Sugar Industry Public Relations Efforts to Influence Dentists' Opinions, 1974-1978
Objectives: The sugar industry influenced research priorities of the National Institute of Dental Research’s 1971 National Caries Program to align with industry interests. Nevertheless, the media continued to suggest sugar was responsible for health problems, including dental caries. We hypothesized that the Sugar Association (SA), which represents the sugar industry, strategically targeted dentists to promote pro-sugar messaging on dental caries control from 1974-1978.
Methods: 515 internal SA documents from 1974-1978 were reviewed for terms related to oral health, dentists, and dental professional groups. 186 documents were identified for further review. Emerging themes related to pro-sugar messaging were identified. Secondary sources were used to contextualize findings.
Results: SA’s position was that dental caries could be controlled with water fluoridation, good oral hygiene, developing a vaccine, and discouraging frequent use of sticky sugars between meals without limiting the total amount of sugar consumption. SA formed this position by: 1) consulting with dentists and dental researchers amenable to the industry position and 2) commissioning a white paper to support the industry position without disclosing SA funding. SA identified sources of anti-sugar attitudes by: 1) identifying media promoting anti-sugar messages and 2) categorizing dental organizations, dental research, and dental researchers as positive, neutral, or negative to sugar. SA disseminated their position by: 1) sending spokespeople and SA representatives to speak in the media and at dental conferences and 2) hiring dietitians to interact directly with dental professionals. Consequently, SA received a public relations award for gaining credibility in the medical community, aligning their position on basic nutrition with those of leading professional organizations and diminishing public criticism by bringing “balance” to the discussion of sugar.
Conclusions: SA enlisted dentists’ aid in changing anti-sugar attitudes toward dental caries control. The public health community should consider sugar industry public relations programs as an important determinant of disease.