Monday, June 23, 2014

Dentists should be at the forefront in the fight against sugar


The Lancet, Volume 383, Issue 9934, Page 2046, 14 June 2014
doi:10.1016/S0140-6736(14)60996-X
Sugar is the new tobacco.1 All efforts should be made to reduce sugar consumption. Education and governmental regulations alone cannot reduce consumption. A multisectorial approach is required using all possible routes: whole population, high-risk group, and targeted population approaches.2
Decreases in tobacco consumption have arguably flowed from the introduction of legislation (a whole population approach) and smoking cessation in clinics (a targeted population approach).3 We should consider the use of similar approaches to combat the threat posed by sugar.
Whole population approaches to control sugar consumption such as legislation and partnership with manufacturers have been attempted;4 however, few efforts have been made for a targeted population approach—eg, sugar cessation programmes at the individual level similar to smoking cessation.
Evidence supports the effectiveness of tobacco cessation services delivered via dental health-care practitioners. Tobacco cessation services delivered in public dental clinics have the potential to improve the health and wellbeing of millions of people globally.5 Dentists are well positioned to play an important part in reducing sugar consumption just as they do for smoking cessation.6
Dental caries is one of the earliest consequences of sugar consumption. Dentists have a strategic position to identify risk early in life and take preventive measure. Early detection of high sugar consumption in children is very important; children are the main targets of marketing campaigns for sweet products. Added sugar has found its way into almost all food, and the use of sugar as a means to calm, entertain, or reward children has become normalised, whereas sugar should be an occasional treat.
At the individual level, reducing sugar consumption can be particularly challenging. Estimation of individuals sugar intake can be difficult: food products labelling is often unclear.
Effectiveness, cost-effectiveness, and feasibility of sugar cessation programmes in dental clinics need to be established, and more reasearch is needed. According to the Healthy lives, healthy peoplereport from the Department of Health, if sugar consumption could be reduced by 30% within the next 5 years, the obesity epidemic could be stopped and the benefits for individuals and countries could be enormous. According to the Tackling obesities: future choices projectreport, the obesity epidemic costs the UK £5 billion a year, potentially rising to £50 billion by 2050.8 Therefore, it is crucial to use dentists' strategic position to help controlling sugar consumption as a targeted population approach from early childhood to later in life.

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