SWEET – SUGAR RESEARCH

According to a recent study by British researchers, in order to reduce the significant financial and social burdens of dental decay, free sugars in the diet should make up no more than 3% of total energy intake.

Dental decay (caries) is the most common chronic disease worldwide, affecting 60% to 90% of schoolchildren and the majority of adults. In the U.S., 92% of adults ages 20 to 64 have had caries in at least one of their permanent teeth. The treatment of dental diseases costs 5% to 10% of total health expenditure in industrialized countries.

The study findings indicate that current approaches to controlling dental caries are failing to prevent high levels of caries in adults in all countries, according to the researchers. This is related to the current high amount of sugar intake worldwide, and a new and radical policy of progressive sugar reduction is needed. “It is now even more important to develop a radical prevention policy with a marked reduction in sugar intake since the use of fluoride on its own is insufficient to reduce substantially the burden of caries over the lifetime of individuals,” they wrote.

According to World Health Organization (WHO) nutrition guidelines, “free sugars” include “monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer, and sugars naturally present in honey, syrups, fruit juices, and fruit concentrates.” Sugar consumption should make up only 10% of total energy intake, ideally only 5%, based on WHO guidelines, even with the use of fluoridated water and fluoride toothpaste. That equals about 3 tablespoons (50 grams) of free sugars as the daily maximum, with 2 tablespoons (25 grams) as the target. Research published earlier this year suggests that 5% should be the maximum, with a target of less than 3%.

The researchers recommended radical policy changes to reduce sugar consumption and address the issue of caries. “Our top priority is not to allow the idea of a magic single bullet to solve the problem to be developed,” stated study co-author Philip James, MD, an honorary professor of nutrition at the London School of Hygiene & Tropical Medicine, in the release. “A fundamental aspect of public health planning is to develop society-wide measures which impact the health of the whole community.”

He believes vending machines that sell sugary drinks in areas that are controlled or supported financially by local or central governments should be removed. Publicly supported facilities should not contribute to the expensive problems of dental caries, obesity, and diabetes, Dr. James noted. The food industry should progressively reformulate their products to reduce or remove all sugar from their products, and food labels should label anything containing more than 2.5% sugars as “high,” he recommended.

Dentists, including myself, see far more decay than we should. As I have stated in past columns, dental decay has numerous etiologies but is a very preventable disease.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.