Sugar consumption is a worldwide problem. Did you know that around 95% of 12-year-olds in the Philippines have tooth decay or cavities? Did you know that cavities affect 7 in 10 children in India, one-third of Tanzania teens and nearly 1 in every 3 Brazilians in general? A recent study shows that sugar rules the world and it still ruins teeth.
These startling oral health statistics are the focus of a two-part series published online. In it, more than a dozen dentists and public health experts call for radical action to end neglected and widespread oral disease.
So Who is the Culprit
“Sugar is the causative agent for dental decay,” says Robert Weyant, one of the study authors and a dental public health expert at the University of Pittsburgh. “Basically, without sugar, you won’t develop decay.”
Study authors also pointed out what they call a failed dental system, where many dentists prioritize treatment over prevention efforts. Things like toothbrushing with fluoride and restricting sugar intake. This with an overwhelming number of sweetened food and beverage options, dental cavities are on the rise. This is especially true for low and middle-income countries.
Residents in these places are undergoing a global phenomenon known as a “nutrition transition,” says Habib Benzian, a study co-author and associate director of global health and policy at New York University’s College of Dentistry.
“Low-income countries usually have traditional diets, more plant and meat-based foods, less sugar and processed foods,” Benzian says. “But as a country’s socioeconomic conditions evolve, there’s a transition in terms of what people eat.”
Benzian explains, “It’s a part of convenience. If you work all day and come home, you want quick food. Fast foods that are fried, high in fat, sweet — and very cheap.”
What is the Sugar Industry Doing
The sugar industry has been quick to jump on the trend. Weyant says, “I do see efforts [by the sugar industry] to break into new areas and foster an interest in high sugar foods in particularly vulnerable populations.”
According to Marion Nestle, author of the book Soda Politics: Taking on Big Soda (and Winning), by the year 2020, Coca-Cola will spend $12 billion in marketing in just Africa alone. PepsiCo will spend $5.5 billion in India by 2020 to expand operations and develop products “geared toward Indian tastes.”
Big Sugar’s reach currently influences oral research organizations worldwide as well.
The European Organization for Caries Research (ORCA) is supported by corporate members like Mars Wrigley Confectionery. Mars Wrigley is a manufacturer of chocolate, mints, chewing gum and other sugary treats. Unilever, whose products include ice cream and sweetened beverages, is a corporate member of the International Association for Dental Research (IADR).
These obvious conflicts of interest can sway the direction and results of diet and nutrition research, says sugar politics expert Cristin Kearns, who is based at the University of California, San Francisco. Kearns has seen this happen before.
In a 2015 PLOS Medicine study, Kearns revealed how the sugar industry influenced the U.S. National Institute of Dental Research in the 1960s, diverting attention from the real problem…that sugar is unhealthy.
Big Sugar Responds
In response to Kearns’ 2015 study, the Sugar Association stated,
“We acknowledge that Dr. Kearns has devoted significant time to the task of reviewing thousands of documents from over 50 years ago; however, we question her motives and certainly the accuracy of her conclusions. The Sugar Association … believe[s] that sugar is best enjoyed in moderation, a fact that is supported by decades of scientific research.”
Up against ‘Big Sugar’, what can dentists around the world do?
Weyant believes that it’s time for state and national governments to step in.
He points to the tobacco industry. There is now a global tobacco control agenda through the World Health Organization. The treaty was established in 2003 in response to a global surge in tobacco usage. The WHO treaty demanded reduction strategies, like tobacco tax increases, to dissuade people from using the addictive substance.
“There is no united global movement against sugar,” Weyant says. “I think that model needs to be adapted for sugar.”
Habib Benzian points to the need for more focused oral hygiene efforts.
“They are bringing education directly to the schools,” Benzian says. “It’s a mandatory program where every day, all the children go out into the courtyards to brush their teeth and wash their hands.”
Something needs to give if we are going to combat this sugar problem.
Dr. Steven A. Rosenberg likes hearing this news. Dr. Rosenberg cares for his patients unlike any other dentist in the South Florida, primarily the Plantation area. Whether you are getting extensive work done like a root canal, Invisalign, crowns, or full dentures, or lighter work such as whitening, fillings, or preventative oral care, this is your dentist’s office. His office is friendly, professional, clean open to new clients.
Dr. Rosenberg is a Miami, Florida native who received his undergrad degree from Emory University and got his Doctor of Dental Surgery degree from Georgetown University Dental School. He has been in private practice for over 20 years. Dr. Rosenberg is President-Elect of the Broward County Dental Association. He is Vice President of the Broward Dental Research Clinic where has been on the board of directors for five years. He is a member of the Intracoastal Study Club. Professional memberships include the American Dental Association, the Florida Dental Association, the Atlantic Coast District Dental Association, and the Broward County Dental Association.