Even low sugar intakes carry risk of caries, finds review

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Even low sugar intakes carry risk of caries, finds review

Related tags: Dental caries

Even low intakes of free sugars can lead to an increased risk of tooth decay and dental caries - a finding that re-emphasises the importance cutting dietary sugar intakes, say researchers.

The new review in to the effect of sugar on dental health, published in the Journal of Dental Research,​ has warned that the importance of sugars as a cause of caries is underemphasised and not prominent enough in preventive strategies.

The warning comes after researchers led by Aubrey Sheiham from University College London found evidence to demonstrate the sensitivity of cariogenesis (the development of caries) to even very low sugars intakes.

In the review, the authors reviewed the literature on the role of sucrose in the cariogenic process – concluding that there is ‘extensive’ scientific evidence that free sugars are the primary necessary factor in the development of dental caries.

“We demonstrate the sensitivity of cariogenesis to even very low sugars intakes. Quantitative analyses show a log-linear dose-response relationship between the sucrose or its monosaccharide intakes and the progressive lifelong development of caries,”​ wrote the authors. “This results in a substantial dental health burden throughout life.”


According to the team, the clear relationship between free sugars and dental caries has been well documented but remains underemphasised when it comes to health policy and public education.

“This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic,”​ they said.

“Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars.”​ 

Sheiham and his colleagues warned that the situation results in a substantial dental health burden throughout life – adding that the World Health Organisation (WHO) recently recognised that dental diseases are the most prevalent non-communicable diseases globally and the treatment of dental diseases is expensive, and would exceed the entire financial resources available for the health care of children in most lower income countries.

They concluded that there has been a ‘long-standing failure’ to identify the need for drastic national reductions in sugars intakes.

“Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause — sugars,”​ they argued.

Source: Journal of Dental Research
Published online ahead of print, doi: 10.1177/0022034515590377
“Diet and Dental Caries: The Pivotal Role of Free Sugars Reemphasized”
Authors: A. Sheiham, W.P.T. James

Related topics: Science

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Forced fluoridation

Posted by Dan Germouse,

Here's some quotes from the 2015 Cochrane review.
p 2 "A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis."
p 2 "There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.
There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.
No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria."
p 3 "Researchers from the Cochrane Oral Health Group reviewed the evidence - up to 19 February 2015 - for the effect of water fluoridation. They identified 155 studies in which children receiving fluoridated water (either natural or artificial) were compared with those receiving water with very low or no fluoride. Twenty studies examined tooth decay, most of which (71%) were conducted prior to 1975. A further 135 studies examined dental fluorosis."
p 14 "Five studies were funded by research grants from research organisations, health authorities and government organisations, one study was funded in collaboration with members of the committee pro-fluoridation, while the other studies [on caries] did not state their funding sources."
p 17 "We judged that all the 20 studies included for the caries outcome (including disparities in caries) were at high risk of bias overall."
p 17 "We found all studies to be at high risk of bias for confounding. We considered confounding factors for this outcome to be sugar consumption/dietary habits, SES, ethnicity and the use of other fluoride sources."
p 28 "Whilst these [fluoridated] areas tend to have low to very low DMFT, there are many other parts of the world where fluoridated water is not widespread that also have low caries levels. Equally, there are areas with relatively high distribution of water fluoridation and moderate caries levels (e.g. Brazil)."
p 30 "The quality of the evidence, when GRADE criteria are applied, is judged to be low."

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Forced fluoridation

Posted by Dan Germouse,

There is no credible evidence that fluoridated water has ever prevented a single dental cavity. The forced-fluoridation fanatics often try to claim that the low rates of dental caries in western European countries which do not have artificial water fluoridation are due to naturally occurring fluoride in water, or some other kind of artificial fluoridation such as salt fluoridation. They are lying.

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