Positive association between sugar consumption and dental decay prevalence independent of oral hygiene in pre-school children: a longitudinal prospective study

BACKGROUND: Few studies explore how the longitudinal cumulative and combined effects of dietary habits and oral hygiene habits relate to dental decay in very young children. METHODS: Using longitudinal survey data, logistic regression models were specified to predict dental decay by age 5. Predictor variables included questions on diet and oral hygiene from ages 2 to 5. RESULTS: Compared to mainly eating meals, children who snacked all day but had no real meals had a higher chance of dental decay (odds ratios (OR) = 2.32). There was an incremental association between a decreasing frequency of toothbrushing at age 2 and higher chances of dental decay at age 5 (OR range from 1.39 to 2.17). Among children eating sweets or chocolate more frequently (once/day or more), toothbrushing more often (once/day; twice/day or more) reduced the chance of decay (OR of 2.11–2.26 compared to OR 3.60 for the least frequent brushing group). Compared to mothers in managerial and professional occupations, those who had never worked had children with a much higher chance of decay (OR = 3.47). CONCLUSION: This study has shown that toothbrushing can only in part attenuate the association between snacking and long term sugar consumption on dental decay outcomes in children under 5.