Skip to main content

Advertisement

Log in

Free sugars and early childhood caries development: a prospective cohort study

  • Original Scientific Article
  • Published:
European Archives of Paediatric Dentistry Aims and scope Submit manuscript

Abstract

Purpose

To investigate the impact of giving children younger than 2 years foods and beverages with free sugars on the prevalence of early childhood caries at 5 years.

Materials and methods

The study group consisted of 208 children (105 boys and 103 girls) with a complete set of data on nursing, diet and caries from birth to 5 years. We collected feeding habits and dietary data through structured questionnaires at 6, 12, 18 and 24 months and the presence of decayed (d), missed (m) and filled (f) teeth was scored according to the WHO criteria at five years of age. We processed data with chi-square tests and expressed as relative risk (RR) with 95% confidence intervals.

Results

At the age of 5 years, 22% of the children had caries. Intake of fruit juice with meals (RR 2.3) and cookies or biscuits at 24 months of age (RR 2.4), as well as fast food consumption at least once every week (RR 2.9), more than doubled the risk for early childhood caries (p < 0.05).

Conclusions

Within the limitations of the present study, we found a relationship between consumption of free sugars early in life and dental caries prevalence at 5 years. It therefore seems important to embrace and emphasise the current sugar recommendations in primary and dental care to educate caregivers to avoid serving free sugars to their children before the age of 2 years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Bernabé E, Ballantyne H, Longbottom C, Pitts NB. Early introduction of sugar-sweetened beverages and caries trajectories from age 12 to 48 months. J Dent Res. 2020;99:898–906.

    Article  PubMed  Google Scholar 

  • Boustedt K, Dahlgren J, Twetman S, Roswall J. Tooth brushing habits and prevalence of early childhood caries: a prospective cohort study. Eur Arch Paediatr Dent. 2020a;21:155–9.

    Article  PubMed  Google Scholar 

  • Boustedt K, Roswall J, Kjellberg E, Twetman S, Dahlgren J. A prospective study of perinatal and metabolic risk factors for early childhood caries. Acta Paediatr. 2020b;109:2356–61.

    Article  PubMed  Google Scholar 

  • Boustedt K, Roswall J, Twetman S, Dahlgren J. Influence of mode of delivery, family and nursing determinants on early childhood caries development: a prospective cohort study. Acta Odontol Scand. 2018;76:595–9.

    Article  PubMed  Google Scholar 

  • Diani L, Forchielli ML. Sugar intake: are all children made of sugar? Life (basel). 2021;11:444. https://doi.org/10.3390/life11050444.

    Article  Google Scholar 

  • Echeverria MS, Schuch HS, Cenci MS, Motta JVS, Bertoldi AD, Hallal PC, Demarco FF. Trajectories of sugar consumption and dental caries in early childhood. J Dent Res. 2022;101:724–30.

    Article  PubMed  Google Scholar 

  • Ha DH, Spencer AJ, Moynihan P, Thomson WM, Do LG. Excess risk of dental caries from higher free sugars intake combined with low exposure to water fluoridation. J Dent Res. 2021;100:1243–50.

    Article  PubMed  Google Scholar 

  • Keller MK, Kressirer CA, Belstrøm D, Twetman S, Tanner ACR. Oral microbial profiles of individuals with different levels of sugar intake. J Oral Microbiol. 2017;9(1):1355207. https://doi.org/10.1080/20002297.2017.1355207.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kitsaras G, Goodwin M, Kelly MP, Pretty IA. Bedtime oral hygiene behaviours, dietary habits and children’s dental health. Children (basel). 2021;8(5):416. https://doi.org/10.3390/children8050416.

    Article  Google Scholar 

  • Mahboobi Z, Pakdaman A, Yazdani R, Azadbakht L, Montazeri A. Dietary free sugar and dental caries in children: a systematic review on longitudinal studies. Health Promot Perspect. 2021;11:271–80.

    Article  PubMed  PubMed Central  Google Scholar 

  • Melough MM, Sathyanarayana S, Zohoori FV, Gustafsson HC, Sullivan EL, Chi DL, Levy SM, McKinney CM. Impact of fluoride on associations between free sugars intake and dental caries in US children. JDR Clin Trans Res. 2022. https://doi.org/10.1177/23800844221093038.

    Article  PubMed  Google Scholar 

  • Pitts NB, Baez RJ, Diaz-Guillory C, Donly KJ, Feldens CA, McGrath C, Phantumvanit P, Seow WK, Sharkov N, Songpaisan Y, Tinanoff N, Twetman S. Early childhood caries: IAPD Bangkok declaration. Int J Paediatr Dent. 2019;29:384–6.

    Article  Google Scholar 

  • Pitts NB, Twetman S, Fisher J, Marsh PD. Understanding dental caries as a non-communicable disease. Br Dent J. 2021;231:749–53.

    Article  PubMed  PubMed Central  Google Scholar 

  • Riggs E, Kilpatrick N, Slack-Smith L, Chadwick B, Yelland J, Muthu MS, Gomersall JC. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev. 2019;2019(11):CD012155.

  • Robinson SL, Sundaram R, Lin TC, Putnick DL, Gleason JL, Ghassabian A, Stevens DR, Bell EM, Yeung EH. Age of juice introduction and child anthropometry at 2–3 and 7–9 years. J Pediatr. 2022;S0022–3476(22):00140–8. https://doi.org/10.1177/23800844221093038.

    Article  Google Scholar 

  • Robinson SL, Sundaram R, Putnick DL, Gleason JL, Ghassabian A, Lin TC, Bell EM, Yeung EH. Predictors of age at juice introduction and associations with subsequent beverage intake in early and middle childhood. J Nutr. 2021;151:3516–23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ruxton CHS, Myers M. Fruit juices: are they helpful or harmful? an evidence review. Nutrients. 2021;13(6):1815. https://doi.org/10.3390/nu13061815.

    Article  PubMed  PubMed Central  Google Scholar 

  • Thornley S, Bach K, Bird A, Farrar R, Bronte S, Turton B, Atatoa Carr P, Fa’alili-Fidow J, Morton S, Grant C. What factors are associated with early childhood dental caries? A longitudinal study of the growing up in New Zealand cohort. Int J Paediatr Dent. 2021;31:351–60.

    Article  PubMed  Google Scholar 

  • Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, Phantumvanit P, Pitts NB, Seow WK, Sharkov N, Songpaisan Y, Twetman S. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent. 2019;29:238–48.

    Article  PubMed  Google Scholar 

  • U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans. 9th Edn. December 2020. Available at http://www.DietaryGuidelines.gov (2020–2025). Accessed May 15 2022.

  • WHO. Sugars intake for adults and children. Geneva: WHO. (2015). Available online: http://apps.who.int/iris/bitstream/handle/10665/149782/9789241549028eng.pdf. Accessed May 15 2022.

  • World Health Organization. Oral health surveys: basic methods. 5th ed. Geneva: World Health Organization; 2013.

    Google Scholar 

  • Zaror C, Matamala-Santander A, Ferrer M, Rivera-Mendoza F, Espinoza-Espinoza G, Martínez-Zapata MJ. Impact of early childhood caries on oral health-related quality of life: a systematic review and meta-analysis. Int J Dent Hyg. 2022;20:120–35.

    Article  PubMed  Google Scholar 

  • Ziesmann A, Kiflen R, Rubeis V, Smith BT, Birken CS, Anderson LN, Maguire on behalf of the TARGet kids collaboration JL. The association between early childhood and later childhood sugar-containing beverage intake: a prospective cohort study. Nutrients. 2019;11(10):2338. https://doi.org/10.3390/nu11102338.

    Article  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank all parents and children for their kind willingness to invest time and take part in the present project and Dr. Jovanna Dahlgren for data access.

Funding

The project was funded by grants from Region Halland, Sweden and the author’s institutions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Twetman.

Ethics declarations

Conflict of interest

The authors report no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boustedt, K., Roswall, J. & Twetman, S. Free sugars and early childhood caries development: a prospective cohort study. Eur Arch Paediatr Dent 23, 829–833 (2022). https://doi.org/10.1007/s40368-022-00745-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40368-022-00745-3

Keywords

Navigation