title: Sugar-sweetened beverages and dental caries in adults: a 4-year prospective study.
abstract: OBJECTIVE
  To explore the association between frequency of consumption of sugar-sweetened beverages (SSB) and caries increment over 4 years in adults. A second objective was to explore whether the association between frequency of SSB consumption and caries increment varied by socio-demographic characteristics and use of fluoride toothpaste.
  
  
  METHODS
  Data from 939 dentate adults who participated in both the Health 2000 Survey and the Follow-Up Study of Finnish Adults' Oral Health were analysed. At baseline, participants provided information on demographic characteristics, education and dental behaviours, including two questions on frequency of SSB consumption. The 4-year net DMFT increment was calculated using data from baseline and follow-up clinical oral examinations. The association was tested in negative binomial regression models and the moderating role of sex, age, education and use of fluoride toothpaste was examined by adding their two-way interaction with SSB consumption to the main effects model.
  
  
  RESULTS
  A positive association was found between frequency of SBS consumption and 4-year net DMFT increment, regardless of participants' socio-demographic and behavioural characteristics. Adults drinking 1-2 and 3+ SSB daily had, respectively, 31% (Incidence Rate Ratio: 1.31; 95%CI: 1.02-1.67) and 33% (IRR: 1.33; 95%CI; 1.03-1.72) greater net DMFT increments than those not drinking any SSB. None of the four two-way interaction terms was significant (all p>0.05).
  
  
  CONCLUSIONS
  There seems to be a dose-response relationship between frequency of SSB consumption and caries increment in adults. That association was consistent across socio-demographic characteristics, and more importantly, use of fluoride toothpaste.
  
  
  CONCLUSIONS
  Drinking sugar-sweetened beverages on a daily basis is related to greater caries risk in adults.
authors.affiliation: King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, Division of Population and Patient Health, London, United Kingdom. Electronic address: eduardo.bernabe@kcl.ac.uk.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bernabé
authors.affiliation: Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland; Department of Community Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland; Department of Oral and Maxillofacial Diseases, Oulu University Hospital, Oulu, Finland.
authors.forename: Miira M
authors.initials: MM
authors.lastname: Vehkalahti
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Aubrey
authors.initials: A
authors.lastname: Sheiham
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Arpo
authors.initials: A
authors.lastname: Aromaa
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland; Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Suominen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001628:Beverages; D002327:Cariostatic Agents / Q000627:therapeutic use; D004245:DMF Index; D003729:Dental Care / Q000706:statistics & numerical data; D003731:Dental Caries / Q000209:etiology*; D019422:Dietary Sucrose / Q000008:administration & dosage*; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D011446:Prospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014100:Toothpastes / Q000627:therapeutic use
chemical_list: D002327:Cariostatic Agents; D019422:Dietary Sucrose; D014100:Toothpastes; D005459:Fluorides
keywords: Adults; Cohort studies; Dental caries; Dietary carbohydrates