204 - The Impact of Beverage Choice on Early Childhood Caries in Kentucky

Purpose: The high prevalence of Early Childhood Caries (ECC) in Kentucky’s children does not appear to be decreasing. ECC is multifactorial, largely dependent on parental behaviors and influences leading to consumption of high sugar containing foods and non-fluoridated beverages. Overall, studies show there has been a decline in consumption of milk, fruit and vegetables, with an increase in consumption of sugar-sweetened beverages. The purpose of this study is to examine the association between beverage choice and early childhood dental caries among a representative sample of children two to five years of age seen for routine dental exams.

Methods: Participant parents complete an anonymized, voluntary survey via REDCap consisting of questions regarding their child’s consumption of various amounts/types of sugar sweetened and non-sugar sweetened beverages. The caries prevalence of each patient (dmft)will be analyzed in relation to the type and amount of sugar-sweetened beverage the child consumes. Descriptive statistics for all variables were calculated, and differences in prevalence across ethnicities were analyzed using Fisher’s Exact tests. To model the relationship between the total number of teeth affected by caries and the various drink types, we fit quasi-Poisson regression models to allow for potential overdispersion. Ethnicity was also included as a covariate in each case. All analysis will be performed using SAS 9.4, with a significance level of 0.05.

Results: 65.2% Hispanic/Latino patients drink no tap water (Table 1). 65.2% Hispanic/Latino patients and 72.2% Black patients drink 2 or more cups of bottled water (Table 2). 0.6 times as many teeth were affected by caries in patients drinking 2 or more cups of tap water each day compared to 1.4 times as many teeth affected by caries in patients drinking only 1 cup of tap water each day (Graph 1). Patients drinking soda had an estimated 1.6 times as many total teeth affected by caries as those not drinking any soda (Graph 3). Patients drinking 1 cup daily and those drinking 2 or more cups daily of sports drinks such as Gatorade had an estimated 2.6 and 3.0 times as many total teeth affected by caries, respectively, as those not drinking any sports drinks (Graph 4). Average number of teeth affected by caries are not significantly different across the ethnicity categories studied (Chart 1).

Conclusions: Hispanic/Latino patients consume significantly less tap water versus bottled water; and Hispanic/Latino and Black patients consume marginally significant more bottled water than tap water than other representative population groups. When comparing tap water consumption to bottled water consumption, consuming 2 or more cups of tap water daily has a more significant impact on reducing caries prevalence than consuming 2 or more cups of bottled water. Soda and sports drinks such as Gatorade have a more significant impact on caries experience than milk, chocolate milk, and juice does contributing to higher caries prevalence.