Systematic reviewindependent cross-checkabstract only checked I-SUG-04 standard review
Sugar and tooth decay: 10-year update
Systematic Review of the Effect on Caries of Sugars Intake: Ten-Year Update.
Overview
Moores CJ et al.. J Dent Res 2022 · PMID 35302414 · DOI 10.1177/00220345221082918
Most studies link more sugar with more tooth decay; keeping sugar below 10% of energy lowers decay.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Association of sugars amount with caries; effect of <10% and <5% energy.
- How was the study done?
Systematic review update (2011-2020) with GRADE.
- How many people, animals or samples were studied?
23 new studies; 78 total; Children and adults
- What was actually found?
64 of 78 studies showed at least one positive association; caries lower when sugars <10%E (moderate quality); <5%E evidence upgraded to low.
- How large was the observed effect?
Not pooled
- What do the results mean in everyday life?
All free sugars affect teeth.
- What are the study's limitations?
Vote counting; Mostly observational
- What does it say about Elawady's specific claim?
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Not applicable.
Scientific in-depth review
1. Full reference
- Authors
- Moores CJ et al.
- Journal
- J Dent Res
- Year
- 2022
- Identifier
- PMID 35302414 DOI 10.1177/00220345221082918
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Not stated in abstract
2. Research question
Association of sugars amount with caries; effect of <10% and <5% energy.
3. Study design and population
- Study design
- Systematic review – Systematic review update (2011-2020) with GRADE.
- Population
Children and adults
- Country
Multinational
- Period
2011-2020
- Sample size
23 new studies; 78 total
- Inclusion and exclusion criteria
Epidemiological studies reporting sugars and caries
4. Methods and endpoints
- Exposure / intervention
Amount of sugars
- Comparator
<10%E or <5%E
- Endpoints
Caries
- Statistical methods
Vote counting, GRADE
5. Actual results
- Results
64 of 78 studies showed at least one positive association; caries lower when sugars <10%E (moderate quality); <5%E evidence upgraded to low.
- Absolute risks
not applicable
- Authors' conclusion
Findings support and strengthen WHO sugar recommendations.
6. Strengths
- Systematic
7. Weaknesses
- Vote counting
- Mostly observational
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
No meta-analysis.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Supports C-SOD-11; contradicts C-SUG-01.
11. Independent contrary findings
None.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Solid support for caries.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
None.
15. Linked fact checks
- Soft drinks cause tooth decay. – Studies supporting the claim
- White sugar is the greatest product humans ever made; any amount of sugar per day is beneficial, and one can eat a kilogram of white sugar or honey. – Studies contradicting or limiting the claim