Sugar consumption and dental caries: evidence from 90 countries.

An examination is made of data on dental caries amongst 12-year-old children and sugar consumption of the total population for 90 countries. For the whole data set, DMFT score tends to rise with sugar consumption. The linear relationship between the logarithm of DMFT and sugar is estimated to have a slope of 0.021 per kg/year per head of population (P < 0.0001), and accounts for 28% of the variation in DMFT. In contrast, when data from 29 industrialised nations are analysed separately, there is no evidence of a sugar-caries relationship; the slope of the linear regression line is estimated to be -0.013, not significantly different from zero. This latter result is in agreement with the considerable evidence of a lack of strong relationship between the amount of sugar consumed and caries occurrence in Western countries. These results suggest that, in addition to sugar, other factors, such as other aspects of diet, exposure to fluoride and genetic effects, must be taken into account when seeking to explain variations in caries prevalence, and when making recommendations for caries control.