Perplexing features in the occurrence of dental caries and its relationship to sugar intake

Epidemiologically, there are numerous perplexing features, insufficiently appreciated, in the occurrences of degenerative diseases, and in the roles of their risk factors. This applies particularly to dental caries, the commonest of all diseases, and the risk factor, sugar intake. In some contexts, caries scores are much lower, or are much higher, than expected. Moreover, even in contexts where outwardly the same risk factors are widespread, ranges of scores are much wider than would be expected. In all contexts, among groups and more especially among individuals, the association of caries experience and dietary intakes, particularly that of sugar intake, is limited. Accordingly, caution must be exercised in the over-blaming of sugar and in the overclaiming of benefits to be derived from reducing intake.