The effects of nutritional quality and frequency of consumption of sugary foods on dental caries increment

This study investigates the association of dietary quality with dental caries increment of 11-year-old children. A 3-day dietary record including one weekend day was completed by the subjects and their parents. The nutritional quality was evaluated using a quality index based on the eating frequency of foods recommended in food guides and divided into 8 levels. The frequency of consumption of sugary foods, liquid and solid, at and between meals was also calculated. Two oral examinations 20 months apart were made in 1983-85; each time, the quality of oral hygiene was determined by using the simplified oral hygiene was determined by using the simplified oral hygiene index of Greene and Vermillon. the dental caries increment between the two examinations was evaluated using the DMFS index. When the subjects were distributed into 3 groups according to their nutritional quality index, the mean dental caries increment had a tendency to decrease as the nutritional quality increased for the total sample as well as for boys and girls considered separately; however, the analysis of variance did not reveal any differences of statistical significance. No association was established for children in this study between frequency of consumption of sugary foods and caries increment. No association was observed between nutritional quality and oral hygiene nor between the mother's education and the children's frequency of consumption of sugary foods. Thus, in our study, children with the highest dental caries increment are not necessarily the ones having a diet of poor nutritional quality nor the ones consuming sugary foods more frequently.     

A study of caries polarization in 1-, 2- and 3-year-old children

INTRODUCTION: The polarization of dental caries is a notion defined as a small percentage of persons with high dental caries rate and a large percentage of caries-free persons. This phenomenon has not been studied sufficiently in children aged 12 to 47 months which has justified the undertaking of this study. AIM: To determine the percentages of persons with different levels of caries incidence and the percentages of their carious and filled teeth (dft) of the total number of dft in the respective age group. MATERIAL AND METHODS: The study is representative and was conducted in accordance with the World Health Organization requirements for epidemiological study of dental caries. It comprises 370 children from 12 to 47 months of age selected by a random sampling method. Three age groups were formed: group I (12-23 months), group II (24-35 months) and group III (36-47 months). Dental caries on a cavitation level was diagnosed by means of a probe and a mirror. In all groups we further divided the subjects into subgroups of different level of dft (carious and filled teeth): subgroup I--dft = 0 (caries free), subgroup II--dft = 1, subgroup III--dft = 2 and subgroup IV--dft > or = 3. RESULTS: Marked dental caries polarization is observed in all studied age groups--a large percentage of persons free of caries and a small percentage of persons with high dental caries rate--P < 0.001. In one-year-old children 8.33% are carriers of 63.08% of the total dft in that age group, in two-year-old children 18.33% are carriers of 81.50% of the total dft in that age group, and in three-year-old children 25.38% are carriers of 74.58% of the total dft of that age group. CONCLUSION: This study support the assertion that early childhood caries affects predominantly high-risk individuals, which requires differentiated approach to caries prevention and treatment.     

南充市学龄前儿童龋齿现状及其相关因素分析

目的 分析南充市学龄前儿童龋齿现状并探讨其相关因素,为南充市学龄前儿童龋齿防治工作提供参考。方法 2020年10月抽取南充市下辖3个区、1个县级市各1所幼儿园共4所幼儿园,对抽中幼儿园的全部学龄前儿童进行患龋情况调查,对学龄前儿童进行口腔检查并对儿童主要监护人进行饮食习惯和口腔保健行为的问卷调查。采用描述流行病学分析方法进行分析,并采用单、多因素分析方法对学龄前儿童患龋影响因素进行分析。结果 本研究共对1 026名学龄前儿童开展研究,男童占51.6%,年龄3~6岁,平均（4.1±1.4）岁。开始刷牙年龄以<3岁为主,占67.6%。共检出龋齿学龄前儿童341例,患龋率为33.2%。共检出龋齿527颗,上、下乳磨牙龋齿243颗,占46.1%;上、下乳切牙龋齿195颗,占37.0%;上、下乳尖牙龋齿89颗,占16.9%。多因素Logistic回归分析结果显示,年龄越大（OR=2.361）、甜食食用频次>6次/周（OR=2.951）、开始刷牙年龄≥3岁（OR=1.674）的学龄前儿童患龋风险较高,经常餐后漱口（OR=0.824）、早晚刷牙（OR=0.424）、经常使用含氟牙膏（OR=0.410）、定期口腔检查（OR=0.692）的学龄前儿童患龋风险较低。结论 南充市学龄前儿童龋齿普遍存在,其受到饮食习惯和口腔保健行为多种因素影响,需要加大口腔健康教育宣传工作力度,提高学龄前儿童口腔保健意识,督促其建立良好的饮食及口腔保健行为习惯。     

Encouraging healthier lifestyles--1. Children and their teeth

The dental health of children under five years has stagnated in recent years. In 2005, 39.6% of five year olds in England and Wales and 55.4% in Scotland had evidence of decay. Deprived communities are most at risk. All practitioners in child health, especially health visitor teams and general practitioners, must take the initiative in preventing oral disease, working more closely with dental health teams. A change in attitude is needed so that the whole community health team regard oral health as an integral part of general health. As well as monitoring pregnant women and young families, there are three key messages to get across for caries prevention. These are brushing with a fluoride toothpaste as soon as the first tooth erupts, keeping sugary foods to mealtimes and establishing a pattern of regular visits to the dentist. Minimising the frequency of exposure to sweet food and drink is much more important than the quantity of sugar ingested in preventing dental caries. Fluoridation of water supplies is another key preventive measure; at present, fluoridated water reaches less than 14% of the UK's population.     

衡阳市实验中学学生龋齿患病影响因素调查

目的探讨衡阳市实验中学学生龋齿患病的影响因素。方法据衡阳市实验中学卫生科提供的2004年的体检结果,从中随机抽取53名有龋齿和49名无龋齿学生分成病例组和对照组,并用自制的调查表进行调查。结果所得数据经统计分析龋患学生具有睡前吃零食者高于不吃零食者、刷牙时间短高于刷牙时间长的特点。结论由于中学生口腔防病知识、口腔卫生习惯较差,健康教育未能及时跟上,睡前喜吃甜食、使用不正确的刷牙方法等是造成龋齿患病的原因。     

Unhealthy sport sponsorship at the 2017 AFL Grand Final: a case study of its frequency,duration and nature

Objective: To assess the frequency, duration and nature of unhealthy marketing during the highest‐rating sporting event in Australia in 2017. Methods: A content analysis of the 2017 Australian Football League (AFL) Grand Final television broadcast identified episodes of unhealthy food and sugary drink, alcohol and gambling marketing (and pro‐health marketing as a comparison). Results: There were 559 unhealthy marketing episodes (47 minutes 17 seconds). Most (81%) were for unhealthy food and sugary drink products, while alcohol (9%) and gambling (10%) were less frequent. The total duration of unhealthy marketing was delivered primarily via fixed advertising (55%), dynamic advertising (32%) and branded objects (11%). For unhealthy food and sugary drinks, at least one episode was visible 25% of the time. For each of alcohol and gambling, at least one episode was visible 4% of the time. Unhealthy food and sugary drink marketing peaked in Quarter 2. Pro‐health marketing was limited, with 26 episodes (2 minutes 59 seconds). Conclusions: The 2017 AFL Grand Final broadcast featured a high frequency and extensive duration of unhealthy marketing, especially for unhealthy food and sugary drink brands. Implications for public health: Findings strengthen evidence supporting calls to increase regulation of sport sponsorship by unhealthy brands.     

Comparing Sugary Drinks in the Food Retail Environment in Six NYC Neighborhoods

Obesity is a national public health concern linked to numerous chronic health conditions among Americans of all age groups. Evidence suggests that discretionary calories from sugary drink consumption have been a significant contributor to excess caloric intake among both children and adults. Research has established strong links between retail food environments and purchasing habits of consumers, but little information exists on the sugary drink retail environment in urban neighborhoods. The objective of this assessment was to compare various aspects of the sugary drink retail environment across New York City (NYC) neighborhoods with disparate self-reported sugary drink consumption patterns. In-store retail audits were conducted at 883 corner stores, chain pharmacies, and grocery stores in 12 zip codes throughout NYC. Results showed that among all beverage types assessed, sugary drinks had the most prominent presence in the retail environment overall, which was even more pronounced in higher-consumption neighborhoods. In higher- versus lower-consumption neighborhoods, the mean number of sugary drink varieties available at stores was higher (11.4 vs. 10.4 varieties), stores were more likely to feature sugary drink advertising (97 vs. 89 %) and advertising at multiple places throughout the store (78 vs. 57 %), and several sugary drinks, including 20-oz Coke^® or Pepsi^®, were less expensive ($1.38 vs. $1.60). These results, all statistically significant, indicate that neighborhoods characterized by higher levels of sugary drink consumption expose shoppers to sugary drinks to a greater extent than lower-consumption neighborhoods. This builds upon evidence documenting the association between the environment and individual behavior.     

儿童口腔疾病相关因素分析及预防建议

目的探讨儿童乳牙龋的发病相关饮食及预防措施。方法采用病例对照研究,136例为乳牙龋患儿为病例组,同时选择100例口腔健康的儿童为对照组,采用单因素与多因素非条件的Logistic分析儿童乳牙龋发病的相关饮食。结果经过单因素和多因素分析结果显示父亲学历高中以下,进食糖果每周﹥7次,喝碳酸饮料﹥7次,睡前经常吃甜点,每天刷牙的次数≤1次是乳牙龋发病的相关危险因素,而开始刷牙年龄﹤2岁是乳牙龋发病的保护性因素。结论应加强对家长的口腔知识宣教,主动采取利于口腔健康的行为,以达到建立儿童的口腔健康行为的目的 。     

西藏自治区3~5岁儿童口腔健康行为及家长知识、态度的问卷调查分析

目的收集西藏自治区3~5岁儿童口腔健康知、信、行现状数据,为少数民族学龄前儿童的口腔保健以及龋病的防治决策提供依据。方法采用多阶段分层抽样方法对西藏自治区3~5岁儿童家长进行问卷调查,分析儿童口腔健康行为及家长口腔健康知识知晓和态度情况等。使用Epi Data 3.1软件进行数据录入,采用SPSS 23.0统计软件进行统计分析。结果共收回有效问卷1368份。有良好的刷牙习惯的人群所占比例较低。儿童进食含糖食品的频率较高。儿童口腔卫生服务利用低于全国水平。儿童家长口腔健康知识知晓率仅为47.9%。绝大部分家长对口腔健康持积极态度。在开始刷牙年龄、家长帮助刷牙、进食含糖食品的频率、就医行为、口腔健康知识知晓情况及态度等方面,城乡之间差异有统计学意义(P<0.05),性别之间差异无统计学意义(P>0.05)。结论需重点加强对西藏自治区儿童及其家长的口腔保健宣教,强化饮食指导,增加医疗投入,尤其是针对农村地区人群。     

Stop the Pop: A Mixed-Methods Study Examining Children’s Physical and Emotional Responses during Three Days of Sugary Drink Cessation

Despite public health efforts to reduce sugary drink consumption, children’s intake continues to exceed recommendations. While numerous barriers to lowering sugary drink consumption have been identified, aversive feelings during sugary drink cessation may further challenge sustained reduction in children’s sugary drink consumption. Herein, we describe “Stop the Pop”, an intervention to examine children’s physical and emotional responses during three days of sugary drink cessation. Children (n = 150) ages 8–14, who reported habitual consumption of ≥12 ounces of sugary drinks daily, were instructed to avoid sweetened beverages for three days. At baseline and on each day of cessation, children completed a daily feelings questionnaire, and a subset of children (n = 30) also completed a qualitative interview following cessation. During sugary drink cessation, children reported physical and emotional improvements, including being less tired, angry, and annoyed; having less trouble sleeping; and less frequently arguing with others, getting in trouble, and getting mad. However, unfavorable responses, such as mood disturbances and having less energy, were reported by some participants. Our results suggest that children who habitually consume sugary drinks may experience physical and emotional improvements during short-term sugary drink cessation, although longer-term examination is needed and inter-individual variability in responses to cessation warrants further study.     

Water Fluoridation and the Association of Sugar-Sweetened Beverage Consumption and Dental Caries in Australian Children

Objectives. We examined demographic and socioeconomic differences in the consumption of sugar-sweetened beverages (SSBs), its association with dental caries in children, and whether exposure to water fluoridation modifies this association.Methods. In a cross-sectional study, we used a stratified, clustered sampling design to obtain information on 16 508 children aged 5 to 16 years enrolled in Australian school dental services in 2002 to 2005. Dental staff assessed dental caries, and parents completed a questionnaire about their child’s residential history, sources of drinking water, toothbrushing frequency, socioeconomic status (SES), and SSB consumption.Results. Children who brushed their teeth less often and were older, male, of low SES, from rural or remote areas consumed significantly more SSBs. Caries was significantly associated with greater SSB consumption after controlling for potential confounders. Finally, greater exposure to fluoridated water significantly reduced the association between children’s SSB consumption and dental caries.Conclusions. Consumption of SSBs should be considered a major risk factor for dental caries. However, increased exposure to fluoridated public water helped ameliorate the association between SSB consumption and dental decay. These results reconfirm the benefits of community water fluoridation for oral health.Sugar-sweetened beverages (SSBs), including soft drinks (soda or pop), mineral waters (sweetened but noncarbonated beverages), cordials (sweet concentrates to which water is added), and sports (electrolyte) drinks, are commonly consumed in many countries, and consumption patterns have demonstrated an increase over time. In the United States, for example, soft drink consumption increased by approximately 500% between 1947 and 1999.1 Increases in consumption occurred for both children and adults. In the 25-year period between 1977 and 2002, consumption of soft drinks as a percentage of total beverage intake by children aged 6 to 11 years increased from 15% to 33%.2 In Australia, consumption of carbonated beverages increased by 240% between 1969 and 1999.3Because of SSBs’ often high sugar content, their excessive consumption has been linked to several deleterious heath effects, most notably overweight and obesity. One US study found that for each additional serving per day of a sugar-sweetened drink, the risk for obesity increased 60% after adjustment for anthropometric, demographic, dietary, and lifestyle variables.4 In Australia, children consuming 3 or more soft drinks per day have 2.2 times the odds of being obese or overweight than children who do not consume soft drinks.5 Excessive soft drink consumption has also been linked to diabetes, metabolic dysfunction, osteoporosis, high blood pressure, and liver disease.6In terms of oral diseases, the association between SSB consumption and both dental erosion and caries has been investigated. Consistent evidence has shown, for example, that the high acidity of many sweetened drinks, particularly soft drinks and sports drinks, can be a causal factor in dental erosion.7 However, and despite studies going as far back as the 1950s implicating the role of soft drink consumption in dental decay,8 relatively few studies have examined the cariogenicity of SSBs. One reason is that SSB consumption is often subsumed within a broader research perspective investigating the role of dietary sugars generally in the process of dental caries. Although the etiological role of sugars and other fermentable carbohydrates in caries activity has been well established,9,10 the causal role of specific foods in the overall diet can be harder to determine.11Only a handful of studies have shown associations between SSB consumption and dental caries. For example, Ismail et al.12 found a significant positive association between the frequency of at- and between-meal consumption of soft drinks and dental caries. More recently, children aged 2 to 10 years with a predominantly high soft drink diet were found to be 1.8 times more likely to experience dental caries in the primary dentition than children with a predominantly high water consumption pattern.13 Similarly, young children with caries have significantly greater intake of soft drinks than children without caries.14 In the United Kingdom, caries prevalence in the primary dentition was found to be substantially higher among children with a higher than average frequency of SSB consumption, but little difference was found in the permanent dentition of older children.15 In Australia, higher soft drink consumption among children aged 12 years and younger was found to be positively associated with more primary tooth extractions.16 However, other studies investigating soft drink consumption and dental caries have yielded contradictory evidence.11,17 Indeed, a recent review and meta-analysis of the literature, which included only 4 studies, indicated only a small positive (r = .03) association between soft drink consumption and caries.6One question that has received little attention is whether other risk or protective factors might modify any association between soft drink consumption and dental caries. The effect of soft drink consumption on caries might be weaker for children who come from higher income families, who brush their teeth with fluoride toothpaste more often, or who have greater exposure to fluoridated water. In particular, an overwhelming amount of research has demonstrated, and continues to demonstrate, that drinking fluoridated water offers a considerable caries preventive benefit.18–20 The US Surgeon General has declared that water fluoridation is not only efficient and cost effective but is also the single most effective means of preventing tooth decay over a person’s lifetime.21 However, surprisingly little research has been conducted into whether water fluoridation also confers benefits by reducing the impact of risk factors for dental caries. Any effect of soft drink consumption on dental caries may be mitigated to some extent when children are also receiving the benefits of consuming fluoridated water.We investigated this possible association between sweetened drink consumption and caries in both deciduous and permanent teeth in a large and representative group of Australian schoolchildren. In addition, we aimed to describe demographic and socioeconomic status (SES) differences in SSB consumption. Finally, we examined whether other protective factors for dental disease, such as higher SES, more frequent toothbrushing, and residing in an area with fluoridated water, modified any association between the consumption of sugared beverages and dental caries.     

Reducing Sugary Drink Consumption: New York City’s Approach

Studies have linked the consumption of sugary drinks to weight gain, obesity, and type 2 diabetes. Since 2006, New York City has taken several actions to reduce consumption.Nutrition standards limited sugary drinks served by city agencies. Mass media campaigns educated New Yorkers on the added sugars in sugary drinks and their health impact. Policy proposals included an excise tax, a restriction on use of Supplemental Nutrition Assistance Program benefits, and a cap on sugary drink portion sizes in food service establishments.These initiatives were accompanied by a 35% decrease in the number of New York City adults consuming one or more sugary drinks a day and a 27% decrease in public high school students doing so from 2007 to 2013.From 1977 to the early 2000s, Americans dramatically increased their consumption of sugary drinks, including carbonated beverages, fruit drinks, sports and energy drinks, and other drinks with added sugars.1 A nationally representative survey conducted in 2009 to 2010 found that sugary drinks contributed approximately 150 calories a day to the diet of both adults and youths, with some subgroups consuming far more; for example, adolescent boys consumed a mean of 278 calories per day, and men aged 20 to 39 years consumed a mean of 258 calories per day.2 Numerous studies have linked the intake of sugary drinks, the largest single source of added sugars in the diet, with weight gain, obesity, type 2 diabetes, and heart disease.3–8Because of the health and economic toll of the obesity epidemic and the contribution of sugary drinks to poor health outcomes, many public health organizations support reducing the consumption of sugary drinks. We have described the New York City Department of Health and Mental Hygiene’s (DOHMH’s) multipronged efforts to reduce sugary drink consumption from 2006 to 2013, which has included institutional changes, education via mass media, and regulatory and legislative policy proposals.     

Relationship between dietary intake and dental caries in preschool children

This study assessed the relationship between intake of nutrients and dental caries in preschool children. One hundred and eighty-two children aged three to six years were recruited from nine day care centers in central Taiwan. These children had an oral health examination, and their parents or guardians answered a questionnaire. Each child's intake of nutrients was estimated using the 24-hour dietary recall and food frequency questionnaire data. Logistic regression analysis was applied to assess the associations between dental caries and intake of each nutrient or food group, with adjustment for potential confounders. The prevalence of dental caries was 73 % and increased with age. Not being a first-born and having more between-meal snacks were associated with increased caries risk. After controlling for other important factors, vitamin A intake was significantly associated with fewer dental caries (deft, decayed, indicated for extraction, and filled primary teeth: ≥ 4 vs. < 4), with an odds ratio of 0.97 (95 % confidence interval: 0.94 - 0.99) for an 100-μg increase in vitamin A intake. There was no significant association between dental caries and energy, macronutrient intake, and Ca/P ratio, respectively. Vegetable intake was also significantly associated with lower dental caries score.     

Prevalence of dental caries and sugar consumption among 6-12-y-old schoolchildren in La Trinidad, Benguet, Philippines

OBJECTIVE: To determine the prevalence of dental caries and the level of sugar consumption among 6-12-y-old schoolchildren in La Trinidad, Benguet, Philippines. DESIGN: A Cross-sectional study as a baseline survey for a later intervention program. A questionnaire was distributed to obtain information on dental history and total consumption of food with sugar. Caries were diagnosed based on the WHO recommendation. RESULTS: A total of 1200 schoolchildren, aged 6-12 y were included. The prevalence of dental caries in primary dentition was 71.7% and in the permanent dentition, 68.2%. The mean total decayed, extracted due to caries and filled primary teeth (DMFT) and decayed, missing and filled permanent teeth (DMFT) were 4.12 (s.d. 4.03) and 2.40 (s.d. 2.57), respectively. As age increased the mean DMFT increased. Majority (70%) had tooth brushing practices, and less than half (42.5%) had a dental visit only when necessary. Their sugar intake was twice more than the WHO recommendation with a mean daily total intake of 59 g per person. Most common sources of dietary sugar were hard candies (89%), banana cue (84.9%), camote cue (84.9%) and soft drinks (84.4%). No significant correlation was found between sugar intake and dental caries. CONCLUSION: The results indicate that dental caries is highly prevalent and increase with augmented sugar consumption. This maybe due to a widespread neglect of oral health and an increased availability of refined sugary products. Caries rates mirrored those of the developing countries with untreated lesions dominating all ages. The high level of untreated caries in all age groups is a cause for concern.     

Dietary and social characteristics of children with severe tooth decay

BACKGROUND AND AIMS: Dental decay remains a major public health problem in Scottish children. The aim of this study was to investigate the relationship between diet, bowel habit, social class, and body mass index (BMI) in children with severe tooth decay. CHILDREN AND METHODS: A cross sectional study of 165 children aged 3 -11 years attending Glasgow Dental Hospital for extraction of teeth under dental general anaesthesia (DGA), was undertaken. A structured questionnaire was used to obtain information from each child on diet, bowel habit, and social status of their parents. Fibre and sugar scores were calculated from the frequency of consumption of a range of relevant foods. RESULTS: The children (mean age 5.7 (SD1.8) years) had between 1 and 20 decayed, missing or filled primary teeth (dmft) with a mean dmft of 7.9 (SD 3.5). 37% ate a chocolate bar daily, and 29% regularly drank a sugary drink after brushing their teeth. An excess of children were from the most deprived parts of the city and they had the worst decay. Children with the worst decay were also significantly thinner. No relationship was found between tooth decay and bowel habit. CONCLUSIONS: In this selected group of children with poor dental health, those from deprived families were over-represented and had significantly more decay. Severe dental decay was also associated with underweight.     

西安市某高校幼儿园242名儿童口腔卫生状况及分析

目的 针对242名儿童口腔健康存在的问题,探讨口腔卫生习惯与儿童龋齿的关系。方法 通过对西安某高校幼儿园242名儿童做口腔健康全面检查,对4~6岁的儿童的换牙、龋齿、严重龋齿(>4颗)、缺牙、牙结石、延迟换牙和补牙情况进行检查分析。并对242名儿童及家长进行访谈,填写问卷,并将结果进行统计分析。结果 242人中龋齿71人,重度龋齿18人,补牙人数为28人,牙结石人数26人。儿童的口腔卫生习惯与龋齿的发病原因直接相关,导致龋齿发生的原因依次为:1)细菌因素:主要是菌斑,细菌的存在是龋病发生的必然条件;如无刷牙习惯;2)食物因素:过多食用零食,喜好甜食,而全身的营养支持不够;3)宿主因素:影响可能是牙齿排列或形态不整齐、不规则。 结论 242名儿童中龋齿严重,今后应提高儿童乳牙保护意识,养成良好的口腔卫生习惯,可有效防止龋齿的发生和发展。     

Influence of tobacco use in dental caries development

This review article describes different forms of tobacco usage and its direct relationship with the prevalence of dental caries. Smoking along with co-existing factors like old age, bad oral hygiene habits, food habits, limited preventive dental visits and over all health standards, can be associated with high caries incidence. However, a direct etiological relationship is lacking. Environmental tobacco smoke (ETS) causes dental caries in children but no studies have been reported in adults. Existing findings are not sufficient and conclusive enough to confirm that ETS causes dental caries. Oral use of smokeless tobacco (ST), predominantly tobacco chewing, is presumably a positive contributing factor to higher incidence of dental caries. Unfortunately, published studies are not converging towards one single factor through which tobacco usage can have direct relationship to dental caries.     

Guidelines for sugar consumption in Europe: is a quantitative approach justified?

OBJECTIVES: There is incongruity between the sugar consumption guidelines set in different European countries. A number have adopted maximum limits ranging from 10-25% energy, while others have no quantitative recommendations at all. This raises the question whether or not there should be a common European guideline for sugar consumption. DESIGN: This paper examines if such a goal for sugar is merited and reviews the published literature on associations between sugar consumption and dental caries, obesity and micronutrient dilution. RESULTS: Evidence showed that higher intakes of sugar were related to leanness, not obesity, and had no detrimental effects on micronutrient intakes in most people. In the case of dental caries, there was a relationship between frequency of sugar intake and the incidence of decay. However, in populations where fluoride use was adequate, associations between sugar intake and caries rarely reached statistical significance. CONCLUSIONS: The available evidence does not justify a common quantitative recommendation for sugar. It is suggested that dental caries merits a more integrated public health approach where advice on the frequency of foods containing fermentable-carbohydrates is placed in context alongside oral hygiene.     

The relationship between dental caries of deciduous teeth and anxiety of mothers associated with child-care

AIM: The incidence of caries in children is closely related to daily habits and may also be influenced markedly by a mother's attitude to child-care. For example, if a mother has a mental health problem such as child-care anxiety, this may prevent her obtaining advice on the daily health requirements of her children including the need to brush the teeth regularly. It is therefore important that mothers receive guidance in order to minimize the incidence of caries. This study examined the effect of child-care anxiety in mothers on the prevalence of caries in 3-year-old children. METHODS: The subjects were 503 pairs of mothers and their children who attended a check-up at a community health center in Gifu City when the children were aged 3-years. The mothers answered a questionnaire about child-care, while the children had a dental examination and caries activity test (Cariostat). The prevalence of caries and the Cariostat score were examined by binomial logistic regression analysis. The relationship between child-care anxiety of the mothers and children's caries or Cariostat score were analyzed using Covariance Analysis, that incorporated additional multiple indicator models including snack behavior, social-support and food faddism of the children. RESULTS: 1. The rate of caries disease increased with high Cariostat scores and was statistically significant at scores greater than 2.0. 2. Covariance analysis demonstrated both the models of children's caries and Cariostat score provided a good fit to the actual data, the former model having a GFI = 0.951 and RMSEA = 0.046, and the latter a GFI = 0.952 and RMSEA = 0.046. 3. It was found that anxiety over child-care directly affected snack behavior, while itself being influenced directly by both social-support and food fads of the children. 4. Snack behavior influenced Cariostat score, but not the prevalence of child caries. CONCLUSIONS: We suggest it is necessary to provide guidance to mothers with a background of child-care anxiety in order to prevent a high rate of caries in their children. It may be possible to detect mothers with child-care anxiety that leads to bad snack behavior by obtaining information on the child's social-support and food fads. Our study showed that offering social support was an effective means of preventing habits that may predispose to the development of dental caries. Furthermore, we found the Cariostat score was an effective test for assessing the influence of child-care on caries incidence.     

Nothing beats taste or convenience: a national survey of where and why people buy sugary drinks in Australia

Objective : There is limited knowledge of what influences sugary drink purchasing decisions in the Australian population. This study aimed to identify the most common locations and reasons across different demographic groups for purchasing sugary drinks in Australia. Methods : A total of 891 respondents (who purchased sugary drinks for personal consumption at least occasionally) from a broader national population telephone survey of Australian adults conducted in 2017 (n=3,430) were included in the analysis. Results : ‘Taste’ was a ubiquitous reason for purchase (94%) and the majority also agreed with ‘easily available’ (76%). Males, younger people and people of lower socioeconomic status (SES) were significantly more likely to agree that sugary drinks were ‘cheap’ and ‘better value than water’. Furthermore, males and younger people were more likely to report buying sugary drinks because they were ‘part of a meal deal’. The most common purchase locations were supermarkets (56%), followed by convenience stores (19%) and food or entertainment venues (17%). Conclusion : Taste is paramount in decisions to purchase sugary drinks, and widespread availability and value for money support consumption. Implications for public health : Policies and interventions targeting point‐of‐sale sugary drink purchasing decisions among the most ‘at risk’ consumers are warranted.