J Am Dent Assoc. 2017 Jul;148(7):500-509.e4. doi: 10.1016/j.adaj.2017.03.012. Epub 2017 May 5.
Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM.
The authors used a cross-sectional design with data reported by adults (18 years and older) who responded to the 2012 Behavior Risk Factor Surveillance System questionnaire, which was used in 18 states (N = 95,897; 14,043 who had DM and 81,854 who did not have DM). The authors conducted χ and logistic regression analyses to determine associations related to DM status.
Overall, 12.3% of the survey respondents had DM, 15.5% had 6 or more teeth extracted, and 22.6% reported that they consumed 1 or more SSB daily. In the adjusted analyses, among adults who had DM, those who consumed at least 2 SSBs daily were more likely to have had 6 or more teeth extracted than those who reported that they did not consume SSBs (adjusted odds ratio, 2.35; 95% confidence interval, 1.37 to 4.01; P = .0018). Among adults who did not have DM, those who consumed more than 1 but fewer than 2 SSBs per day were more likely to have had at least 6 teeth extracted (adjusted odds ratio, 1.46; 95% confidence interval, 1.21 to 1.77; P < .0001).
The authors found that, among adults with DM, consuming 2 or more SSBs per day was associated with having had 6 or more teeth extracted.
Dietary sugar is a concern for oral and systemic health; however, a strong, independent relationship between the number of teeth extracted and a single source of dietary sugar is not adequate to explain the complexity of tooth loss. Clinicians should use broadly worded dietary messages when discussing caries assessment with patients.
含糖饮料（SSB）是糖的饮食来源，是龋齿发展和牙齿缺失的因素。饮食中的糖也与糖尿病（DM）有关。关于 SSB 和 DM 患者牙齿缺失的研究有限。作者研究了 SSB 与牙齿缺失的关系，以及 DM 的存在与否。
作者采用横断面设计，对 2012 年行为风险因素监测系统问卷的成年人（18 岁及以上）进行了数据分析，该问卷在 18 个州使用（N=95897；14043 人患有 DM，81854 人未患有 DM）。作者进行了 χ 和逻辑回归分析，以确定与 DM 状态相关的关联。
总体而言，调查对象中有 12.3%患有 DM，15.5%有 6 颗或更多牙齿缺失，22.6%报告每天饮用 1 种或更多 SSB。在调整分析中，患有 DM 的成年人中，每天至少饮用 2 份 SSB 的人比不饮用 SSB 的人更有可能有 6 颗或更多牙齿缺失（调整后的优势比，2.35；95%置信区间，1.37 至 4.01；P=0.0018）。在没有 DM 的成年人中，每天饮用超过 1 份但少于 2 份 SSB 的人更有可能至少有 6 颗牙齿缺失（调整后的优势比，1.46；95%置信区间，1.21 至 1.77；P<0.0001）。
作者发现，患有 DM 的成年人每天饮用 2 份或更多 SSB 与有 6 颗或更多牙齿缺失有关。
饮食中的糖对口腔和全身健康都有影响；然而，牙齿缺失的数量与单一饮食糖源之间的强而独立的关系不足以解释牙齿缺失的复杂性。临床医生在与患者讨论龋齿评估时，应使用广泛的饮食信息。
