Role of Sugar in Dental Caries Re-Emphasised

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12 Aug 2015 --- The International and American Associations for Dental Research (IADR/AADR) has published two reports that conclude that even low sugar intake contributes to dental caries, including a critical review titled "Diet and Dental Caries - the Pivotal Role of Free Sugars Reemphasized." 

In this study, authors Aubrey Sheiham, University College London, England; and W. Philip James, London School of Hygiene and Tropical Medicine, England, demonstrate the sensitivity of cariogenesis (the development of caries) to even very low sugars intakes. In this critical review, the authors reviewed the literature on the role of sucrose in the cariogenic process and conclude there is extensive scientific evidence that free sugars are the primary necessary factor in the development of dental caries.

This year, the World Health Organization (WHO) published a guideline on sugars intake for adults and children. The objective of the WHO guideline is to provide recommendations on intakes of free sugars to reduce risks of NCDs in adults and children, with a particular focus on the prevention and control of unhealthy weight gain and dental caries. WHO recognized 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. In this guideline, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake.

A dose-response relationship between the sucrose or its monosaccharide intakes and the progressive life-long development of caries was demonstrated. This situation results in a substantial dental health burden throughout life.

Beau Meyer and Jessica Lee, The University of North Carolina at Chapel Hill, USA, commented on these findings in a perspective article titled "The Confluence of Sugar, Dental Caries and Health Policy". In this paper Meyer and Lee underscore the relationship between sugars intake and dental caries, and implications for health policy interventions. They emphasize that as policies surrounding limiting sugar intake continue to evolve, attention must be given to how best to put these policies into practice to produce positive behavior change that ultimately should lead to improved oral health outcomes.

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