Abstract
Background: The objective of this systematic review was to assess the scope and breadth of publicly available prospective cohort and randomized controlled trial (RCT) literature on 100% fruit juice and dental caries or tooth erosion in humans.Methods: We performed a systematic search in MEDLINE/PubMed, EMBASE, and Web of Science for studies published from inception through May 2018, and the Cochrane Library databases for reports published through January 2018. Prospective cohort studies or RCTs conducted on dental health and 100% fruit juice, and published in English were selected. No restrictions were set for age, sex, geographic location, or socioeconomic status.Results: Eight publications representing five independent prospective cohort studies and nine publications on nine RCTs were included. All prospective cohort studies were in children or adolescents, and all RCTs were in adults. Prospective cohort studies on tooth erosion found no association between juice intake and tooth erosion, while those on dental caries incidence reported either no association or an inverse association between 100% fruit juice intakes and dental caries incidence. RCTs on tooth erosion showed decreased microhardness, increased surface enamel loss, increased erosion depth, greater enamel softening, and/or increased pellicle layer with 100% fruit juice, and those on dental caries showed increased demineralization of enamel slabs with 100% fruit juice.Conclusions: The existing evidence on 100% fruit juice intake and caries and tooth erosion are not conclusive. Overall, prospective cohort studies in children and adolescents found no association between 100% fruit juice intake and tooth erosion or dental caries, but, RCT data in adults suggests that 100% fruit juice could contribute to tooth erosion and dental caries. The RCT data, however, were from small, short-term studies that utilized intra-oral devices generally devoid of normal plaque or saliva action, and generally employed conditions that are not reflective of normal juice consumption.
Highlights
In the United States, dental caries and tooth erosion affect 19 and 30% of school-going children, respectively (1, 2) while 32% of adults have untreated dental caries (1)
The 2015 Dietary Guidelines for Americans included dental caries as one of the chronic health conditions assessed with respect to added sugars (5)
The committee relied on a review of sugars and dental caries conducted for the World Health Organization (WHO) (6, 7), which combined data on total, free, added, and non-milk extrinsic sugars (8)
Summary
In the United States, dental caries and tooth erosion affect 19 and 30% of school-going children, respectively (1, 2) while 32% of adults have untreated dental caries (1). Dental caries and tooth erosion have been indicated as the outcomes most related to food intake and dietary practices and have, been assessed by many authoritative organizations as part of dietary. The 2015 Dietary Guidelines for Americans included dental caries as one of the chronic health conditions assessed with respect to added sugars (5). The etiology of dental caries involves three main factors: (1) presence of cariogenic microorganisms, (2) exposure to fermentable substrates (e.g., carbohydrates), and (3) a susceptible tooth surface/host (10). The objective of this systematic review was to assess the scope and breadth of publicly available prospective cohort and randomized controlled trial (RCT) literature on 100% fruit juice and dental caries or tooth erosion in humans
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