Sugar Consumption and Changes in Dental Caries from Childhood to Adolescence
Sugar Consumption and Changes in Dental Caries from Childhood to Adolescence
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DOI：
10.1177/0022034515625907
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发表时间：
2016-04-01
影响因子：
7.6
通讯作者：
Peres, K. G.
中科院分区：
文献类型：
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作者：
Peres, M. A.;Sheiham, A.;Peres, K. G.
目前还没有前瞻性研究调查与糖相关的喂养方式对儿童早期到成年早期龋齿变化的影响。本研究的目的是评估与糖相关的喂养方式是否会影响 6 岁至 18 岁之间的龋齿。这项出生队列研究于 1993 年在巴西佩洛塔斯启动。进行了 3 项牙科临床评估；年龄为 6 岁 (n = 359)、12 岁 (n = 339) 和 18 岁 (n = 307)。在 4、15 和 18 岁时评估了与糖相关的喂养方式。协变量包括性别和生命历程变量，例如家庭收入、母乳喂养、母亲的教育程度、定期看牙医和孩子的刷牙习惯。进行基于组的轨迹分析来表征具有至少 3 个时间点的时变自变量的轨迹。我们拟合了一个广义线性混合模型，假设负二项式分布，并在 3 次重复的龋齿评估中使用对数链接函数。五分之一的参与者被归类为高糖消费者，近 40% 为高糖消费者。低水平消费者占样本的比例>40%。与低糖消费者相比，高糖和高糖消费者在所有队列中的龋齿患病率和平均 DMFT 均较高。在研究期间，龋齿的发生率相对恒定，但在所有糖摄入组中，6 至 12 岁之间的龋齿增量略高于 12 至 18 岁之间。调整后的分析显示，与低糖消费群体相比，高糖消费群体和高糖消费群体在6岁至18岁之间的龋齿增长比例分别高出20%和66%。生命过程中糖的消耗量越高，龋齿的增量就越高。尽管使用了氟化物，但即使是低水平的糖消耗也与龋齿有关。
There are no prospective studies investigating the effects of sugar-related feeding practices on changes in dental caries from early childhood to young adulthood. The aim of this study was to assess whether sugar-related feeding practices affect dental caries between the ages of 6 and 18 y. This birth cohort study was initiated in 1993 in Pelotas, Brazil. There were 3 dental clinical assessments; at ages 6 y (n = 359), 12 y (n = 339), and 18 y (n = 307). Sugar-related feeding practices were assessed at ages 4, 15, and 18 y. Covariates included sex and life course variables, such as family income, breast-feeding, mother's education, regularity of dental visit, and child's toothbrushing habits. Group-based trajectory analysis was performed to characterize trajectories of time-varying independent variables that had at least 3 time points. We fitted a generalized linear mixed model assuming negative binomial distribution with log link function on 3-time repeated dental caries assessments. One in 5 participants was classified as high sugar consumers, and nearly 40% were upward consumers. Low consumers accounted for >40% of the sample. High and upward sugar consumers had higher dental caries prevalence and mean DMFT in all cohort waves when compared with low sugar consumers. Caries occurred at a relatively constant rate over the period of study, but in all sugar consumption groups, the increment of dental caries was slightly higher between ages 6 and 12 y than between 12 and 18 y. Adjusted analysis showed that dental caries increment ratio between ages 6 and 18 y was 20% and 66% higher in upward and high sugar consumer groups as compared with low consumers. The higher the sugar consumption along the life course, the higher the dental caries increment. Even the low level of sugar consumption was related to dental caries, despite the use of fluoride.