Abstract
BackgroundDental caries (tooth decay) is a significant public health problem in Alaska Native children. Dietary added sugars are considered one of the main risk factors. In this cross-sectional pilot study, we used a validated hair-based biomarker to measure added sugar intake in Alaska Native Yup’ik children ages 6–17 years (N = 51). We hypothesized that added sugar intake would be positively associated with tooth decay.MethodsA 66-item parent survey was administered, a hair sample was collected from each child, and a dental exam was conducted. Added sugar intake (grams/day) was measured from hair samples using a linear combination of carbon and nitrogen ratios. We used linear and log-linear regression models with robust standard errors to test our hypothesis that children with higher added sugar intake would have a higher proportion of carious tooth surfaces.ResultsThe mean proportion of carious tooth surfaces was 30.8 % (standard deviation: 23.2 %). Hair biomarker-based added sugar intake was associated with absolute (6.4 %; 95 % CI: 1.2 %, 11.6 %; P = .02) and relative increases in the proportion of carious tooth surfaces (24.2 %; 95 % CI: 10.6 %, 39.4 %; P < .01). There were no associations between self-reported measures of sugar-sweetened food and beverage intake and tooth decay.ConclusionsAdded sugar intake as assessed by hair biomarker was significantly and positively associated with tooth decay in our sample of Yup’ik children. Self-reported dietary measures were not associated tooth decay. Most added sugars were from sugar-sweetened fruit drinks consumed at home. Future dietary interventions aimed at improving the oral health of Alaska Native children should consider use of objective biomarkers to assess and measure changes in home-based added sugar intake, particularly sugar-sweetened fruit drinks.
Highlights
IntroductionDental caries (tooth decay) is a significant public health problem in Alaska Native children
Dental caries is a significant public health problem in Alaska Native children
Oral health behaviors Regarding beverage consumption data collected via parent survey, 49 % of children were reported to consume sugar-sweetened fruit drinks (e.g., Tang, Kool-Aide) 2–3 times/day and 15.7 % reported consuming sugar-sweetened beverages ≥4 times/day at home
Summary
Dental caries (tooth decay) is a significant public health problem in Alaska Native children. Dietary added sugars are considered one of the main risk factors. In this cross-sectional pilot study, we used a validated hair-based biomarker to measure added sugar intake in Alaska Native Yup’ik children ages 6–17 years (N = 51). We hypothesized that added sugar intake would be positively associated with tooth decay. The Commission cited pediatric dental caries as one of the “new health problems facing Alaska’s Native people”. The pediatric caries epidemic in Alaska Native communities has not abated. The first is regular dental visits, which give dentists an opportunity to assess a child’s risk for developing
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