. Dental caries prevalence was found to be extremely high in their study “at a mean 97.0% and ranging from 94.7% inmost of the villages studied”. One of the major findings of this study was that dental caries prevalence was strongly correlated with children who drank milk with sugar and drank soda.
Applicability A diet high in fermentable carbohydrates involves food products that are high in sugars and starches, including foods and drinks sweetened with sugars. Each study describes dietary habits that involve drinking sugared drinks and/or eating snacks made from processed starches, which is defined as sugars and starches of fermentable carbohydrates. It was found that a statistically significant association exists between the consumption of a diet high in fermentable carbohydrates (sugars and starches) and an increased dental caries experience in children.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords Child; Dental caries risk; diet; fermentable carbohydrates
ID# 2391
Date of submission: 02/28/2013spacer
E-mail muellerc@livemail.uthscsa.edu
Author Christina Mueller
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author David Cappelli, DMD, MPH, PhD
Faculty mentor/Co-author e-mail CAPPELLI@uthscsa.edu
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