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Higher sugar intake is associated with periodontal disease in adolescents

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Abstract

Objectives

Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18–19 years old).

Materials and methods

This was a cross-sectional study nested to RPS Cohorts Consortium, São Luís, Brazil (n = 2515). The exposure was percentage of daily calories from added sugar (≥ 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth ≥ 4 mm, and clinical attachment level ≥ 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent’s educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and ≥ 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson.

Results

High sugar intake was associated with ≥ 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03–1.94; p = 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03–1.29; p = 0.011).

Conclusion

High level of added sugar intake was associated with greater extent of periodontal disease in adolescents.

Clinical relevance

High sugar intake was associated with periodontal disease in adolescents, supporting the integrated hypothesis of dental caries and periodontal disease and giving impetus to future clinical investigation on the effect of restriction of added sugar consumption in periodontal parameters, which potentially may change traditional treatment protocols of periodontal disease.

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Funding

This study was funded by FAPEMA (Maranhão State Foundation for Research and Scientific and Technological Development), CNPq (National Council for Scientific and Technological Development) and CAPES (Coordination for the Improvement of Higher Education Personnel).

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Authors and Affiliations

  1. Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil

    Ana R. O. Moreira, Lorena L. C. Ladeira, Claudia M. C. Alves & Cecilia C. C. Ribeiro

  2. Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil

    Rosangela F. L. Batista, Erika B. A. F. Thomaz, Claudia M. C. Alves, Antonio A. M. Silva & Cecilia C. C. Ribeiro

  3. Department of Pediatric Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil

    Maria C. Saraiva

  4. Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada

    Mario A. Brondani

Authors
  1. Ana R. O. Moreira
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  2. Rosangela F. L. Batista
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  5. Claudia M. C. Alves
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  6. Maria C. Saraiva
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  7. Antonio A. M. Silva
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  9. Cecilia C. C. Ribeiro
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Contributions

A.R.O. Moreira and C.C.C. Ribeiro contributed to conception, design, data acquisition, analysis, and interpretation, and drafted and critically revised the manuscript; R.F.L. Batista, E.B.A.F. Thomaz, C.M.C. Alves, and A.A.M. Silva contributed to conception, design and data interpretation, and drafted and critically revised the manuscript; L.L.C. Ladeira contributed to conception and drafted and critically revised the manuscript; M.C. Saraiva and M.A. Brondani contributed to conception and data interpretation and critically revised the manuscript. All authors gave final approval of the manuscript.

Corresponding author

Correspondence to Cecilia C. C. Ribeiro.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the Federal University of Maranhão (CAAE 49096315.2.0000.5086, process number 1.302.489) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Moreira, A.R.O., Batista, R.F.L., Ladeira, L.L.C. et al. Higher sugar intake is associated with periodontal disease in adolescents. Clin Oral Invest 25, 983–991 (2021). https://doi.org/10.1007/s00784-020-03387-1

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