According to the World Health Organization, dental caries is one of the most common diseases affecting children and adults.1,2 In the United States, an estimated 27% of individuals under the age of 64 have untreated dental caries, and 91% of all adults have experienced dental caries at some point.2
Caries is currently accepted as a sugar and biofilm-dependent disease, and the pathogenesis is well-understood. Though dental caries is a multifactorial disease, epidemiological studies indicate a lifelong synergistic effect between diet, nutrition, and maintaining the health and integrity of the oral cavity.2
Previous studies have primarily focused on the effects of individual foods on dental caries risk. To address this limitation, the authors of a cross-sectional study used cluster analysis to evaluate the relationship between dietary patterns and dental caries among adolescents aged 12 to 15.2
The Study
A total of 11,351 adolescents aged 12 to 15 throughout the Shanxi Province were surveyed for the study. Each individual independently completed a questionnaire before undergoing an oral health evaluation. The questionnaire included basic demographic information, oral hygiene habits, and detailed questions about dietary choices and habits.2
Information was collected based on consumption of the following foods:2
- Desserts (i.e., cakes, bread, chocolate, candy)
- Sweet drinks (i.e., carbonated drinks, fruit juice, lemonade)
- Sugar-sweetened milk (i.e., yogurt, soy milk, coffee, tea)
- Vegetables
- Fruits
- Coarse grains (i.e., corn, oats, wheat bran)
- Protein foods (i.e., beans, egg, meat)
The questionnaire was based on a scale of six responses ranging from “never or hardly ever” to “more than once a day.” Eight dietary clusters were identified based on the reported dietary choices:2
- High-balanced frequency diet: The eating frequency of all types of food was high
- Low-balanced frequency diet: The eating frequency of all foods was relatively low
- Non-staple-food-rich diet: The eating frequency of fruits and vegetables is relatively high
- Refreshment-rich diet: The eating frequency of sugary foods is relatively high
- Vegetable-rich diet
- Coarse grains-rich diet
- Limited refreshments diet: The frequency of eating foods excluding sweets is high
- Dessert-rich diet
Most participants were grouped in the low-balanced frequency diet, while the fewest were in the high-balanced frequency diet.2
The Results
The overall prevalence rate for dental caries in adolescents aged 12 to 15 was 44.57%. Caries prevalence was lower in males than females and positively correlated with age. The authors suggest this could be due to more frequent snacking among female participants.2
The highest prevalence of dental caries was among those in the refreshments-rich diet group (52.78%). Meanwhile, the coarse grains group had the lowest prevalence of dental caries (42.01%).2
Adolescents with high decayed, missing, and filled teeth (DMFT) scores consumed a high-balance frequency, refreshment-rich, and dessert-rich diet. This suggests that compared to a low balanced frequency diet, high balanced frequency, refreshment rich diets, and dessert rich diets increase caries risk.2
Interestingly, the vegetable-rich diet did not affect caries risk. Additionally, the non-staple-food-rich diet showed no significant difference in caries risk.2
Other factors that influenced caries risk included family size. Adolescents from one-child families had lower caries risk when compared to those who grew up in multi-child families.2
Conclusion
This study had both strengths and limitations. The strength was evaluating the whole diet rather than specific foods.2
Limitations included focusing only on dietary patterns instead of frequency of food intake on caries risk. Additionally, when individuals were placed in the food clusters, some clusters had a very small sample size, which could have affected the results. The study was also cross-sectional; therefore, a cohort follow-up study would be ideal to confirm the findings.2
Nonetheless, the study identified an association between dietary patterns and dental caries risk. Reducing the frequency of sugary food intake while increasing the intake of coarse grains could reduce caries risk among adolescents.2
The authors suggest that preventing caries in adolescents necessitates a proactive strategy involving both education and policy. Governments and societies should promote understanding of caries development, encourage healthy diets low in sugar, and ensure schools offer a variety of nutritious choices.2
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References
- WHO Highlights Oral Health Neglect Affecting Nearly Half of the World’s Population. (2022, November 18). World Health Organization. https://www.who.int/news/item/18-11-2022-who-highlights-oral-health-neglect-affecting-nearly-half-of-the-world-s-population
- Wang, X., Chen, H., Hou, R., et al. Effect of Dietary Patterns on Dental Caries Among 12-15 Years-Old Adolescents: A Cross-Sectional Survey. BMC Oral Health. 2023; 23(1): 845. https://pmc.ncbi.nlm.nih.gov/articles/PMC10633925/
