The effect of diet drinks on oral health among US children and adults: cluster analysis
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INTRODUCTION: Dental caries erosion are both multifactorial diseases. One common factor for both diseases is acid attack on dental enamel. Some beverages contain both erosive acids and cariogenic carbohydrates, thus, promoting both types of disease. Previous literature has examined beverages as single source exposures, despite the fact that beverage consumption is a complex process that contains several beverage. A few studies have examined the patterns of beverage consumption and dental caries in both children and adults. These studies found a significant positive relationship between sugar sweetened beverages consumption and caries. These studies did not differentiate between regular and diet soda, so the relationship between diet/low calorie sweetener drinks and dental caries is not established. In contrast with caries, the association between beverage consumption patterns and erosion has not been studied before. OBJECTIVES: Examine the effect of diet drinks on dental caries and erosion among a representative sample of US children and adults. METHODS: All analyses conducted using cluster analysis to account for the complexity of beverage consumption and to better understand the effect of different consumption patterns on the dentition. NHANES data was used to be able to generalize the results to the US population. RESULTS: In children, we managed to define 6 different clusters including: water, milk, juice drinks, 100% juice, soda, and diet drinks. None of the clusters demonstrated statistically significant associations with dental caries. While individuals with high soda consumption had the highest caries risk, diet drinks had no effect on dental caries. On the other hand, adults were grouped into 4 distinct clusters: water, soda, diet drinks, and coffee/tea. The diet drinks cluster was not associated with higher DMFT score, while high soda consumption demonstrated increased DMFT. In contrast, high diet drinks consumption increased the risk for erosion, although this relationship was not statistically significant. CONCLUSION: This dissertation showed that diet drinks are not associated with dental disease. While we can not recommend consuming these drinks based on this one cross sectional study, we believe that more studies should be conducted so that we can draw a final conclusion regarding oral disease and diet drinks.
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