Dietary intake and dental caries in children

Dental caries is a common childhood disease and important health problem in the United States and throughout the world. Most studies that have assessed risk factors for dental caries focused on non-modifiable risk factors such as previous caries experience and socioeconomic status. It is also important to investigate modifiable risk factors that can be used in developing guidelines for risk assessment and prevention. The present dissertation assessed mainly the associations between dental caries and modifiable factors, including dietary factors, water fluoride levels and toothbrushing frequency in children, while adjusting for non-modifiable factors. Data were obtained from subjects who were participants in the Iowa Fluoride Study. Dietary data were collected using 3day dietary diaries from 1.5 months to 8.5 years and detailed questionnaires from 9 years to 13 years. Dental caries examinations were conducted at about 5, 9 and 13 years of age. There are three main analyses. The first analysis assessed risk factors for a 4 group primary dentition caries experience variable: the caries-free (reference group), the d1, the d2+f, and the d1d2+f groups. The dietary consumption frequencies (from ages 3 to 5 years) for the children in the 4 caries groups were compared using multivariable multinomial regression analyses. Lower consumption frequency of milk at meals and greater consumption frequency of pre-sweetened cereal at meals significantly increased the likelihood of being in the d1 group. Greater consumption frequency of regular soda pop at snacks significantly increased the likelihood of being in the d1d2+f group. Greater consumption frequency of added sugars at snacks significantly increased chance to be in the d2+f group and the d1d2+f group. The second manuscript assessed risk factors for new mixed dentition cavitated caries determined based on surface-specific transitions from the primary to mixed dentition exams on 16 teeth using logistic regression analysis. Greater consumption