Cariogenic Diet Assessment and Analysis Tools in Children and Adolescents: A Systematic Review.

PURPOSE: To collect and evaluate the available evidence on existing tools used in research and clinical practice to assess and analyse the diet of children and adolescents for its cariogenicity. MATERIALS AND METHODS: Multiple databases were searched up to October 2022, with no date, publication, or language restrictions, followed by a manual search. Study screening, data extraction, and risk of bias assessment were performed in duplicate. Dietary assessment tools and dental clinical parameters tested were retrieved for qualitative assessment and synthesis. RESULTS: Of the 2896 papers identified, 9 cohort and 23 cross-sectional studies fulfilled the inclusion criteria. To assess dietary data, 13 studies used a 24-h recall, 11 used a food diary, and 7 used a food frequency questionnaire. For analysis, five studies reported using the Healthy Eating Index, ten used a score based on consumption of sugars, and the remaining analysed cariogenic diet based on the weight and frequency of sugars consumed, or the daily caloric intake from free sugars. Risk of bias assessment suggested that 65.7% of the studies were of moderate and 31.5% of high quality. CONCLUSION: Inconsistency exists regarding methods used for the assessment and analysis of dietary cariogenicity. Although every dietary assessment tool has different strengths and limitations, the 24-h recall was the most commonly used method for the assessment of dietary cariogenicity and the most consistent in detecting a positive relationship between sugary diet and carious lesions. A standardised method for cariogenic analysis of dietary data needs to be determined.

Cariogenic diet consumption during lockdown.

BACKGROUND: During stressful situations such as pandemic-associated lockdowns, individuals' diets may change towards (cariogenic) 'comfort food'. This study assessed the dietary patterns during the lockdown in the Colombian population. METHODS: A cross-sectional online survey was designed. A convenience sample of 489 adults was drawn, with 50% of them being in COVID-19 lockdown and the other being not or only partially in lockdown. The questionnaire collected data about the type and frequency of food consumed, with a special focus on cariogenic (i.e., rich in free sugars and starches) food. Descriptive analyses were performed, and a generalised linear model was estimated to predict the frequency of cariogenic diet consumption in this period of time. RESULTS: Sweet whole wheat bread (38.2%, p = 0.005), flavoured milk (26.4%, p = 0.002), sugar-sweetened bubble gums (39.8%, p = 0.001), toffees (35.4%, p = 0.004), soft candies (e.g., gums) (35.4%, p = 0.018), chocolates (55.3%, p = 0.017), filled doughnuts (28.5%, p = 0.013) or grapes (51.2%, p = 0.002) were significantly consumed more during the lockdown. Multivariable generalised linear modelling showed being single, having children and being in lockdown were significantly associated with higher frequency of cariogenic food consumption. CONCLUSIONS: Lockdown was found to be associated with detrimentally altered food consumption patterns and, specifically, a more cariogenic diet. Healthcare professionals should consider this when reopening services, and political decision-makers may want to reflect on the unwarranted side effect of lockdown.

Factors associated with a cariogenic diet among adolescents: a structural equation modeling approach.

OBJECTIVE: To investigate the factors directly and indirectly associated with a cariogenic diet among southern Brazilian adolescents. MATERIALS AND METHODS: This cross-sectional study included 15-19-year-old students attending high schools in Santa Maria, southern Brazil. The participants completed a questionnaire on sociodemographic and behavioral variables. The Oral Health Impact Profile-14 was applied to collect data on oral health-related quality of life (OHRQoL). Clinical examination was used to assess the dental caries status (decayed, missing, and filled teeth index). A cariogenic diet was considered a latent variable measured by the self-perception of a healthy diet and the frequency of consumption of sugary foods and drinks. Structural equation modeling was used to analyze the direct and indirect pathways to a cariogenic diet. RESULTS: A total of 1197 adolescents were included. Low toothbrushing frequency (standardized coefficient (SC), 0.10; p < 0.05), cigarette smoking (SC, 0.15; p < 0.01), and alcoholic beverages (SC, 0.14; p < 0.01) were directly linked to a cariogenic diet, which, in turn, was directly linked to untreated dental caries (SC, 0.18; p < 0.01) and poor OHRQoL (SC, 0.16; p < 0.01). In addition, household income (via toothbrushing frequency) and age (via alcoholic beverages) were indirectly linked to a cariogenic diet. CONCLUSION: A cariogenic diet was consistently associated with a range of unhealthy behaviors during adolescence as well as poor household income. CLINICAL RELEVANCE: Health promotion strategies to restrict sugar consumption and encourage healthier lifestyles should be aware of the synergism observed among unhealthy behaviors during adolescence.

Cambios del pH salival por ingesta cariogénica y no cariogénica en preescolares de Huaura, Perú / Salivary pH changes caused by cariogenic and non-cariogenic food intake in preschoolers from Huaura, Peru

Introducción: El tipo de dieta influye directamente en el valor del pH salival, el cual es un factor importante para evitar la formación de caries. Objetivo: Evaluar el cambio del pH salival por ingesta cariogénica y no cariogénica en preescolares de una institución educativa de Huaura, Perú. Métodos: Esta investigación fue de tipo observacional, comparativo y longitudinal. El tamaño de muestra fue de 30 preescolares. Después que los niños consumieron dieta cariogénica y no cariogénica, se evaluó su pH a diferentes tiempos. Para el contraste de resultados se utilizó la prueba T Student y U de Mann-Whitney. Resultados: El pH salival con dieta no cariogénica a los cinco minutos fue 7,11 ± 0,19 y 7,09 ± 0,20, y, a los 40 minutos, 7,46 ± 0,19 y 7,42 ± 0,22, en mujeres y hombres, respectivamente. El pH salival con dieta cariogénica en mujeres fue 6,56 ± 0,21 a los cinco minutos y 7,15 ± 0,12 a los 60 minutos; mientras que, en los hombres, para iguales rangos de tiempos fue 6,47 ± 0,32 y 7,23 ± 0,22, respectivamente. Al realizar las comparaciones entre grupos de dieta cariogénica y no cariogénica se observaron diferencias muy significativas (p < 0,01). Conclusiones: Para la dieta cariogénica el pH disminuye como máximo a los cinco minutos y se restablece a partir de los 60 minutos. Para la dieta no cariogénica disminuye en el mismo tiempo pero se recupera a los 40 minutos, siendo este proceso similar en ambos géneros(AU)

Introduction: Salivary pH, an important factor in caries prevention, is under the direct influence of diet type. Objective: Evaluate salivary pH changes caused by cariogenic and non-cariogenic food intake in preschoolers from an educational institution in Huaura, Peru. Methods: An observational longitudinal comparative study was conducted of a sample of 30 preschoolers. After the children consumed cariogenic and non-cariogenic food, their salivary pH was evaluated at various times. Student's t-test and the Mann-Whitney U test were used to contrast results. Results: Salivary pH with a non-cariogenic diet at five minutes was 7.11 ± 0.19 and 7.09 ± 0.20; whereas at 40 minutes it was 7.46 ± 0.19 and 7.42 ± 0.22, in female and male participants, respectively. Salivary pH with a cariogenic diet in women was 6.56 ± 0.21 at five minutes and 7.15 ± 0.12 at 60 minutes, whereas values in men for the same time ranges were 6.47 ± 0.32 and 7.23 ± 0.22, respectively. Comparison between the cariogenic and non-cariogenic diet groups revealed very significant differences (p < 0.01). Conclusions: With a cariogenic diet, pH is reduced at five minutes maximum, and is restored as of 60 minutes. With a non-cariogenic diet, pH is reduced in the same time period, but is restored at 40 minutes. This process is similar in the two genders(AU)

Caries en niños. ¿Maltrato infantil o ignorancia parental? / Caries in children. Child abuse or parental ignorance?

El maltrato infantil es un tema polémico en la actualidad, y se caracteriza por realizar acciones u omisiones intencionales destinadas a menoscabar o afectar la integridad física y/o psicológica de un menor. Frecuentemente se considera a la caries en niños como un indicador objetivo de maltrato infantil. La caries es una enfermedad extremadamente común en la población infantil en México y en el mundo, por lo que su relación con el maltrato infantil carece de un sustento real. El desarrollo de caries en niños no es un evento premeditado ni intencional, es más bien la consecuencia de malos hábitos higiénicos y dietéticos que el odontólogo tiene la obligación de corregir y erradicar para asistir a los pacientes pediátricos a recuperar su salud bucodental. El objetivo del presente artículo es debatir la relación entre la caries temprana de la infancia y el maltrato infantil (AU)

Child abuse is currently a controversial issue and is characterized by intentional actions or omissions intended to undermine the physical and/or psychological integrity of a minor. Caries in children is often considered an objective indicator of child abuse. Caries is an extremely common disease in the child population in Mexico and in the world, so its relationship with child abuse lacks any real support. The development of cavities in children is not a premeditated or intentional event, it is rather the consequence of poor hygienic and dietary habits that the dentist has the obligation to correct and eradicate in order to assist pediatric patients to regain their oral health. The aim of this article is to discuss the relationship between early childhood caries and child abuse (AU)

Health professionals' knowledge, views and advice on diet and dental health: a survey of UK and Ireland dietitians and dentists.

BACKGROUND: Oral health is affected by dietary practices and may impact quality of life. Collaboration between dietetics and dental professionals for oral health promotion and disease prevention is recommended. The present study aimed to determine the knowledge and practice of dentists and dietitians on diet and dental health. METHODS: The study comprised a cross-sectional online questionnaire, which was disseminated electronically to dentists and dietitians in the UK and Ireland, via national networks. Questions assessed participants' knowledge of the cariogenicity of different foods, snacking behaviours, familiarity with UK dietary guidelines, dietary advice and their recommendations for cross-professional consistency. RESULTS: In total, 418 responses were received (60% dentists, 40% dietitians). Inter-profession knowledge differences were observed for the cariogenicity of sports drinks (p < 0.001), chocolate/confectionary (p < 0.001), yoghurt (p < 0.001) and sugar-coated breakfast cereals plus milk (p < 0.0001). Dentists showed greater concern over the timings and frequency of food consumption than dietitians. A greater proportion of dentists felt nutrition and oral health counselling is a key component of regular patient care (58.4% versus 8.2%, p < 0.001). Only 18% of dietitians, compared to 56% of dentists, considered that they had received sufficient training about diet and dental health. Both professions indicated the need for multi-disciplinary training. CONCLUSIONS: Dietitians and dentists differ with respect to their knowledge about the effects of snacks and snacking behaviours on dental health, as well as how they prioritise this in their clinical practice. Both professions show a willingness to work collaboratively to ensure accurate and consistent advice-giving and expertise-sharing.

Can Schoolchildren Substitute Mothers' Reports of Cariogenic Foods Consumption?

ABSTRACT Objective: To investigate the influence de two instruments for evaluation of cariogenic foods consumption by schoolchildren. Material and Methods: The convenience sample comprised of 30 active-caries children (7-10 years old) attended in a public dental clinic and their mothers, who have not received dietary orientation before study. A trained evaluator administered the Previous Day Food Questionnaire (PDFQ) to children and other examiner applied the 24-hour dietary recall with mothers. Internal consistency between PDFQ and 24-hour dietary recall regarding frequency of sugar intake was calculated using intraclass correlation coefficient. Bivariate analyses (Mann-Whitney test) were performed to investigate the factors associated with frequency of sugar intake when using both instruments (α=0.05). Results: A moderate correlation (ICC = 0.51; 95%CI: -0.04-0.77; p=0.03) was found between instruments. Mean frequency of sugar intake reported by mothers and children was 3.5 (± 1.8) and 3.7 (± 1.5) times a day, respectively. When using the PDFQ, the frequency of cariogenic foods consumption varied depending on frequency of toothbrushing, i.e., children that had higher frequency of sugar intake brushed their teeth at least two times a day (p=0.016). Conclusion: Previous Day Food Questionnaire applied with schoolchildren could substitute the mothers' reports of cariogenic foods consumption when dietary interventions for controlling dental caries are necessary. If doubts remain regarding the children's response, mothers should be consulted.

Establishment of microcosm biofilm models that reproduce a cariogenic diet intake.

Biofilms were developed from human saliva on bovine enamel discs in four experimental conditions to investigate dental caries development: feast and famine (M1), abundance and scarcity (M2), three meals daily (M3), and three meals plus two snacks daily (M4). The main difference between these models was the diet for microbial growth. The evaluations included verifying the pH of the spent culture media and analyzing the enamel discs for demineralization (microhardness and roughness) and biofilms (biomass, viable populations of mutans streptococci, and total microbiota). Two major behaviors were observed: M1 and M2 promoted an acidic environment, while M3 and M4 maintained pH values closer to neutral. The demineralization process was slower in the neutral groups but more pronounced in M3, while a greater increase in microbiota and biomass was observed over time for both neutral groups. Thus, the M3 model was better at mimicking the oral environment that leads to demineralization.

Saúde bucal de pré-escolares: do processo carioso aos fatores determinantes e moduladores / Preschool oral health: from carious process to determining and modulators

Objetivo: objetivou-se avaliar a experiência de cárie e seus fatores determinantes e moduladores em pré- -escolares de um centro de educação infantil localizado no estado do Ceará. Método: trata-se de um estudo exploratório, descritivo e de abordagem quantitativa realizado com crianças do infantil IV e V do Centro de Educação Infantil Francisca Arruda de Pontes (Redenção, CE) e suas mães. Após consentimento, as mães responderam um questionário contendo perguntas desde os aspectos socioeconômicos e acompanhamento pelo serviço de saúde a conhecimento das doenças bucais. Posteriormente, as crianças foram submetidas à avaliação odontológica para registro do índice CEO-D, o qual corresponde à soma do número de dentes decíduos cariados (c), com extração indicada (e) e restaurados (o). Os dados foram tabulados e descritos como frequência relativa e absoluta. Resultados: das mães, 80,75% tinham renda de até 1 salário mínimo, 61,53% utilizavam creme dental na higiene oral de seu filho e 48,07% desconheciam as doenças bucais. Das crianças, 65,38% não eram atendidas pelo cirurgião-dentista e 50,00% consumiam diariamente bolacha doce. Das crianças avaliadas, 52,50% tinham dentes cariados, 70,00% não apresentavam dentes com extração indicada e nenhuma tinha dentes obturados/restaurados. A média do índice CEO-D foi 1,325. Conclusão: conclui-se que as crianças, apesar de terem baixa prevalência de cárie, apresentam, como fatores de risco determinantes, uma dieta cariogênica e, como fatores de risco moduladores, um reduzido conhecimento sobre doenças bucais, higiene oral inadequada, renda familiar insuficiente, baixa escolaridade e limitada procura por serviço de saúde, especialmente o odontológico.(AU)

Objective: to evaluate the experience of caries and its determining and modulating factors in preschoolers at an early childhood education center located in the state of Ceará. Method: this is an exploratory, descriptive study with a quantitative approach carried out with children from infant IV and V of the Francisca Arruda de Pontes Early Childhood Center (Redenção, CE) and their mothers. After consent, the mothers answered a questionnaire containing questions from the socioeconomic aspects and monitoring by the health service to knowledge of oral diseases. Subsequently, the children underwent dental evaluation to record the dmf Index, which corresponds to the sum of the number of decayed primary teeth (d), missing (m) and filled (f). The data were tabulated and described as relative and absolute frequency. Results: of the mothers, 80.75% had an income of up to 1 minimum wage, 61.53% used toothpaste in their child's oral hygiene and 48.07% were unaware of oral diseases. Of the children, 65.38% were not attended by the dentist and 50.00% consumed sweet cookies daily. Of the children evaluated, 52.50% had decayed teeth, 70.00% did not have teeth with indicated extraction and none had filled/ restored teeth. The average of the dmf Index was 1.325. Conclusion: it is concluded that children, despite having a low prevalence of caries, present, as determining risk factors, a cariogenic diet and, as modulating risk factors, a reduced knowledge about oral diseases, inadequate oral hygiene, family income insufficient, low education and limited demand for health services, especially dental care.(AU)

The influence of television on the food habits of schoolchildren and its association with dental caries.

OBJECTIVES: The consumption of food with a high-sugar content is encouraged by the food industry through television (TV) aimed at children and may be associated with dental caries. This study aims to evaluate the influence of TV on the food habits of schoolchildren aged years and its association with dental caries. MATERIAL AND METHODS: This was an observational, epidemiological, and cross-sectional study. Five neighborhoods of Belem District were selected, and then two schools from each neighborhood were drawn (one private and one public). All sixth and seventh grade students were selected. Data were extracted from questionnaires completed by schoolchildren and their parents and the decayed, missing, and filled teeth (DMFT/dmft) indices of the schoolchildren. The indices were carried out by three examiners previously calibrated (κ > .80). Logistic regression analysis was performed to investigate the association of variables of study with consumption of cariogenic foods and occurrence of dental caries. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Schoolchildren who watched TV for >90 min were more likely to consume cariogenic foods (OR = 2.38; 95% CI [1.57, 3.60]) and have a DMFT + dmft >1 (OR = 2.10; 95% CI [1.37, 3.26]). Those who consumed cariogenic foods while watching TV were more likely to have DMFT + dmft >1 (OR = 14.75; 95% CI [8.24, 6.40]). Parents who bought foods they saw on TV contributed to a higher consumption of cariogenic foods (OR = 3.29; 95% CI [2.07, 5.24]) and DMFT + dmft >1 (OR = 3.93; 95% CI [2.09, 7.37]) among their children. CONCLUSIONS: TV can influence the eating habits of schoolchildren aged 10 to 12 and the food purchases of their parents, stimulating the consumption of cariogenic foods and contributing to the development of dental caries.

Programa de Promoción y Educación para la Salud Bucal, Destinado a Niños y Adolescentes Hospitalizados / Oral Health Education and Promotion Program for Hospitalized Children and Adolescents

La enfermedad sistémica es uno de los riesgos asociados al desarrollo de enfermedades bucales. Este programa fue orientado a promover la salud bucal de niños y adolescentes internados en la clínica de la cátedra de Pediatría del Hospital de Clínicas "José de San Martín". Se realizó un estudio descriptivo transversal sobre una muestra de 1140 individuos registrados entre los años 2008 y 2018. El objetivo fue analizar las variables que afectan su salud bucal. Para ello, cursantes de la Carrera de especialización en Odontopediatría de la UBA implementaron semanalmente un Programa de Promoción y Educación para la salud bucal, destinado a niños internados y sus acompañantes. Para el registro de caries se utilizó el Índice de Necesidad de Tratamiento comunitario (INTc), se analizó la dieta, el riesgo social y la presencia o no de cepillo dental. Se realizó prueba de Chi cuadrado para la comparación de las variables cualitativas, cálculo de medias, rangos, porcentajes y desvíos. Como resultado se observaron diferencias significativas del INTc en los pacientes con dieta cariogénica entre los distintos grupos de edad. El coeficiente asociado a la dieta es aproximadamente 5 veces mayor que el asociado al uso de cepillo. El INTc evidenció una media en preescolares de 2.45 con DS 2.47, en escolares de 4.59 con DS de 3.33 y en adolescentes fue de 4.02 con DS de 3.15. En conclusión, la salud bucal no está separada de la salud general, por lo que se destaca la necesidad de incorporar al odontólogo dentro del grupo interdisciplinario que atiende a niños hospitalizados. La dieta cariogénica fue la covariables con mayor efecto y luego el uso de cepillo dental (AU)

Is there an association between children's screen use and cariogenic diet?

Data sources Databases searched included the International Database for Medical Research MEDLINE/Pubmed, ISI Web of Science, Scopus, Scientific Electronic Library Online (SciELO), and Latin American and Caribbean Health Sciences (LILACS).Study selection Studies of observational design that examined the association between any screen-time behaviour and dietary intake in preschool and school-aged children (younger than 12 years) were selected by two independent reviewers. If a consensus could not be reached, a third reviewer was consulted.Data extraction and synthesis Data were extracted independently by two reviewers using a pre-tested data extraction form. Risk of bias was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies. A PRISMA flow chart was used to present the study selection results. The GRADE system was used to evaluate the strength of evidence. A qualitative synthesis was used to report the results. A meta-analysis was not conducted.Results Nineteen studies were included in the review, all of which were of cross sectional design or conducted cross-sectional analysis. Fourteen studies were assessed as high quality, three as moderate quality and two as low quality. All studies found a significant positive association between television and/or total screen-time viewing and poor quality diet including lower intake of fruit and vegetables and higher intake of unhealthy foods. Screen-based sedentary behaviour was positively associated with cariogenic foods consumption in 15 studies. Based on the GRADE rating, there was moderate evidence of an association between TV viewing and intake of potentially cariogenic diet.Conclusions Although there could be an association between TV viewing and poor quality cariogenic diet in preschool and school-aged children, the authors conclude that the strength of evidence is limited.Commentary.

The FLASHE Study: Racial and Sex Disparities in Adolescent and Parent Modifiable Cancer Risk Behavior.

Objectives: Understanding modifiable risk factors related to cancer among adolescents and their parents may help identify at-risk populations and intervention aims for reducing cancer risk among families. Methods: Participants were 1336 adolescent-parent dyads who participated in the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) conducted by the National Cancer Institute. Using independent samples t-test and one-way ANOVA, we assessed differences in mean behavioral scores by sex and race/ethnicity, respectively. Results: For this nationwide sample, non-Hispanic black adolescents and parents were significantly (p < .05) more likely to participate in multiple dietary and sedentary behaviors than their Hispanic and non-black counterparts. Male adolescents reported significantly higher consumption of sugar-sweetened beverages and processed and red meats than their female peers (p < .02 for all). We also found a strong positive association between adolescents' and their parents' dietary and sedentary behaviors (p < .001 for all). Conclusions: Sex and racial differences in cancer-related health behaviors among adolescents and their parents suggest current guidelines for cancer may benefit from inclusion of younger populations and families. Effective health interventions targeting adolescent-parent dyads may help reduce cancer risk among multiple populations simultaneously.

The effect of iron deficiency anemia on experimental dental caries in mice.

OBJECTIVE: The objective of this study was to examine the relationship between iron deficiency and caries susceptibility in a mouse model. MATERIALS AND METHODS: Three-week-old C57BL/J6 mice were fed a cariogenic diet containing either standard iron (48 ppm Fe) or low iron (4 ppm Fe) levels. Concurrently, groups of mice with both diets were orally inoculated with Streptococcus mutans (1 × 108) cells on three consecutive days. At the end of the 5th week after infection, mice were sacrificed and jaws were collected for caries scoring, rating the number and severity of lesions using a modified Keyes method applicable to mice. RESULTS: Blood analysis by the end of the 5th week revealed marked reduction in the hemoglobin and hematocrit levels of the mice fed the iron deficient diet (IDA and IDA-S. mutans). Anemic mice in both groups lacked the incisor enamel pigmentation observed in mice fed an iron deficient diet. Anemic infected mice had the highest caries severity scores reflecting extensive deep lesions (P < 0.05). S. mutans infected mice fed a standard iron diet had similar numbers of lesions and severity scores as un-infected IDA animals (p < 0.05). IDA did not alter S. mutans CFU counts in infected animals (P < 0.05). CONCLUSION: These results demonstrated that IDA mice are at a higher risk of developing deep dental caries compared to non-anemic mice; highlighting the protective role of iron against dental caries.

Risk Factors of Dental Caries: Consumption of Sugary Snacks Among Indonesian Adolescents

Objective: To determine the risk factors of caries among adolescents in Padang City, by assessing the frequency of sugary snack consumption. Material and Methods: A cross-sectional study was conducted on 150 randomly selected junior high school students using a selfadministered questionnaire along with oral examinations. The questionnaire consisted of questions on socio-demographic characteristics, oral health behavior, and frequency of consumption of sugary foods. Data were analyzed using the Chi-square tests and multivariate analysis. Results: Dental caries was found in 61% of the total students and was more prevalent in males when compared with females. The mean DMFT score was 1.3±1.4. Sugary snack consumption, attitude, and protective factors were significantly related to the occurrence of caries (p<0.001). The risk of dental caries in subjects with high amounts of sugary snack consumption was 5.67 times higher (OR=5.7; CI: 2.7-11.9) than those with low consumption. Subjects with low protective factors, high consumption of sugary foods and drinks, and bad attitude presented with a caries prevalence of 94%. Conclusion: The consumption of sugary foods was found to play an important role in the development of caries in the current study.

Feeding Practices of Potential Risk to Dental Caries in Early Childhood and its Relationship with Sociodemographic Variables and Prematurity

Objective: To verify the relationship of feeding practices of potential risk to dental caries in early childhood with sociodemographic variables, prematurity and Neonatal Intensive Care Unit admission (NICU). Material and Methods: Data from medical records of infants and preschool children, including feeding practices (breastfeeding, bottle feeding, feeding during sleep, introduction and frequency of sugar use), sociodemographic variables, prematurity and NICU admission were collected. Chi-square, Fisher and Maximum Likelihood Ratio tests were used. Results: The number of medical records was 222 in the age group of 01-45 months. Breastfeeding was not present in 66.7% of preterm infants (p=0.003) and 66.1% of infants admitted at NICU (p=0.011). The use of feeding bottle occurred in 58.4% of infants whose mothers work / study; 58.4% of preterm infants and 60.9% of children admitted at NICU (p<0.001). Feeding during sleep occurred in 70.5% of infants aged 1-24 months (p<0.001); 51.4% were single children (p=0.010) and 76.7% did not attend daycare centers (p=0.003). The introduction of sugar occurred in 60.6% in the age group of 01-24 months. The use of sugar more than 3x / day occurred in 52.6% of infants aged 25-45 months (p=0.003) and; 51.8% with mothers whose schooling corresponded to elementary school (p=0.039). Conclusion: Among caries-risk feeding practices, there was relationship between breastfeeding and prematurity and NICU admission; use of feeding bottle and mothers who worked and / or studied, prematurity and NICU admission; feeding during sleep and younger children, single child and those who did not attend daycare centers; and higher frequency of sugar use and older infants, and maternal schooling corresponding to elementary school.

Feasibility and development of a cariogenic diet scale for epidemiological research.

BACKGROUND: Diet cariogenicity plays a major role as both a protective and risk factor in the development of early childhood caries (ECC). AIM: Develop a scale measuring the cariogenicity of foods and beverages and employ it to describe the cariogenicity of young children's diets and predict dental caries outcomes. DESIGN: Scores of cariogenicity and consumption frequency were applied to food frequency questionnaire (FFQ) collected from an Australian children's cohort study with three time-points of data. One-way ANOVA, with post hoc Tukey test compared mean cariogenic scale measured at 18 months between the subsample of children with caries classification at age 5 years. RESULTS: At 6 months, children's mean cariogenic score was 10.05, increasing to 34.18 at 12 and 50.00 at 18 months. Mean cariogenic scale score at 18 months was significantly higher in children with advanced disease at 5 years (mean scale score: 59.0 ± 15.9) compared to those that were healthy (mean score 47.7 ± 17.5, P = 0.007) or had mild-moderate disease (mean score 48.2 ± 17.3, P = 0.008). CONCLUSIONS: The cariogenic diet scale provides a useful indication of the increasing cariogenicity of children's diets with age and highlights the incorporation of discretionary choice foods and beverages into the diets of young children much earlier than nutritionally recommended.

The scientific basis for healthful carbohydrate profile.

Dietary guidelines indicate that complex carbohydrates should provide around half of the calories in a balanced diet, while sugars (i.e., simple carbohydrates) should be limited to no more than 5-10% of total energy intake. To achieve this public health goal a collective effort from different entities including governments, food & beverage industries and consumers is required. Some food companies have committed to continually reduce sugars in their products. Different solutions can be used to replace sugars in food products but it is important to ensure that these solutions are more healthful than the sugars they replace. The objectives of this paper are, (1) to identify carbohydrates and carbohydrates sources to promote and those to limit for dietary intake and food product development, based on current knowledge about the impact of carbohydrates on the development of dental caries, obesity and cardio-metabolic disorders (2) to evaluate the impact of food processing on the quality of carbohydrates and (3) to highlight the challenges of developing healthier products due to the limitations and gaps in food regulations, science & technology and consumer education.

Cariogenicity of a Milk-Based Drink Used as a Dietary Supplement for Older Adults Using a Root Caries Experimental Model.

The aim of this study was to evaluate the cariogenicity of a milk-based drink intended for older adults that was used as part of a governmental initiative in Chile to improve their nutritional conditions. This drink contains a high concentration of sugars, which can contribute to root caries development. To test this hypothesis, an experimental biofilm/caries model was used. Dentin slabs were used to grow biofilms of Streptococcus mutans UA159. Slabs/biofilms were exposed 3× per day to bovine milk with different fat content, the milk-based drink, and the milk-based drink supplemented with 10 g of sucrose added per serving. Slabs exposed to 10% sucrose or 0.9% NaCl were used as positive and negative controls, respectively. Biofilms were analyzed for bacterial counts and acidogenicity. Dentin demineralization was estimated by the loss of surface microhardness and integrated mineral loss. Results were compared by analysis of variance and Tukey's test. The milk-based drink showed higher acidogenicity than milk with its entire (whole) or reduced total fat content (skim). The milk-based drink supplemented with -sucrose had similar acidogenicity as the 10% sucrose positive control (p = 0.506). Whole milk exposure elicited lower bacterial counts than the positive control, the milk-based drink, and the milk-based drink supplemented with sucrose (p = 0.002; 0.006 and 0.014 respectively). Although skim milk induced higher demineralization than whole milk, both milk types produced lower demineralization than the milk-based drink. Regarding integrated mineral loss, demineralization induced by the milk-based drink and the milk-based drink supplemented with sucrose was similar to that induced by the positive control and skim milk (p > 0.05). Sugar-containing milk-based drinks used as dietary supplements for older adults may be highly cariogenic and could represent a potential risk for root caries.

A content analysis of Australian television advertising: focus on child and adolescent oral health.

BACKGROUND: Children's preferences for cariogenic foods and/or drinks has been proven to be associated with exposure to advertisements. This study aimed to assess and compare the proportion of cariogenic food and /or drink advertisements aired on three metropolitan Sydney commercial television channels at different broadcast times during school term and school holidays. METHODS: Three Sydney free-to-air television channels (Channels Seven, Nine, and Ten) were recorded between June 2016 and January 2017. Two weekdays and one weekend day were recorded for a week for each channel during the school term and school holidays, respectively. All channels were recorded from 0630 h until 2300 h. Food and/or drink advertisements were categorised according to the time they were aired and their sugar and acid content. For each channel, school holiday data was compared with school term data. Pearson chi-squared testing was used to determine the difference in advertisements rates across TV channels and broadcast times including school holidays and school term. RESULTS: The proportion of food and/or drink advertisements for all networks was less than 10% of all advertisements. Overall, Channel Ten had the most food and/or drink advertisements (39.74%) and Channel Seven had the lowest (28.60%). Channel Ten aired the largest proportion of food and/or drink advertisements (27.18%) during school term Channel Nine aired the highest number of food and/or drink adverts (15.50%) during school holidays. There were more food and/or drink advertisements during children's viewing hours compared to overlap, adult, and other viewing periods respectively, with Channel Ten airing the highest advertisements (15.72%) and Channel Seven airing the least (11.35%) food and/or drink advertisements. For all analyses, Pearson chi-square tests had a p-value < 0.001. CONCLUSION: Although the overall proportion of food and/or drink advertisements aired on Sydney television is low, the advertisements containing high sugar and /or acid were broadcasted more during children's viewing times than other times and during school term compared to school holidays.