Impact of Fluoride on Associations between Free Sugars Intake and Dental Caries in US Children

Effect of Drinking Water Fluoride on Gingivitis and Caries: A Study in Peat and Non-Peat Land: A Comparative Cross-Sectional Study

Aim

Humans get fluoride from food and water available in their environment. The source of clean water in peatlands comes from rainwater with a low mineral content, especially fluoride. The objective of this study was to investigate the correlation between the fluoride level in drinking water and salivary fluoride levels, as well as their potential impact on dental and oral health conditions.

Materials and Methods

It is a causal-comparative study with a cross-sectional approach at the Health Polytechnics of Pontianak and Yogyakarta. The population were indigenous people in peat land (Pontianak) and non-peat land (Yogyakarta). The data were pH and mineral content in drinking water, saliva, the number of Streptococcus mutans colonies, dental caries rates, and gingivitis.

Results

Drinking water fluoride is only significantly correlated with salivary fluoride on non-peat land. If these data are combined, it can be seen that drinking water fluoride is positively correlated (P < 0.05; CI 95%) with pH water, fluoride water, and pH saliva. Increased levels of fluoride in drinking water were negatively correlated with gingivitis, dental caries, and S. mutans.

Conclusion

Drinking water fluoride is negatively correlated with dental caries and gingivitis in peatland and non-peatland communities, but would be significantly associated with dental caries and gingivitis if both peatland and non-peatland data were analyzed together. This is due to the low content of fluoride in the drinking water of peatland. Therefore, it is necessary to add fluoride gel to the teeth to prevent the development of dental caries.

Feasibility and acceptability of home delivery of water for dental caries control in Latinx children-"Sediento por una Sonrisa," Thirsty for a Smile: Single-arm feasibility study

Background

Outcomes of surgical treatments under general anesthesia for early childhood caries of young children from low-income groups are poor requiring retreatment within 2 years. Dietary sugar is an ideal intervention target given that it is the most prominent risk factor for dental caries and there is increasing evidence of successful interventions to reduce its intake. Our aim is to investigate the feasibility and acceptability of the Thirsty for a Smile intervention, designed to promote consumption of water in lieu of sugar sweetened beverages, among children who underwent surgery for early childhood caries and their caregivers, mostly from Latino heritage.

Methods

A single-arm feasibility study was conducted in a dental practice from a community health center in eastern Washington State. Bottled water was delivered to the participants' homes and caregivers received patient-centered counseling for setting goals to increase children's water intake and reduce sugar sweetened beverages consumption. We assessed the feasibility and acceptability of the intervention and study procedures through participation rates, interviews and a questionnaire completed by the caregivers. Data was analyzed and themes and descriptive statistics presented.

Results

Twenty-two dyads of caregivers and their children between 2 and 9 years old who recently had surgical treatment for early childhood dental caries were enrolled. All study assessments were completed by more than 90% of participants, except for the final 24-h dietary recall (73%). Dietary counseling, both in person and brief telephone calls, was highly acceptable to the caregivers, and they also reported their children enjoyed and used the water bottles. On a scale from 1 to 10, the average rating for the helpfulness of the dietary counseling component for changing child's drinking habits was 9.62 and for the water delivery component, 8.86.

Conclusions

This study tested the feasibility of conducting a trial in a dental practice setting, and the acceptability among caregivers of young children who underwent surgery for early childhood caries. It demonstrated that the Thirsty for a Smile intervention and study processes were feasible and acceptable. The study provides useful information for implementation of a two-arm randomized controlled trial in this setting and may also benefit other researchers attempting to test similar interventions.

Free sugars and early childhood caries development: a prospective cohort study

PURPOSE

To investigate the impact of giving children younger than 2 years foods and beverages with free sugars on the prevalence of early childhood caries at 5 years.

MATERIALS AND METHODS

The study group consisted of 208 children (105 boys and 103 girls) with a complete set of data on nursing, diet and caries from birth to 5 years. We collected feeding habits and dietary data through structured questionnaires at 6, 12, 18 and 24 months and the presence of decayed (d), missed (m) and filled (f) teeth was scored according to the WHO criteria at five years of age. We processed data with chi-square tests and expressed as relative risk (RR) with 95% confidence intervals.

RESULTS

At the age of 5 years, 22% of the children had caries. Intake of fruit juice with meals (RR 2.3) and cookies or biscuits at 24 months of age (RR 2.4), as well as fast food consumption at least once every week (RR 2.9), more than doubled the risk for early childhood caries (p < 0.05).

CONCLUSIONS

Within the limitations of the present study, we found a relationship between consumption of free sugars early in life and dental caries prevalence at 5 years. It therefore seems important to embrace and emphasise the current sugar recommendations in primary and dental care to educate caregivers to avoid serving free sugars to their children before the age of 2 years.