Reduction of caries in pre-school children by sucrose restriction and substitution with invert sugar

Abstract

In Gustavsberg, a suburb of Stockholm, a number of families with 3 year old children were invited to participate in a two year clinical study to demonstrate whether or not an invert sugar diet would lower the caries activity in comparison to a sucrose diet. About a quarter of the families (i.e. 67 children) accepted the offer, making up four invert sugar groups. The parents of the invert sugar groups were given lists of all articles of food available in a modern local supermarket and labelled »Allowed« or »Unsuitable«. »Allowed« were those free from sucrose and »Unsuitable« were all those containing sucrose. A number of other »caries risk products« such as candies, beverages, marmalades, jam, chewing gum etc. in which sucrose was substituted by invert sugar, were also offered at regular prices to the participants. Two contrast groups including 89 children of the same age, lived on ordinary diets and did not have access to invert sugar products. (The expression »contrast group« has been used in this study since these groups were not considered to be true control groups.) After the first year a moderate and insignificant caries reduction was observed in the pooled invert sugar group in comparison to the pooled contrast group. After the second year the caries reduction in dmfs was about 55 per cent (P < 0.005). The reduction in dmfs over the two year study was 35 per cent and was statistically significant (P < 0.01). Mean plaque and gingival indices for the invert sugar group decreased slightly after two years, whereas an increase was noted in the contrast groups. These differences were significant (P < 0.05 and P < 0.01, respectively).