Dried fruit and dental health – how strong is the evidence?

Abstract

AbstractChildren's dental health in England has shown improvement in recent decades. However, 24.7% of 5 year‐olds have obvious decay, with the average number of affected teeth being 3.4, and tooth decay is the most common reason for hospital admissions in 5–9 year‐olds. Public Health England advises that foods and drinks containing free sugars are limited because of the increased risk of dental caries associated with frequent intakes. Although dried fruit contains more sugars than fresh fruit by weight due to the dehydration process, the portion size of dried fruit is 30 g compared with 80 g for fresh fruit. Additionally, these sugars are not defined as ‘free’ according to the current UK definition. However, unlike other sources of natural sugars, dried fruit is recommended to be eaten with meals only rather than as a snack because there is a supposition that it ‘sticks’ to teeth. A comprehensive review of the evidence published last year found a lack of good quality studies to support this advice. In the absence of data from intervention and cohort studies for effects of dried fruit on dental caries endpoints, studies of proxy measures of tooth demineralisation show inconsistent effects on plaque pH and acidogenicity. Measurement of net demineralisation, following consumption of raisins seven times a day for 10 days, showed comparable effects with fresh fruit and vegetables under similar conditions. Oral retention (‘sticking’) has been investigated in few subjects. The results do not demonstrate that dried fruit is worse in terms of oral clearance than alternative snack foods. More robust research with validated methods is needed before firm conclusions can be drawn about the retention of dried fruit, and hence its potential for adverse effects on teeth. This is important because eating traditional dried fruits can help towards the achievement of a number of dietary recommendations, including contributing to the 5 A DAY target and increasing fibre intake.