Frequent Sugar Intake Tied to Progression of Dentin Shadow Lesions Over 5 Years

Posted: November 13, 2026

Frequent Sugar Intake Tied to Progression of Dentin Shadow Lesions Over 5 Years

Edited by Hygienetown staff

About one in three occlusal underlying dentin shadow lesions found in adolescents progressed over five years, and frequent sugary food consumption was tied to higher odds of progression, according to a population-based cohort study published Nov. 7 in Caries Research.

Researchers examined 1,197 adolescents aged 15 to 19 in a school-based survey in southern Brazil in 2018 and re-evaluated 570 of them after a mean of five years, between 2022 and 2024. The analysis included 49 participants with 66 occlusal underlying dentin shadows, classified as ICDAS 4 lesions, at baseline.

Progression was defined as a restoration, dentin cavitation, or tooth loss at follow-up. Twenty-four of the 66 lesions, or 36.4%, progressed.

Participants who ate sugary foods more than twice a day had higher odds of lesion progression, with an adjusted odds ratio of 4.68 (95% CI, 1.36–16.07; P = .01).

Questionnaires captured toothbrushing frequency and sugar consumption. Clinical examinations at both time points used visual-tactile criteria under standardized conditions.

The authors concluded that the lesions showed a moderate progression rate over five years and that the sugar finding reinforces the importance of promoting healthy dietary habits among adolescents and young adults.

Bianca Schlesener Dettmer, Patricia Kolling Marquezan, and colleagues conducted the study. Because the analysis included 66 lesions, the confidence interval around the sugar finding was wide.

Sources:
Caries Research, “Progression of underlying dentin shadows (ICDAS 4 caries lesions) in young adults: a 5-year cohort study,” published online Nov. 7, 2026:
doi.org/10.1159/cre/abuag020
PubMed, PMID 42998264:
pubmed.ncbi.nlm.nih.gov/42998264


Frequent Sugar Intake Tied to Progression of Dentin Shadow Lesions Over 5 Years

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