Diet and Caries in Low-INcome Adults

Objectives: There is little information on the diet of adult African-Americans, especially as it relates to dental caries. This study examines the relationship between dietary patterns and caries experience in a representative group of low-income African-American adults. Methods: Participants were residents of Detroit, Michigan, with household incomes below 250% of the federally-established poverty level (n=1,021). Dietary histories were obtained by trained interviewers, in face-to-face interviews with the participants, using the Block 98.2® food frequency questionnaire (Block Dietary Systems, Berkeley, CA). Caries was measured by the ICDAS criteria (International Caries Detection and Assessment System). Analyses were conducted using software from SAS and SUDAAN. Results: 200 dietary records were not usable; these participants were omitted from the dietary analyses to leave n=821. Factor analysis identified patterns of liquid and solid food consumption, and the resulting factor scores were used as covariates in multivariable linear regression. Nearly three-quarters of the adult participants were overweight or obese. Caries was extensive, with 82.3% of the participants having at least one cavitated lesion. This population has severe caries, poor oral hygiene, and diets that are high in sugars and fats and low in fruits and vegetables. Apart from tapwater, the most frequently consumed food item by adults of all ages was soft drinks; 19% of all energy from sugar came from soft drinks alone. Conclusions: In both the bivariate analyses and in the regression model, the frequency of soft drink consumption and the presence of gingival plaque deposits were significantly associated with caries severity. Interventions to promote oral health are unlikely to be successful without improvements in the social and physical environment. Supported by NIDCR grant no. U-54 DE 14261.