Sugars and dental caries

Touger-Decker, Riva; van Loveren, Cor

doi:10.1093/ajcn/78.4.881s

Cited by 682Dental Health and Care UtilizationOral microbiology and periodontitis researchDiet, Metabolism, and Disease

Sugars and dental caries

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Touger-Decker, Riva, van Loveren, Cor·2003·The American Journal of Clinical Nutrition

DOI 10.1093/ajcn/78.4.881s

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Abstract

A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.

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Increased sugar from SSBs intensifies acid production by oral bacteria and causes further tooth decay.
“Increased sugar from SSBs intensifies the acid production and causes further decay of teeth [108].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [108]
Dental caries are caused by acids produced by bacteria metabolizing sugar in the mouth.
“The mechanism for the association between SSB consumption and dental caries is well understood: dental caries are caused by acids produced by bacteria metabolizing sugar in the mouth.”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [108]

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Effect of xylitol‐containing chewing gum on sorbitol metabolism in dental plaque
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Effects of a carbohydrate‐free diet and sugar substitutes on dental plaque accumulation
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EFFECTIVENESS OF CHEWING GUM AND TOOTHPASTE OF XYLITOL ON THE PLAQUE INDEX IN ADOLESCENT GROUP.
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Authors: Touger-Decker, R., & van Loveren, C.
Affiliations: Academic Center for Dentistry Amsterdam (NL)
Corresponding author: Touger-Decker, Riva
ORCID: Touger-Decker, Riva
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2003-10
Volume: 78
Issue: 4
Pages: 881S-892S
ISSN: 0002-9165 (ISSN-L)
DOI: 10.1093/ajcn/78.4.881s
OpenAlex: W2147937174
Cited by: 682
References: 94
Citations by year: 2026: 27 · 2025: 37 · 2024: 38 · 2023: 43 · 2022: 53 · 2021: 53 · 2020: 64 · 2019: 42 · 2018: 45 · 2017: 28 · 2016: 37 · 2015: 40 · 2014: 37 · 2013: 26 · 2012: 23
FWCI: 2.34
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 7080 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords: dietary sugar, dental caries, oral health, salivary pH, dental plaque, tooth demineralization, salivary amylase, fermentable carbohydrates, fluoride, xylitol, oral hygiene, dental caries prevention, dietary guidelines
MeSH terms: Adolescent, Adult, Child, Child, Preschool, Dental Caries, Dietary Carbohydrates, Dose-Response Relationship, Drug, Europe, Female, Humans, Male, Oral Health, Periodontal Diseases, United States, Prevalence

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