The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: a longitudinal study.
OBJECTIVE
To investigate the effects of dietary guidelines on sugar and sugar intake at day nurseries, and other potential risk factors on dental caries in two groups of low socio-economic nursery schoolchildren.


METHODS
Nursery based, longitudinal study.


METHODS
Metropolitan area of Recife, north-eastern Brazil.


METHODS
The study population comprised 510, 3-year-old low socio-economic nursery schoolchildren. Sugar intake at the nursery was based upon a weighed inventory method during 2 non-consecutive days. Parents answered a questionnaire.


RESULTS
Children attending nurseries not adopting guidelines on reduction of sugar intake had a higher caries risk, with an odds ratio of 3.6 compared to those attending nurseries with guidelines. A higher caries increment was related to higher daily frequency and weight of sugar intake at nursery, overall daily frequency of sugar intake (sugar intake at home plus nursery), past caries experience, use of fluoride, and habits related to toothbrushing. Children having more than 32.6 g of sugar daily at nursery were 2.99 times more likely to have high caries increment than those having less than that amount.


CONCLUSIONS
Sugar intake at nursery and the adoption of guidelines on sugar were associated with lower caries increment in low income nursery schoolchildren. A number of modifiable factors such as a higher daily frequency and weight of sugar intake at nursery, use of fluoride and habits related to toothbrushing were strongly related to caries increment.
Rodrigues
C S
CS
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
Sheiham
A
A
D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D004037:Diet, Cariogenic; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D018673:Nutrition Policy; D016017:Odds Ratio; D011203:Poverty; D015995:Prevalence; D012578:Schools, Nursery
D019422:Dietary Sucrose; D005460:Fluorides, Topical