​For many parents, sugar-free alternatives for their children’s snacks are a positive way to manage their child’s oral health and sugar intake. A new study from the International Association for Dental Research suggests sugar-free might have negative effects on oral health for children.

The study measured in children enrolled in the Barwon Infant Study at age 18-months and 4-years. The exposure, sugar free intake was quantified as continuous and binary variables indicating less than five per cent of total energy intake (TEI) at 18-months and 4-years of age. Through analysis of dental records, the study estimated the effect of the exposure variables on the presence of dental caries at 4-6 years of age, adjusting for potential confounders.

The media outlet Eureka Alert summarised the findings, stating “Of the original birth cohort, dietary data (N=863) and dental caries data (N=368) were available. 70.4 per cent and 36.7 per cent participants consumed less than five per cent TEI from free sugars at 18-months and 4-years, respectively. Dental caries affected 46.7 per cent of children.

“In fully adjusted models, free sugar at 18-months (OR 1.74; 95 per cent CI 1.06, 2.86 per five per cent of TEI) and at 4-years of age (OR 1.43; 95 per cent CI 0.90, 2.28, per five per cent of TEI) increased dental caries risk at 4-6 years. The estimated effect of consuming less than five per cent free sugars of TEI at 18-months and 4-years of age on dental caries prevalence at 4-6 years was an OR 0.71, 95 per cent CI 0.42, 1.19 and OR: 0.61; 95 per cent CI 0.38, 0.97 respectively.

“The estimated effect of lowering free sugars to less than five per cent of TEI at both timepoints compared to exceeding five per cent TEI at one or both timepoints, on dental caries risk at 4-6 years was an OR 0.55; 95 per cent CI 0.33, 0.93.”

The study had two critical conclusions:

  • For children 18-months and 4-years, free sugar consumption increased markedly with two thirds of children exceeding five per cent of TEI at 4-years of age.
  • Consuming sugar-free foods at an early age increases the risk of dental caries at 4-6-years of age.

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