A CROSS-SECTIONAL STUDY OF DENTAL-CARIES, INTAKE OF CONFECTIONERY ANDFOODS RICH IN STARCH AND SUGARS, AND SALIVARY COUNTS OF STREPTOCOCCUS-MUTANS IN CHILDREN IN SPAIN

In this cross-sectional study of 236 schoolchildren living in Manresa, Spain, we evaluated the association between prevalence of dental cari es and frequency of consumption of various food groups, including swee tened baked goods and similar foods (rich in starch and sugars) and co nfectionery (rich in sugars but not starch), using a food-frequency qu estionnaire. Because Streptococcus mutans is associated with the cario genicity of carbohydrates, we also evaluated the modification of these associations by salivary counts of this microorganism. Odds ratios (O Rs) were used to measure the association between caries and tertiles o f consumption. Sex, age, use of fluorides, tooth-brushing frequency, f requency of dental visits, socioeconomic status, and intake of other p otentially cariogenic food groups were considered as potential confoun ders. We did not find a significant association between any of the foo d groups evaluated and caries prevalence. Failure to detect an associa tion could have been due to the low prevalence of caries in our popula tion (decayed, missing, or filled permanent teeth = 1.3 at age 10.6 y) or to underestimation of the association due to diet misclassificatio n. In this population, the association between consumption of sweetene d baked goods and caries appeared to be modified by the numbers of S. mutans [OR = 6.1 (95% CI: 1.6, 23.0) for low compared with high intake in children with moderate-to-high S. mutans counts and OR = 0.3 (95% CI: 0.1, 1.6) for low compared with high intake in children with low S . mutans counts]. These results suggest that a high intake of sweetene d baked goods may be a determinant of caries prevalence in children wi th moderate-to-high salivary counts of S. mutans.