Carbohydrates and Health

6.53 No meta-analyses have been conducted for studies on dental caries because
the data on measures of dietary exposure, caries incidence/prevalence and risk
assessment methods were insufficiently comparable. Therefore, only a narrative
synthesis of the evidence has been provided.
6.54 Four cohort studies were identified that presented evidence on the relationship
between sugars intake and the incidence of dental caries in the mixed and
permanent dentition in children. Three of these adjusted their results for tooth
brushing (Rugg-Gunn et al., 1984; Rugg-Gunn et al., 1987; Szpunar et al., 1995;
Ruottinen et al., 2004) one of them did not (Campain et al., 2003). Two papers
report on the same cohort study (Rugg-Gunn et al., 1984; Rugg-Gunn et al., 1987).
No further studies were identified in the update search (Oral health review).
6.55 All three cohort studies that adjusted their results for tooth brushing report an
association between higher sugars consumption and greater risk of developing
dental caries of some type. One study observes an association with fissure caries
only, but not for overall two year caries increment or approximal surface caries
(Rugg-Gunn et al., 1984; Rugg-Gunn et al., 1987). The study that did not adjust its
results for tooth brushing reports no significant association between higher sugars
consumption and the incidence of dental caries (Campain et al., 2003).
Amount of sugars consumed (g/day or % energy) and dental caries in mixed and
permanent dentition
• Association
• Moderate evidence
• The direction of the association indicates that greater consumption of sugars is
detrimental to oral health
• The association is biologically relevant
6.56 Three cohort studies were identified that presented evidence on the relationship
between frequency of sugars intake and the incidence of dental caries in the
mixed and permanent dentition in children, all of which adjusted their results for
tooth brushing (Rugg-Gunn et al., 1984; Rugg-Gunn et al., 1987; Szpunar et al., 1995;
Levine et al., 2007). Two papers report on the same cohort study (Rugg-Gunn et
al., 1984; Rugg-Gunn et al., 1987). No further studies were identified in the update
search (Oral health review).
6.57 All three cohort studies that adjusted their results for tooth brushing, report no
significant association between the frequency of sugars consumption and risk of
developing dental caries. One study that reports the frequency of bedtime sugars
consumption from drinks suggests that greater frequency is associated with greater
prevalence of dental caries (Levine et al., 2007).
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