Sugar sweetened beverages and childhood dental caries : a systematic review

Background Dental caries on primary and permanent teeth is a common chronic disease worldwide with negative effects on children`s quality of life, both in the present and future. Sugar intake is a risk factor for caries. However, the association between sugar-sweetened beverages (SSBs) and dental caries is unclear. Methods A systematic review of relevant literature was performed in PubMed, Cochrane Library and ScienceDirect to locate every journal article in English assessing the association between SSBs and dental caries up to May 2014. Quality assessment criteria were formed by 10 essential items in STROBE statement. Results Fourteen studies were included in the present review, of which 11 were cross-sectional studies and 3 were cohort studies. Study participants were recruited from dentistry units, schools or communities. Interview-based or self-reported questionnaires for parents or caregivers were measurement tools for exposure variables. Clinical/dental examination was used to assess the outcome variables in participating children. Decayed, missing, and filled system was used among studies to record caries status. Sources of potential bias may be measurement on exposure and outcome as well as sources and methods of participants selection. Confounding existed due to nature of observational study and possible confounders included age, gender, education and location of children as well as socioeconomic position and oral health awareness of parents. Synthesis of results suggested that there may be a positive association between SSBs and dental caries, providing evidence for policymaking and recommendations for further studies. Conclusions Sugar-sweetened beverages intake could be considered as positively associated with childhood dental caries. Prevention strategy on individual level and population level on dental caries should put more attention on SSBs. Further experimental studies or research with advanced epidemiological instruments are needed for more confident recommendations on preventive strategies.published_or_final_versionPublic HealthMasterMaster of Public Healt