ABSTRACT. Objective. Dental caries is a common, chronic disease of childhood. The impact of contemporary changes in beverage patterns, specifically decreased milk intakes and increased 100% juice and soda pop intakes, on dental caries in young children is unknown. We describe associations among caries experience and intakes of dairy foods, sugared beverages, and nutrients and overall diet quality in young children.Methods. Subjects (n ‫؍‬ 642) are members of the Iowa Fluoride Study, a cohort followed from birth. Food and nutrient intakes were obtained from 3-day diet records analyzed at 1 (n ‫؍‬ 636), 2 (n ‫؍‬ 525), 3 (n ‫؍‬ 441), 4 (n ‫؍‬ 410), and 5 (n ‫؍‬ 417) years and cumulatively for 1 through 5 (n ‫؍‬ 396) years of age. Diet quality was defined by nutrient adequacy ratios (NARs) and calculated as the ratio of nutrient intake to Recommended Dietary Allowance/Adequate Intake. Caries were identified during dental examinations by 2 trained and calibrated dentists at 4 to 7 years of age. Examinations were visual, but a dental explorer was used to confirm questionable findings. Caries experience was assessed at both the tooth and the surface levels. Data were analyzed using SAS. The Wilcoxon rank sum test was used to compare food intakes, nutrient intakes, and NARs of subjects with and without caries experience. Logistic and Tobit regression analyses were used to identify associations among diet variables and caries experience and to develop models to predict caries experience. Not all relationships between food intakes and NARs and caries experience were linear; therefore, categorical variables were used to develop models to predict caries experience. Food and beverage intakes were categorized as none, low, and high intakes, and NARs were categorized as inadequate, low adequate, and high adequate.Results. Subjects with caries had lower median intakes of milk at 2 and 3 years of age than subjects without caries. Subjects with caries had higher median intakes of regular (sugared) soda pop at 2, 3, 4, and 5 years and for 1 through 5 years; regular beverages from powder at 1, 4, and 5 years and for 1 through 5 years; and total sugared beverages at 4 and 5 years than subjects without caries.Logistic regression models were developed for exposure variables at 1, 2, 3, 4, and 5 years and for 1 through 5 years to predict any caries experience at 4 to 7 years of age. Age at dental examination was retained in models at all ages. Children with 0 intake (vs low and high intakes) of regular beverages from powder at 1 year, regular soda pop at 2 and 3 years, and sugar-free beverages from powder at 5 years had a decreased risk of caries experience. High intakes of regular beverages from powder at 4 and 5 years and for 1 through 5 years and regular soda pop at 5 years and for 1 through 5 years were associated with significantly increased odds of caries experience relative to subjects with none or low intakes. Low (vs none or high) intakes of 100% juice at 5 years were associated with decreased caries experience. In general, in...

Caries and obesity coexist in children of low socioeconomic status. Public health measures to improve dietary education and access to appropriate foodstuffs could decrease the risk of both diseases.

poplasia had a significantly higher risk for caries at age 5 and 9 after controlling for other risk factors. Enamel hypoplasia appears to be a significant risk factor for caries and should be considered in caries risk assessment. Copyright © 2009 S. Karger AG, Basel Developmental enamel defects are disturbances during enamel formation and may be manifested as enamel hypoplasia or opacities. Enamel hypoplasia is a quantitative defect associated with reduced thickness of enamel formed during the secretory stage of amelogenesis [Suckling, 1989;Seow, 1991]. Developmental enamel defects, such as hypoplasia, have been speculated to increase the risk of dental caries in the affected teeth [Pascoe and Seow, 1994;Li et al., 1996;Lai et al., 1997]. Defective enamel sites (hypoplasia or hypocalcification) may provide suitable local environment for adhesion and colonization of cariogenic bacteria, and bacteria may retain at the base of the defect in contact with exposed dentin, thus dental caries on these defective sites may develop more rapidly [Li et al., 1996]. Defective enamel has higher acid solubility than normal enamel and is more susceptible to caries attack [Zheng et al., 1998]. The association between enamel hypoplasia and dental caries has been reported in several cross-sectional studies [Matee et al., 1994;Pascoe and Seow, 1994;Li et al., 1996;Ellwood and O'Mullane, 1996; Key Words Dental caries ؒ Enamel hypoplasia ؒ Primary teeth AbstractThe purpose of this study was to assess the longitudinal relationships between enamel hypoplasia and caries experience of primary second molars. The study sample was 491 subjects who received dental examinations at both age 5 and 9 by the calibrated examiners. Four primary second molars (n = 1,892) were scored for the presence of enamel hypoplasia for each participant. Caries presence and number of decayed and filled surfaces (dfs) were determined at age 5 and 9. The relationships between enamel hypoplasia and caries experience were assessed. Among primary second molars, 3.9% of children and 1.7% of primary second molars had enamel hypoplasia. At age 5, 36.8% of children with hypoplasia had caries, while 16.9% of children without enamel hypoplasia had caries. At age 9, the corresponding numbers were 52.6% for children with hypoplasia and 34.5% for children without hypoplasia, respectively. At the tooth level, for age 5, 28.1% of teeth with hypoplasia had caries (mean dfs = 0.40), and 7.6% of teeth without hypoplasia had caries (mean dfs = 0.11). At age 9, the corresponding numbers were 41.9% (mean dfs = 0.76) for teeth with hypoplasia and 18.3% (mean dfs = 0.34) for teeth without hypoplasia. In multivariable logistic regression analyses, teeth of subjects with enamel hy-

Dietary methods used to investigate diet-caries relationships can influence the outcome. The cariogenicity of food, but not beverages, is associated with the timing of exposure.

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