Kelsey H Jordan1,2, Gerald McGwin1, Noel K Childers3. 1. Department of Epidemiology, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA. 2. Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. 3. Department of Pediatric Dentistry, School of Dentistry, The University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
OBJECTIVES: Sugar-sweetened beverages and dental caries are prevalent among children. Measurement choices could explain their inconsistent relationships. This study evaluated associations between detailed baseline non-water beverage consumption (NWBC) behaviors and longitudinal early childhood caries (ECC) experiences in young, high-caries risk children. METHODS: Researchers followed poor, rural, African Americans, recruited at 8-18 months old from Uniontown, Alabama, through convenience sampling, annually for 5 years (N = 66). Baseline questionnaires obtained demographics, oral hygiene, and daily dietary histories, including beverage types, frequencies, and NWBC behaviors of intake speed (intermittent/rapid), container (bottles/non-bottles), and bedtime beverages (yes/no). Dentists conducted examinations annually to determine decayed, missing, filled (carious) surfaces (dmfs) scores, producing increments (dmfsfinal - dmfsinitial ). Age-adjusted logistic regressions estimated odds ratios (OR) and 95% confidence intervals (95% CI) for ECC (carious: incidence >0 versus caries-free: incidence = 0) with NWBC behavior then NWBC frequency, individually and conditional on NWBC behaviors, exposures. RESULTS: NWBC behaviors were not associated with ECC; juice was significant (OR: 2.0, 95% CI: 1.0, 4.2). Adjusting for intake speed, juice persisted as a risk factor (OR: 2.1, 95% CI: 1.0, 4.3), remaining suggestive after controlling for container or bedtime beverages (OR: 2.0, 95% CI: 0.9, 4.3; OR: 1.9, 95% CI: 0.9, 4.0, respectively). Container could be an effect modifier (ORbottle : 3.5, 95% CI: 0.8, 16.2 vs. ORnon-bottle : 1.5, 95% CI: 0.6, 3.7). Milk was not associated with ECC. CONCLUSIONS: Independently, NWBC behaviors are insufficient in evaluating NWBC/ECC relationships; beverage type, frequency, and consumption behaviors, collectively, can better evaluate associations.
OBJECTIVES: Sugar-sweetened beverages and dental caries are prevalent among children. Measurement choices could explain their inconsistent relationships. This study evaluated associations between detailed baseline non-water beverage consumption (NWBC) behaviors and longitudinal early childhood caries (ECC) experiences in young, high-caries risk children. METHODS: Researchers followed poor, rural, African Americans, recruited at 8-18 months old from Uniontown, Alabama, through convenience sampling, annually for 5 years (N = 66). Baseline questionnaires obtained demographics, oral hygiene, and daily dietary histories, including beverage types, frequencies, and NWBC behaviors of intake speed (intermittent/rapid), container (bottles/non-bottles), and bedtime beverages (yes/no). Dentists conducted examinations annually to determine decayed, missing, filled (carious) surfaces (dmfs) scores, producing increments (dmfsfinal - dmfsinitial ). Age-adjusted logistic regressions estimated odds ratios (OR) and 95% confidence intervals (95% CI) for ECC (carious: incidence >0 versus caries-free: incidence = 0) with NWBC behavior then NWBC frequency, individually and conditional on NWBC behaviors, exposures. RESULTS: NWBC behaviors were not associated with ECC; juice was significant (OR: 2.0, 95% CI: 1.0, 4.2). Adjusting for intake speed, juice persisted as a risk factor (OR: 2.1, 95% CI: 1.0, 4.3), remaining suggestive after controlling for container or bedtime beverages (OR: 2.0, 95% CI: 0.9, 4.3; OR: 1.9, 95% CI: 0.9, 4.0, respectively). Container could be an effect modifier (ORbottle : 3.5, 95% CI: 0.8, 16.2 vs. ORnon-bottle : 1.5, 95% CI: 0.6, 3.7). Milk was not associated with ECC. CONCLUSIONS: Independently, NWBC behaviors are insufficient in evaluating NWBC/ECC relationships; beverage type, frequency, and consumption behaviors, collectively, can better evaluate associations.