Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is ,15‐20 kg/yr (,6‐10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

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Diet, nutrition and the prevention of dental diseases

A reference guide to drugs and dry mouth.

Rampant caries in infants and young children has long been recognized as a clinical syndrome referred to by various names, including nursing caries, nursing bottle syndrome, night bottle mouth, and baby bottle tooth decay. The common theme among these terms is the perceived central role of inappropriate use of the baby bottle in the etiology and progression of carious lesions. Use of the baby bottle is not the only, and may not be the most important, factor in caries development. Because of questions about the role of the baby bottle in caries among young children, the Centers for Disease Control and Prevention recently suggested that the term for this clinical syndrome be replaced with early childhood caries (ECC). The purpose of this paper is to evaluate the literature on the influence of psychosocial and behavioral factors in early childhood caries. Prevalence of caries and maxillary anterior decay varies greatly in developed and undeveloped countries and among socioeconomic groups in developed countries. However, relatively little is known about the onset and progression of the disease or the antecedents of ECC, such as high risk behaviors, cultural norms, health beliefs and attitudes, or health care delivery factors. Furthermore, studies that do exist are limited by small and possibly biased samples and a lack of clear case definition. Future research should aim to develop a clear case definition of ECC, differentiate patterns of caries and conduct community-based epidemiological studies in order to obtain accurate estimates of the etiology and epidemiology of ECC in the general population, as well as in high risk groups.

Psychosocial and behavioral issues in early childhood caries.

Relationship between dietary habits and caries increment assessed over two years in 405 English adolescent school children

OBJECTIVES: To investigate the effects of dietary guidelines on sugar and sugar intake at day nurseries, and other potential risk factors on dental caries in two groups of low socio-economic nursery schoolchildren. DESIGN: Nursery based, longitudinal study. SETTING: Metropolitan area of Recife, north-eastern Brazil. SAMPLE AND METHODS: The study population comprised 510, 3-year-old low socio-economic nursery schoolchildren. Sugar intake at the nursery was based upon a weighed inventory method during 2 non-consecutive days. Parents answered a questionnaire. RESULTS: Children attending nurseries not adopting guidelines on reduction of sugar intake had a higher caries risk, with an odds ratio of 3.6 compared to those attending nurseries with guidelines. A higher caries increment was related to higher daily frequency and weight of sugar intake at nursery, overall daily frequency of sugar intake (sugar intake at home plus nursery), past caries experience, use of fluoride, and habits related to toothbrushing. Children having more than 32.6 g of sugar daily at nursery were 2.99 times more likely to have high caries increment than those having less than that amount. CONCLUSIONS: Sugar intake at nursery and the adoption of guidelines on sugar were associated with lower caries increment in low income nursery schoolchildren. A number of modifiable factors such as a higher daily frequency and weight of sugar intake at nursery, use of fluoride and habits related to toothbrushing were strongly related to caries increment.

The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: a longitudinal study.

The study covered 515 children, aged 4 years and 1 month at the time of examination, selected from a total sample of about 1,600 individuals from two limited areas in southern Sweden. The investigatio

Lennart Köhler

Papers

Variation in caries prevalence related to combinations of dietary and oral hygiene habits and chewing fluoride tablets in 4-year-old children.

Abstracts of Papers presented at the 24th ORCA Congress