Methods: A literature search for caries papers from Iraq in the English language until December 2012 was conducted through three search engines: PubMed, Web of Knowledge and Cochrane library. Papers from the Iraqi Academic Scientific journals, the WHO and the UNICEF websites were also included. The papers were critically appraised for the rigour of their design and methodology, before inclusion in the review.
Results: According to the Iraqi Ministry of Trade, the sugar consumption in Iraq increased from 37.5 Kg/person/year in 1977 to 50 Kg/person/year in 1984. A Comparison of the studies, showed an increase in the DMFT in 12-year-old children (±SD) from 2.7 ±2.4 (n=1213) in 1982 to 7±2.9 (n=502) in 1989. Subsequently, the sugar consumption in Iraq was reported to decrease dramatically from 50 Kg/person/year in 1989 to 16.28 Kg/person/year in 1990-2003, due to the UN sanctions and food imports restrictions. Interestingly, studies showed that the DMFT mirrored the sugar consumption, and declined to 2.7 ±1.5 (n=503) in 1995, and to 1.7 ±1.9 (n=392) in 2003. This cannot be explained by water fluoridation, which has been consistently too low to be effective for caries prevention in Iraq.
Conclusion: The alignment of DMFT with the level of sugar consumption in the Iraqi population may be considered as a natural experiment of the cause and effect relationship of diet with dental caries. A study of the current caries experience in Iraq would complete the picture and provide further evidence for the timely introduction of oral health education programme in Iraq.