Water fluoridation and the association of sugar-sweetened beverage consumption and dental caries in Australian children

Am J Public Health. 2013 Mar;103(3):494-500. doi: 10.2105/AJPH.2012.300889. Epub 2013 Jan 17.


Objectives: We examined demographic and socioeconomic differences in the consumption of sugar-sweetened beverages (SSBs), its association with dental caries in children, and whether exposure to water fluoridation modifies this association.

Methods: In a cross-sectional study, we used a stratified, clustered sampling design to obtain information on 16 508 children aged 5 to 16 years enrolled in Australian school dental services in 2002 to 2005. Dental staff assessed dental caries, and parents completed a questionnaire about their child's residential history, sources of drinking water, toothbrushing frequency, socioeconomic status (SES), and SSB consumption.

Results: Children who brushed their teeth less often and were older, male, of low SES, from rural or remote areas consumed significantly more SSBs. Caries was significantly associated with greater SSB consumption after controlling for potential confounders. Finally, greater exposure to fluoridated water significantly reduced the association between children's SSB consumption and dental caries.

Conclusions: Consumption of SSBs should be considered a major risk factor for dental caries. However, increased exposure to fluoridated public water helped ameliorate the association between SSB consumption and dental decay. These results reconfirm the benefits of community water fluoridation for oral health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Beverages / adverse effects*
  • Beverages / statistics & numerical data
  • Carbonated Beverages / adverse effects
  • Carbonated Beverages / statistics & numerical data
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Dental Caries / epidemiology*
  • Dental Caries / etiology
  • Dental Caries / prevention & control
  • Dietary Sucrose / adverse effects
  • Female
  • Fluoridation / statistics & numerical data*
  • Humans
  • Male
  • Sex Factors
  • Socioeconomic Factors


  • Dietary Sucrose