Even low sugar intakes carry risk of caries, finds review

By Nathan Gray contact

- Last updated on GMT

Even low sugar intakes carry risk of caries, finds review

Related tags: Dental caries

Even low intakes of free sugars can lead to an increased risk of tooth decay and dental caries - a finding that re-emphasises the importance cutting dietary sugar intakes, say researchers.

The new review in to the effect of sugar on dental health, published in the Journal of Dental Research,​ has warned that the importance of sugars as a cause of caries is underemphasised and not prominent enough in preventive strategies.

The warning comes after researchers led by Aubrey Sheiham from University College London found evidence to demonstrate the sensitivity of cariogenesis (the development of caries) to even very low sugars intakes.

In the review, the authors reviewed the literature on the role of sucrose in the cariogenic process – concluding that there is ‘extensive’ scientific evidence that free sugars are the primary necessary factor in the development of dental caries.

“We demonstrate the sensitivity of cariogenesis to even very low sugars intakes. Quantitative analyses show a log-linear dose-response relationship between the sucrose or its monosaccharide intakes and the progressive lifelong development of caries,”​ wrote the authors. “This results in a substantial dental health burden throughout life.”


According to the team, the clear relationship between free sugars and dental caries has been well documented but remains underemphasised when it comes to health policy and public education.

“This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic,”​ they said.

“Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars.”​ 

Sheiham and his colleagues warned that the situation results in a substantial dental health burden throughout life – adding that the World Health Organisation (WHO) recently recognised that dental diseases are the most prevalent non-communicable diseases globally and the treatment of dental diseases is expensive, and would exceed the entire financial resources available for the health care of children in most lower income countries.

They concluded that there has been a ‘long-standing failure’ to identify the need for drastic national reductions in sugars intakes.

“Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause — sugars,”​ they argued.

Source: Journal of Dental Research
Published online ahead of print, doi: 10.1177/0022034515590377
“Diet and Dental Caries: The Pivotal Role of Free Sugars Reemphasized”
Authors: A. Sheiham, W.P.T. James

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