Sugar Sweetened Beverages (SSB) And Early Childhood Caries (ECC) Risk

Objectives: Examine the relationship between SSB consumption and risk of ECC.  

Methods: We conducted a nested case-control analysis to identify ECC risk factors in 2 to 6-year-old children, comparing 359 with severe ECC to 421 who were caries-free (CF).  Subjects were recruited from pediatric dental clinics at children’s hospitals in Washington D.C. and Columbus and Cincinnati, OH. Information regarding the children’s diet in the preceding 6 months was collected from the parents using the Block Kids 2-7 Food Frequency Questionnaire (FFQ) 2004. Associations between the dietary and socio-demographic factors, SSB consumption, and ECC are analyzed by χ² test, Wilcoxon rank sum test, and logistic regression analysis using SAS^®.

Results: For each additional serving per week of SSB, the odds of having ECC increased by 8.1% [OR 1.081; 95% CI: 1.055, 1.108], after adjustment for age in months, gender, body weight, and mother’s education level. ECC was associated with intakes of SSB, sweets, sugared cereal, processed meat, potatoes, eggs, and white bread and negatively associated with cereal without sugar, dark bread, rice, dark green and orange vegetables, citrus fruits, water, and micronutrients such as magnesium and vitamin K. Socio-demographic factors such as older age, lower level of parents’ education, male gender, and lower percentage of family Federal Poverty Level (FPL), were associated with higher likelihood of ECC. ECC children drank more SSB while CF children drank more water and real fruit juice. Higher SSB consumption was associated with lower FPL and lower level of parents’ education but was not significantly associated with BMI.

Conclusions: SSB consumption was significantly associated with increased likelihood of ECC, controlling for age in months, gender, body weight, and mother’s education level. ECC experience in this pediatric population was closely related to certain dietary and socio-demographic factors.