SynthesisPublic health nutrition2014
A new understanding of the relationship between sugars, dental caries and fluoride use: implications for limits on sugars consumption.
Synthesis in Public health nutrition, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it, 170 citations in OpenAlex.
- Caries prevention in permanent teeth - basic recommendations of the German S 3 guideline.Clinical oral investigations · 2026Guideline
- Educational interventions in health services and oral health: systematic review.Revista de saude publica · 2018Pooled it
- Impact of school policies on non-communicable disease risk factors - a systematic review.BMC public health · 2017Pooled it
- Dietary intake and meal patterns among young adults with high caries activity: a cross-sectional study.BMC oral health · 2022Trial
- Fermentable carbohydrates intake and dental caries in adolescents under household food insecurity: a counterfactual analysis.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026Article
- Article
- Dietary and Oral Hygiene Behaviors Associated with Prevalent Caries Status in School-Aged Children of Northern Italy.Nutrients · 2026Article
- Ultra-processed food consumption across early life: implications for pediatric health and disease risk.Frontiers in nutrition · 2026Review
- Management of early childhood caries through parental diet counselling: A pilot study in Bhopal, Madhya Pradesh, India.Bioinformation · 2026Article
- Developmental ecology of the infant oral ecosystem: a framework for early childhood caries.Frontiers in oral health · 2026Review
- Barriers and facilitators of diet counselling in prevention of early childhood caries: A qualitative study of primary caregivers.Journal of family medicine and primary care · 2025Article
- The association between cariogenic diet and dental caries in the Azar cohort population: a cross-sectional study.BMC public health · 2025Article
- Oral health evolution in Brazilian adolescents: comparative analysis of SB Brasil Surveys 2003, 2010 and 2023.Brazilian oral research · 2025Article
- Dental Caries, Periodontal Status, and Lifestyle Connections: Examining the Moderating Effects of Sleep, Smoking, Diet, and Mealtime Routines.Nutrients · 2025Article
- A Narrative Review on Advancing Pediatric Oral Health: Comprehensive Strategies for the Prevention and Management of Dental Challenges in Children.Children (Basel, Switzerland) · 2025Review
- Structural determinants of inequalities in untreated dental caries in the Global Burden of Disease Study.PloS one · 2025Article
- Initial development of the Sugar-Sweetened Fruit Drink Questionnaire for examining beliefs, knowledge, and behaviors in an intervention to reduce sugar-sweetened fruit drink intake in Alaska Native children.Journal of public health dentistry · 2024Article
- Healthy Drinks, Healthy Teeth - Ciunerkaq Tanqigtuq (The Future is Bright): A study protocol for a community-based, non-randomized sociobehavioral trial to reduce added sugar intake in Alaska Native Yup'ik children in the Yukon-Kuskokwim Delta.Contemporary clinical trials · 2024Article
- Article
- Theories, determinants, and intervention models and approaches on inequalities of undernutrition amongst under fives: A literature review.Health science reports · 2024Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the quantitative relationship between sugar intake and the progressive development of dental caries.
designA critical in-depth review of international studies was conducted. Methods included reassessing relevant studies from the most recent systematic review on the relationship between levels of sugars and dental caries. Reanalysis of dose-response relationships between dietary sugars and caries incidence in teeth with different levels of caries susceptibility in children was done using data from Japanese studies conducted by Takeuchi and co-workers.
settingGlobal, with emphasis on marked differences in both national sugar intake and fluoride use and preferably where one factor such as sugar intake changed progressively without changes in other factors over a decade or more. SUBJECTS: Children aged 6 years or more and adults.
resultsCaries occurred in both resistant and susceptible teeth of children when sugar intakes were only 2-3 % of energy intake, provided that the teeth had been exposed to sugars for >3 years. Despite increased enamel resistance after tooth eruption, there was a progressive linear increase in caries throughout life, explaining the higher rates of caries in adults than in children. Fluoride affects progression of caries development but there still is a pandemic prevalence of caries in populations worldwide.
conclusionsPrevious analyses based on children have misled public health analyses on sugars. The recommendation that sugar intakes should be ≤10 % of energy intake is no longer acceptable. The much greater adult burden of dental caries highlights the need for very low sugar intakes throughout life, e.g. 2-3 % of energy intake, whether or not fluoride intake is optimum.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.