Cholera Mimansa, Cape Rowena, Tanbonliong Thomas, Stookey Jodi D
Pediatric Dentistry, Department of Orofacial Sciences, University of California, San Francisco, San Francisco, CA, United States.
Maternal, Child & Adolescent Health, Epidemiology Unit, San Francisco Department of Public Health, San Francisco, CA, United States.
Front Nutr. 2025 Jun 10;12:1561771. doi: 10.3389/fnut.2025.1561771. eCollection 2025.
To inform drinking water guidance and intervention, this randomized controlled trial tested the hypothesis that a standard serving of drinking water would normalize saliva insulin and improve caries risk factors to a greater extent, within 60 min, than no beverage or a standard serving of apple juice.
After baseline saliva collection, 105 healthy children (5-10y), attending routine dental check-ups, were randomly assigned to receive 500 mL water, 200 mL apple juice, or no drink. Simple unblinded randomization was stratified by age-and-sex-specific BMI percentile (5-85th or >85th). Follow-up saliva was collected at 45-60 min and classified with respect to insulin<170 pg/mL, pH > 7.0, buffering>5.0, osmolality<70 mmol/kg, amylase<60 μ/mL, IgG > 10 μg/mL, IgA < 112 μg/mL, and the sum of protective factors. In intention-to-treat analyses, quantile regression models tested for drinking water effects on median oral health factors and logistic regression models tested for greater relative odds of normalized saliva insulin and protective factors after drinking water.
Drinking water instead of apple juice resulted in a significantly lower median saliva insulin (172 vs. 364 pg/mL), 10 times greater relative odds of saliva insulin below 170 pg/mL (OR = 10.84, 95%CI: 3.86-30.49, < 0.001), and 5 times greater relative odds of 4 to 7 co-occurring saliva factors that protect against tooth decay (OR = 4.98, 95%CI: 1.42-17.48, < 0.012). Drinking water instead of apple juice significantly increased the relative odds of pH > 7.0, buffering capacity>5.0, alpha-amylase<60 u/mL, and IgG > 10 μg/mL. Drinking water instead of no drink resulted in significantly lower median saliva insulin (172 vs. 266 pg/mL), significantly greater odds of saliva osmolality <70 mmol/kg, IgA < 112 μg/mL, and 4 to 7 co-occurring protective factors (OR = 4.63, 95%CI: 2.90-7.34, < 0.001).
Drinking water instead of apple juice or no drink significantly improved 4 to 7 caries risk factors, simultaneously, within 60 min. The results warrant drinking water intervention to promote oral health.
为指导饮用水相关建议及干预措施，本随机对照试验检验了以下假设：与不饮用饮料或饮用一份标准量苹果汁相比，饮用一份标准量的饮用水能在60分钟内使唾液胰岛素水平恢复正常，并在更大程度上改善龋齿风险因素。
在收集基线唾液后，105名参加常规牙科检查的健康儿童（5 - 10岁）被随机分配接受500毫升水、200毫升苹果汁或不饮用任何饮料。简单非盲随机分组按年龄和性别特异性BMI百分位数（5 - 85或>85）进行分层。在45 - 60分钟时收集随访唾液，并根据胰岛素<170 pg/mL、pH>7.0、缓冲能力>5.0、渗透压<70 mmol/kg、淀粉酶<60 μ/mL、IgG>10 μg/mL、IgA<112 μg/mL以及保护因素总和进行分类。在意向性分析中，分位数回归模型检验饮用水对口腔健康因素中位数的影响，逻辑回归模型检验饮水后唾液胰岛素正常化和保护因素相对优势更大的情况。
饮用饮用水而非苹果汁导致唾液胰岛素中位数显著降低（172 vs. 364 pg/mL），唾液胰岛素低于170 pg/mL的相对优势高10倍（OR = 10.84，95%CI：3.86 - 30.49，P<0.001），同时存在4至7种预防龋齿的唾液因素共同出现的相对优势高5倍（OR = 4.98，95%CI：1.42 - 17.48，P<0.012）。饮用饮用水而非苹果汁显著增加了pH>7.0、缓冲能力>5.0、α - 淀粉酶<60 u/mL以及IgG>10 μg/mL的相对优势。饮用饮用水而非不饮用饮料导致唾液胰岛素中位数显著降低（172 vs. 266 pg/mL），唾液渗透压<70 mmol/kg、IgA<112 μg/mL以及4至7种共同出现的保护因素的优势显著增加（OR = 4.63，95%CI：2.90 - 7.34，P<0.001）。
饮用饮用水而非苹果汁或不饮用饮料能在同时在60分钟内显著改善4至7种龋齿风险因素。这些结果证明饮用水干预对促进口腔健康是必要的。
