Higher sugar intake is associated with periodontal disease in adolescents

Objectives Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18-19 years old). Materials and methods This was a cross-sectional study nested to RPS Cohorts Consortium, Sao Luis, Brazil (n= 2515). The exposure was percentage of daily calories from added sugar (>= 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth >= 4 mm, and clinical attachment level >= 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent's educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and >= 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson. Results High sugar intake was associated with >= 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03-1.94;p= 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03-1.29;p= 0.011). Conclusion High level of added sugar intake was associated with greater extent of periodontal disease in adolescents.