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J Am Dent Assoc, Vol 139, No 7, 959-967.
© 2008 American Dental Association
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RESEARCH

JADA Continuing Education

Cariogenicity of Soft Drinks, Milk and Fruit Juice in Low-Income African-American Children

A Longitudinal Study



Sungwoo Lim, MA, MS, Woosung Sohn, DDS, PhD, DrPH, Brian A. Burt, BDS, MPH, PhD, Anita M. Sandretto, PhD, Justine L. Kolker, MS, PhD, DDS, Teresa A. Marshall, PhD, RD and Amid I. Ismail, BDS, MPH, MBA, DrPH

Background. The authors conducted a study to test the hypothesis that high consumption of soft drinks, relative to milk and 100 percent fruit juice, is a risk factor for dental caries in low-income African-American children in Detroit.

Methods. Trained dentists and interviewers examined a representative sample of 369 children, aged 3 to 5 years, in 2002–2003 and again two years later. The authors used the 2000 Block Kids Food Frequency Questionnaire (NutritionQuest, Berkeley, Calif.) to collect dietary information. They assessed caries by using the International Caries Detection and Assessment System.

Results. Soft drinks, 100 percent fruit juice and milk represented the sugared beverages consumed by the cohort. A cluster analysis of the relative proportion of each drink at baseline and follow-up revealed four consumption patterns. Using zero-inflated negative binomial models, the authors found that children who changed from being low consumers of soft drinks at baseline to high consumers after two years had a 1.75 times higher mean number of new decayed, missing and filled tooth surfaces compared with low consumers of soft drinks at both time points.

Conclusion. Children who consumed more soft drinks, relative to milk and 100 percent fruit juice, as they grew older were at a greater risk of developing dental caries.

Clinical Implications. Health promotion programs and health care providers should emphasize to patients and caregivers the caries risk associated with consumption of soft drinks.

Key Words: Cariogenicity; soft drinks; low-income children; caries

Abbreviations: d1: Noncavitated surfaces • d2: Cavitated/dentinal surfaces • dtmfs: Noncavitated surfaces, cavitated/dentinal surfaces, missing owing to caries, filled surfaces • f: Filled surfaces • FFQ: Food Frequency Questionnaire • IRR: Incidence rate ratio • m: Missing surfaces owing to caries • PAM: Partitioning around medoids • s: Surfaces • ZINB: Zero-inflated negative binomial regression






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