Department of Health Sciences, University of York, York, UK.
School of Dentistry, University of Leeds, Leeds, UK.
Eur J Public Health. 2021 Feb 1;31(1):122-129. doi: 10.1093/eurpub/ckaa147.
The impact of consumption of sugar-sweetened beverages (SSB) on health outcomes such as obesity have been studied extensively, but oral health has been relatively neglected. This study aims to assess the association between SSB consumption and dental caries and erosion.
Systematic review of observational studies. Search strategy applied to Medline, Embase, Cochrane Library, SciELO, LILACS, OpenGrey and HMIC. The risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cross-Sectional Studies and evidence certainty using Grading of Recommendation Assessment Development and Evaluation. Relationships between SSB consumption and caries and erosion were estimated using random-effects model meta- and dose-response analyses.
A total of 38 cross-sectional studies were included, of which 26 were rated as high quality. Comparing moderate-to-low consumption, there was significantly increased risk of both caries [OR = 1.57, 95% CI: 1.28-1.92; decayed, missing and filled teeth weighted mean differences (DMFT WMD) = 0.82, 95% CI: 0.38-1.26] and erosion (OR = 1.43, 95% CI: 1.01-2.03). Comparing high-to-moderate consumption, there was further increased risk of caries (OR = 1.53, 95% CI: 1.17-1.99; DMFT WMD = 1.16, 95% CI: -0.59-2.91) and erosion (OR = 3.09, 95% CI: 1.37-6.97). A dose-response gradient and high certainty of evidence was observed for caries.
Increasing SSB consumption is associated with increased risk of dental caries and erosion. Studies were cross-sectional, hence temporality could not be established, but the positive dose-response suggests this relationship is likely to be causal. These findings illustrate the potential benefits to oral health of policies that reduce SSB consumption, including sugar taxation.
糖饮料（SSB）的消费对肥胖等健康结果的影响已被广泛研究，但口腔健康相对被忽视。本研究旨在评估 SSB 消费与龋齿和腐蚀之间的关联。
对观察性研究进行系统评价。搜索策略应用于 Medline、Embase、Cochrane 图书馆、SciELO、LILACS、OpenGrey 和 HMIC。使用 NIH 观察性横断面研究质量评估工具评估偏倚风险，并使用推荐评估、制定与评价分级（Grading of Recommendation Assessment Development and Evaluation）评估证据确定性。使用随机效应模型荟萃分析和剂量-反应分析来估计 SSB 消费与龋齿和腐蚀之间的关系。
共纳入 38 项横断面研究，其中 26 项被评为高质量。与中低摄入量相比，龋齿的风险显著增加[比值比（OR）=1.57，95%置信区间（CI）：1.28-1.92；失牙、补牙和患牙加权平均值差异（DMFT WMD）=0.82，95%CI：0.38-1.26]和腐蚀（OR=1.43，95%CI：1.01-2.03）。与高-中摄入量相比，龋齿的风险进一步增加（OR=1.53，95%CI：1.17-1.99；DMFT WMD=1.16，95%CI：-0.59-2.91）和腐蚀（OR=3.09，95%CI：1.37-6.97）。观察到龋齿存在剂量-反应梯度和高确定性证据。
SSB 消费的增加与龋齿和腐蚀的风险增加有关。这些研究是横断面研究，因此不能确定时间关系，但阳性剂量-反应表明这种关系可能是因果关系。这些发现说明了减少 SSB 消费的政策对口腔健康的潜在益处，包括征收糖税。
