Intergenerational Oral Conditions' Relationships: The Role of Sugar Intake

Maternal oral health is associated with the oral health of children. However, the role of free sugar intake as a potential effect modifier in this relationship remains unclear. We examined the association between maternal and child caries and assessed whether free sugar intake modifies this relationship.

Data were obtained from the Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE), an Australian population-based birth cohort study. Maternal caries experience, measured by the number of decayed, missing, and filled surfaces (DMFS; 0 to 9, 10 to 19, 20 to 29, or ≥30 surfaces) when children were at age 2 y was the exposure. Outcomes were children's caries experience (dmfs/DMFS) and prevalence (dmfs/DMFS>0) at age 5 y. We investigated the association between maternal caries experience and children's caries status using negative binomial and Poisson regression models, adjusting for potential confounders. We also assessed the interaction to investigate whether free sugar intake (<12 g: <5% estimated energy requirement [EER], 12 to 24.9 g, ≥25g: ≥10% EER) modified this relationship.

A total of 879 mother-child dyads were analyzed (54.0% male). The average number of caries surfaces was 11.8 for mothers and 1.4 for children. Among children, 24.9%, 31.7%, and 43.3% consumed <12 g, 12 to 24.9 g, and ≥25 g of free sugar daily, respectively. At age 5 y, children whose mothers had ≥30 surfaces with caries experienced a 2.84 times greater number of surfaces with caries experience (95% confidence interval [CI], 1.52 to 5.30) and had a 1.68 times higher risk of having caries (95% CI, 1.19 to 2.36). Interactions between maternal caries experience (≥30 surfaces) and both 12 to 24.9 g or ≥25 g free sugar intake were observed (mean ratios [95% CI] for interaction terms: 11.16 [1.55 to 80.34] for 12 to 24.9 g and 17.91 [2.76 to 116.44] for ≥25 g).

Having a mother with higher caries experience increases the risk of caries among children; however, limiting free sugar intake mitigates the risk.Knowledge Transfer Statement:This study demonstrates that having a mother with higher caries experience increases a child's risk of developing caries; limiting free sugar intake mitigates the risk. Policymakers and clinicians could promote lower caries prevalence and prevent caries severity of children by encouraging upstream policies of reducing sugar intake.