Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.00721
Revista de Odontologia da UNESP
Original Article

Timing of sugar introduction in diet and early childhood caries: a population-based study in preschoolers

Momento de introdução de açúcar na dieta e cárie na primeira infância: um estudo de base populacional em pré-escolares

Guilherme Nilson ALVES DOS SANTOS; Cacilda Castelo Branco LIMA; Ananda Souza PEREIRA; Marina de Deus Moura LIMA; Lúcia de Fátima Almeida de Deus MOURA; Marcoeli Silva de MOURA

Downloads: 5
Views: 746

Abstract

Abstract: Introduction: Sugar ingestion is the most important isolated factor related to dental caries. Contact with sugary foods at an early age may represent a risk to the oral health of preschool children.

Objective: To evaluate the timing of the introduction of sugar in the diet of preschoolers and its association with early childhood caries.

Material and method: Cross-sectional population-based study with 888 five-year-old preschoolers from public and private schools. Parents answered a questionnaire on sociodemographic data, eating habits and oral health. The variables timing of sugar introduction (>1 year and ≤1 year) and dental caries experience were dichotomized and data were analyzed using descriptive statistics and Poisson regression (p<0.05).

Result: The introduction of sugar in the diet occurred during the first twelve months of life for 73.8% of preschoolers. There was no association between the timing of sugar introduction and early childhood caries (p>0.05). The interruption of exclusive breastfeeding and low family income increased the prevalence of preschoolers having early contact with sugar by 32% and 23%, respectively (p<0.05). The prevalence of early childhood caries was 42.3% and was associated with a lower level of maternal education, low income, increased frequency of ingestion of candy and the use of nonfluoridated toothpaste (p<0.05).

Conclusion: The introduction of sugar in the diet occurred during the first year of life in most preschoolers and there was no association with early childhood caries.

Keywords

Sugars, diet, dental caries, child

Resumo

Resumo: Introdução: A ingestão de açúcar é um importante fator relacionado à cárie dentária. O contato com alimentos açucarados em idade precoce pode representar risco para a saúde bucal de crianças em idade pré-escolar.

Objetivo: Avaliar o momento de introdução do açúcar na dieta de pré-escolares e sua associação com a cárie na primeira infância.

Material e método: Estudo transversal de base populacional com 888 pré-escolares de cinco anos de escolas públicas e privadas. Os pais responderam questionário sobre dados sociodemográficos, hábitos alimentares e saúde bucal. As variáveis ​​tempo de introdução do açúcar (> 1 ano e ≤1 ano) e experiência de cárie dentária foram dicotomizadas e os dados foram analisados ​​por meio de estatística descritiva e regressão de Poisson (p <0,05).

Resultado: A introdução do açúcar na dieta ocorreu nos primeiros doze meses de vida para 73,8% dos pré-escolares. Não houve associação entre o momento de introdução do açúcar e a cárie na primeira infância (p> 0,05). A interrupção do aleitamento materno exclusivo e a baixa renda familiar aumentaram a prevalência de pré-escolares com contato precoce com açúcar em 32% e 23%, respectivamente (p <0,05). A prevalência de cárie na primeira infância foi de 42,3% e esteve associada à menor escolaridade materna, baixa renda, maior frequência de ingestão de doces e uso de dentifrício não fluoretado (p <0,05).

Conclusão: A introdução de açúcar na dieta ocorreu durante o primeiro ano de vida na maioria dos pré-escolares e não houve associação com cárie na primeira infância.
 

Palavras-chave

Açúcares, dieta, cárie dentária, criança

References

1 da Cunha AJLA, Leite ÁJM, de Almeida IS. The pediatrician’s role in the first thousand days of the child: the pursuit of healthy nutrition and development. J Pediatr (Rio J). 2015 Nov-Dec;91(6 Suppl 1):S44-51. http://dx.doi.org/10.1016/j.jped.2015.07.002. PMid:26351769.

2 Angelopoulou MV, Beinlich M, Crain A. Early childhood caries and weight status: a systematic review and meta-analysis. Pediatr Dent. 2019 Jul;41(4):261-72. PMid:31439085.

3 Murray RD. Savoring sweet: sugars in infant and toddler feeding. Ann Nutr Metab. 2017;70(Suppl 3):38-46. http://dx.doi.org/10.1159/000479246. PMid:28903112.

4 Nicklaus S, Schwartz C, Monnery-Patris S, Issanchou S. Early development of taste and flavor preferences and consequences on eating behavior. Nestle Nutr Inst Workshop Ser. 2019;91:1-10. http://dx.doi.org/10.1159/000493673. PMid:30865953.

5 Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015 May;94(5):650-8. http://dx.doi.org/10.1177/0022034515573272. PMid:25740856.

6 WHO: World Health Organization. Guideline: sugars intake for adult and children. Geneve: WHO; 2015.

7 Sheiham A, James WPT. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015 Oct;94(10):1341-7. http://dx.doi.org/10.1177/0022034515590377. PMid:26261186.

8 Johansson I, Lif Holgerson P, Kressin NR, Nunn ME, Tanner AC. Snacking habits and caries in young children. Caries Res. 2010;44(5):421-30. http://dx.doi.org/10.1159/000318569. PMid:20720422.

9 Fabiano V, Albani E, Cammi GM, Zuccotti GV. Nutrition in developmental age: few rules to stay healthy. Minerva Pediatr. 2020 Jun;72(3):182-95. http://dx.doi.org/10.23736/S0026-4946.20.05803-X. PMid:32274912.

10 Feldens CA, Vítolo MR, Maciel RR, Baratto PS, Rodrigues PH, Kramer PF. Exploring the risk factors for early-life sugar consumption: a birth cohort study. Int J Paediatr Dent. 2021 Mar;31(2):223-30. http://dx.doi.org/10.1111/ipd.12713. PMid:32815208.

11 Masztalerz-Kozubek D, Zielinska MA, Rust P, Majchrzak D, Hamulka J. The use of added salt and sugar in the diet of polish and austrian toddlers. Associated factors and dietary patterns, feeding and maternal practices. Int J Environ Res Public Health. 2020 Jul;17(14):5025. http://dx.doi.org/10.3390/ijerph17145025. PMid:32668675.

12 WHO: World Health Organization. World Health Statistics. Geneva: WHO; 2013.

13 Chaffee BW, Feldens CA, Rodrigues PH, Vitolo MR. Feeding practices in infancy associated with caries incidence in early childhood. Community Dent Oral Epidemiol. 2015 Aug;43(4):338-48. http://dx.doi.org/10.1111/cdoe.12158. PMid:25753518.

14 Sethi Dalai S, Sinha A, Gearhardt AN. Low carbohydrate ketogenic therapy as a metabolic treatment for binge eating and ultraprocessed food addiction. Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):275-82. http://dx.doi.org/10.1097/MED.0000000000000571. PMid:32773576.

15 Watt RG. A national survey of infant feeding in asian families: summary of findings relevant to oral health. Br Dent J. 2000 Jan;188(1):16-20. http://dx.doi.org/10.1038/sj.bdj.4800374. PMid:10697340.

16 Bernabé E, Ballantyne H, Longbottom C, Pitts NB. Early introduction of sugar-sweetened beverages and caries trajectories from age 12 to 48 months. J Dent Res. 2020 Jul;99(8):898-906. http://dx.doi.org/10.1177/0022034520917398. PMid:32374714.

17 Thornley S, Bach K, Bird A, Farrar R, Bronte S, Turton B, et al. What factors are associated with early childhood dental caries? A longitudinal study of the growing up in New Zealand Cohort. Int J Paediatr Dent. 2021 May;31(3):351-60. http://dx.doi.org/10.1111/ipd.12686. PMid:32602981.

18 Martin-Kerry J, Gussy M, Gold L, Calache H, Boak R, Smith M, et al. Are Australian parents following feeding guidelines that will reduce their child’s risk of dental caries? Child Care Health Dev. 2020 Jul;46(4):495-505. http://dx.doi.org/10.1111/cch.12768. PMid:32246860.

19 Möller LM, de Hoog ML, van Eijsden M, Gemke RJ, Vrijkotte TG. Infant nutrition in relation to eating behaviour and fruit and vegetable intake at age 5 years. Br J Nutr. 2013 Feb;109(3):564-71. http://dx.doi.org/10.1017/S0007114512001237. PMid:22717117.

20 Zhang M, Zhang X, Zhang Y, Li Y, Shao C, Xiong S, et al. Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study. BMC Oral Health. 2020 May;20(1):139. http://dx.doi.org/10.1186/s12903-020-01104-8. PMid:32398067.

21 WHO: World Health Organization. United Nations International Children's Emergency Fund – UNICEF. Global Breastfeeding Scorecard [Internet]. Geneve: WHO; 2019 [cited 2020 Aug 26]. Available from: https://www.who.int/nutrition/publications/infantfeeding/global-bf-scorecard-2019/en/

22 Kotha SB, Alfaraj NSM, Ramdan TH, Alsalam MA, Ameer MJ, Almuzin ZM. Associations between diet, dietary and oral hygiene habits with caries occurrence and severity in children with autism at dammam city, Saudi Arabia. Open Access Maced J Med Sci. 2018 Jun 6;6(6):1104-10. http://dx.doi.org/10.3889/oamjms.2018.245. PMid: 29983812.

23 Calvasina P, O’Campo P, Pontes MM, Oliveira JB, Vieira-Meyer APGF. The association of the Bolsa Familia Program with children’s oral health in Brazil. BMC Public Health. 2018 Oct;18(1):1186. http://dx.doi.org/10.1186/s12889-018-6084-3. PMid:30340475.

24 WHO: World Health Organization. Ending childhood dental caries: WHO implementation manual. Geneve: WHO; 2020.

25 Zero DT, Lippert F, Hara AT, Creeth JE, Newby EE, Butler A, et al. In situ anticaries efficacy of dentifrices with different formulations - a pooled analysis of results from three randomized clinical trials. J Dent. 2018 Oct;77:93-105. http://dx.doi.org/10.1016/j.jdent.2018.07.014. PMid:30048657.
 


Submitted date:
02/08/2021

Accepted date:
06/10/2021

610d94b8a95395069953c953 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections