Table 3 Studies on the dental caries risk associated with SSB consumption

Armfield, 2013

Australian children enrolled in school dental services

16,508

5-16 years

Questionnaire given to parents asked about SSB consumption

≥3/day, 1-2/day vs. 0/day, (1 serving = “1 medium glass”)

Decayed, missing and filled deciduous teeth (for ages 5-10)

Decayed, missing and filled permanent teeth (for ages 11-16)

Positive

5-10 years old

≥3 vs. 0 servings/day

β = 0.46 [95%CI: 0.29, 0.64]*

1-2 vs. 0 servings/day

β = 0.34 [95%CI: 0.23, 0.45]*

11-16 years old

≥3 vs. 0 servings/day

β = 0.27 [95%CI: 0.13, 0.41]*

1-2 vs. 0 servings/day

β = 0.16 [95%CI: 0.06, 0.26]*

Chi, 2015

Convenience sample of Alaska Native Yup’ik children

51

6-17 years

Verbally administered survey, including questions on beverage consumption adapted from Beverage and Snack Questionnaire

40 grams/day of added sugar (i.e. amount of sugar in 12-ounce soda) measured using hair biomarker and self-report.

Note: Biomarker would include all sources of added sugar, not just liquid.

Proportion of carious tooth surfaces

Mixed

Biomarker:

6.4% [95%CI: 1.2, 11.6%]*

Self-Report:

Null. No measure of association reported.

Derlerck, 2008

Preschool children in four distinct geographical areas of Belgium

2533

3 and 5 year olds

Questionnaire given to parents with structured open-ended questions about dietary habits

Daily or more consumption of SSBs at night vs. none

Daily consumption of SSBs between meals vs. none

Odds of caries experience (using criteria from British Association for the Study of Community Dentistry)

Positive

SSB consumption at night

3 year-olds

OR= 7.96 [95%CI: 1.57, 40.51] *

5 year-olds

OR = 1.64 [95%CI: 0.18, 14.63]

SSB consumption between meals

3 year-olds

OR=1.47 [95%CI: 0.36, 6.04]

5-year olds

OR= 2.60 [95%CI: 1.16, 5.84] *

Evans, 2013

Low-income children recruited from pediatric dental clinics in D.C. and Ohio

883

2-6 years

Parent-completed 24-hour recall and interviewer-administered FFQ

Using 24-hour recall

1.7 to 14 servings SSB/day vs. 0 servings/day

Using FFQ

0.63 to 7 servings SSB/day vs. <0.16 servings/day (1 serving = 8 ounces)

Odds of severe early childhood caries

Positive

Using 24-hour recall

OR = 2.02 [95%CI: 1.33, 3.06]*

Using FFQ

OR = 4.63 [95%CI: 2.86, 7.49]*

Guido, 2011

Children from small rural villages in Mexico

162

2-13 years

Questionnaire with questions about beverage consumption specific to ones sold in local stores

Drinking soda at least onece/day

Decayed, missing and filled deciduous teeth

Decayed, missing and filled permanent teeth

Positive

No measures of association reported

p=0.71

p=0.04*

Hoffmeister, 2015

Random sample of children in southern Chile from a daycare center register

2987

2 and 4 years

Survey filled out by parents with questions about sugary drink frequency

>3 servings of sugary drinks/week at bedtime vs. ≤ 3 servings of sugar drinks/week at bedtime (1 serving = not reported)

Prevalence ratio of decayed, missing and filled deciduous teeth

Positive

2 year olds

PR = 1.43 [95%CI: 0.97, 2.10] *

4 year olds

PR = 1.30 [95%CI: 1.06, 1.59] *

Jerkovic, 2009

Children recruited from primary schools in northern region of the Netherlands, including low and high SES schools

301

6 and 10 years

Questionnaire filled out by parents including information on nutritional care

≥5 glasses of fruit juice/soft drinks vs. ≤4 glasses of fruit juice/soft drinks

Prevalence of caries

Positive

Measures of association not reported.

p<0.001 *

Jurzak, 2015

Pediatric patients from university dental clinic in Poland

686

1-6 years

Questionnaire including questions about SSB consumption

Frequent consumption of fruit juices and carbonated drinks vs. Infrequent consumption (1 serving = not reported)

Odds of decayed, missing and filled teeth

Mixed, depending on age

1-2 years old

2.60 [95%CI: 0.77, 8.74]

3-4 years old

2.23 [95%CI: 1.25, 3.96] *

5 years old

OR=2.134 [95%CI: 0.84, 5.44]

6 years old

OR= 2.25 [95%CI: 1.03, 4.92]*

Kolker, 2007

African American children with household incomes below 250% of the 2000 federal poverty level

436

3-5 years

Block Kids FFQ

Consumption of soda (1 serving = not reported)

Odds of higher score of decayed, missing and filled deciduous teeth

Null

OR = 1.00 [95%CI: 1.0, 1.1]

Note: this result is for soda. See full paper for powdered drinks, sports drinks, fruit drinks, etc.

Lee, 2010

Convenience sample of healthy primary school children in Australia

266

4-12 years

Prat Questionnaire asked about consumption of sweet drinks

Sweet drinks consumed in the evening/night vs. no sweet drinks consumed

Caries experience in past 12 months

Positive

18% vs. 29%

p=0.004*

Measure of association not reported.

Majorana, 2014

Italian toddlers born to mothers attending two obstetric wards

2395

24-30 months

Self-administered questionnaire for mothers with questions about SSB consumption

≥2 servings day vs. ≤1 servings of SSBs, (1 serving = 250mL)

Odds of higher International Caries Detection and Assessment System score

Positive

OR = 1.18 [95%CI: 0.99-1.40]*

Mello, 2008

Sample of schoolchildren in Portugal

700

13 years

Semi-quantitative FFQ

≥2 servings/week vs. ≤2 servings/week of soft drinks derived from cola, other soft drinks and any soft drinks (1 serving = not reported)

Odds of ≥4 decayed, missing and filled teeth

Positive

Soft drinks from cola

OR = 2.23 [95%CI: 1.50, 3.31]*

Other soft drinks

OR = 1.54 [95%CI: 1.05, 2.26]*

Any soft drinks

OR = 1.88 [95%CI: 1.07, 3.29]*

Nakayama, 2015

Japanese infants

1675

18-23 months

Questionnaire for parents or guardian with questions about SSB consumption

Drinking soda ≥4 times/week vs. <4 times/week, (1 serving = not reported)

Odds of early childhood caries

Positive

OR = 3.70 [95%CI: 1.07, 12.81] *

Pacey, 2010

Inuit preschool-aged children in Nunavut, Canada

388

3-5 years

Past-month qualitative FFQ, 24-hour dietary recall (with repeat 24-hour recalls on 20% of sub-sample)

Mean SSB consumption compared between groups of Reported Caries Experience

Reported Caries Experience (RCE)

Positive

Mean SSB consumption /day among those with RCE

0.8 [SE=0.1]

Mean SSB consumption /day among those without RCE

0.5 [SE=0.1]

*Significant difference between groups.

Skinner, 2015

Random sample of adolescents in Australia

1187

14 to 15 years

Questionnaire including questions about SSB consumption

0 cup of soft drinks or cordial vs. 1-2 cups per day vs. 3+ cups per day

Mean decayed, missing and filled permanent teeth

Positive

0 cups per day

Male: 1.14

Female: 0.81

1-2 cups per day

Male: 1.12

Female: 1.47

3+ cups per day

Male: 1.69

Female: 1.39

*Significant difference

between groups.

Measure of variation not reported

Note: this result is for soft drinks or cordial. See full paper for sweetened fruit juice, diet soft drinks and sports drinks.

Wilder, 2016

School-based sample of third grade students in Georgia, U.S.

2944

8 and 9 years

Supplemental survey including questions about SSB consumption

Increment of a serving/day of SSB, (1 serving = not reported)

Prevalence ratio of caries experience

Positive

PR: 1.22 [95%CI: 1.13, 1.32]*

Lim, 2008

Low-income African American children in Detroit

369

3-5 years, followed-up 2 years later

Block Kids FFQ

Change from low SSB consumption cluster to high SSB consumption cluster vs. low consumers at both time periods

Incident decayed, missing and filled deciduous teeth and incident filled surfaces at follow-up

Positive

New d ₂ mfs:

IRR=1.75 [95%CI: 1.16, 2.64]*

New filled surface:

IRR=2.67 [95%CI: 1.36, 5.23]*

Park, 2015

U.S. children in Infant Feeding Practices Study II and Follow-up Study

1274

10-12 months, followed-up at 6 years of age

10 postpartum surveys through infancy, which asked about intake of SSBs during past 7 days

Any SSBs vs. no SSBs during infancy

SSB introduction at or after 6 months, SSB introduction before 6 months vs. Never consumed SSBs during infancy

SSB consumption < 1 time/week, 1-3 times/week, ≥3 times/week vs. No SSBs

Dental caries in child’s lifetime at follow-up

Mixed

Any vs. No intake during infancy

OR = 1.14 [95%CI: 0.82, 1.57]

SSB intro at or after 6 months vs. no SSB

OR = 1.07 [95%CI: 0.76, 1.52]

SSB intro before 6 months vs. no SSB

OR = 1.29 [95%CI: 0.77, 2.17]

Consumed <1 time/week vs. No SSBs during infancy

OR = 1.15 [95%CI: 0.61, 2.18]

Consumed 1-3 times/week vs. No SSBs during infancy

OR = 0.85 [95%CI: 0.48, 1.49]

Consumed ≥3 times/week vs. No SSBs during infancy

OR = 1.83 [95%CI: 1.14, 2.92]*

Warren, 2009

Children in rural community in Iowa enrolled in WIC program

212

6-24 months, followed-up 9 and 18 months later

Questionnaire asking about SSB consumption at each follow-up

SSB consumption vs. no SSB consumption at baseline

Odds of caries at 18-month follow-up

Positive

OR = 3.0 [95%CI: 1.1, 8.6]*

Warren, 2016

American Indian infants from Northern Plains Tribal community

232

Infants followed-up at 4, 8, 12, 16, 22, 28 and 36 months

Validated beverage frequency questionnaire for parents adapted from Iowa Fluoride study, a 24-h dietary recall tool and food habit questionnaire

Added-sugar beverage intake as proportion of total

Odds of caries experience at follow-up

Positive

OR = 1.02 [95%CI: 1.00, 1.04]*

Watanabe, 2014

Japanese infants recruited from Kobe City Public Health Center

31,202

1.5 years, followed-up 21 months later (at ~3 years old)

Questionnaire for parents asking about SSB consumption and frequency

Daily SSB consumption vs. no SSB consumption, at baseline

Odds of dental caries at 3-years

Positive

OR = 1.56 [95%CI: 1.46, 1.65]*

Wigen, 2015

Children in the Norwegian Mother and Child Cohort Study

1095

1.5 years, followed-up at 5 years old

Questionnaire for parents asking about SSB consumption

SSBs offered at least once a week vs. less than once a week, at 1.5 years

Odds of decayed, missing and filled deciduous teeth

Positive

OR = 1.8 [95%CI: 1.1, 2.9]*

Author, Year

Setting

Sample Size

Sample Age

Intervention

Control

Primary Outcome

Direction of Association

Findings

Maupomé, 2010

American Indian toddlers in U.S.

Four geographically separate tribal groups (3 intervention groups, 1 control group); Group A = 63 enrolled, 53 completed. Group B = 62 enrolled, 56 completed; Group C = 80 enrolled, 69 completed. Group D = NR.

18-30 months,

3-pronged approach: 1) increase breastfeeding, 2) limit SSB consumption, 3) promote consumption of water for thirst

Each intervention group measured at pre and post; also compared to control group to account for secular trends

No intervention received.

Post-pre difference in fraction of affected mouths by incident caries (d1t and d2t)

Positive

d1t

Group A:

-0.574 [SDE: 0.159]*

Group B:

-0.300 [SDE: 0.140]*

Group C:

-0.631 [0.157]*

d2t

Group A:

-0.449 [SDE: 0.180]*

Group B:

-0.430 [SDE: 0.153]*

Group C:

-0.342 [SDE: 0.181]