Effect of sugar-sweetened beverage taxation on sugars intake and dental caries: an umbrella review of a global perspective. 2023

Maryam Hajishafiee, and Kostas Kapellas, and Stefan Listl, and Madhuri Pattamatta, and Athanasios Gkekas, and Paula Moynihan
Adelaide Dental School, The University of Adelaide, Adelaide, Australia.

As part of the Global Strategy on Oral health, the World Health Organization (WHO) is exploring cost-effective interventions for oral health, including taxation on sugar-sweetened beverages (SSBs). To inform this process, this umbrella review aimed to identify the best available estimates pertaining to the impact of SSB taxation on the reduction of sugars intake, and the sugars-caries dose-response, such that estimates of the impact of SSB taxation on averting dental caries in both high (HIC) and low and middle (LMIC) countries be available. The questions addressed were: (1) what are the effects of SSB taxation on consumption of SSBs and (2) sugars? (3) What is the effect on caries of decreasing sugars? and (4) what is the likely impact of a 20% volumetric SSB tax on the number of active caries prevented over 10 years? Data sources included PubMed, Embase, Web of Science, Scopus, CINAHL, Dentistry and Oral Sciences Source, Cochrane Library, Joanna Briggs Institute (JBI) Systematic Review Register, and PROSPERO. The review was conducted with reference to JBI guidelines. The quality of included systematic reviews was assessed using AMSTAR to identify best evidence. From 419 systematic reviews identified for questions 1 & 2, and 103 for question 3, 48 (Questions 1 & 2) and 21 (Question 3) underwent full text screening, yielding 14 and five included reviews respectively. Best available data indicated a 10% tax would reduce SSB intake by 10.0% (95% CI: -5.0, 14.7%) in HIC and by 9% (range -6.0 to 12.0%) in LMIC, and that a 20% tax would reduce free sugars intake on average by 4.0 g/d in LMIC and 4.4 g/d in HIC. Based on best available dose response data, this could reduce the number of teeth with caries per adults (HIC and LMIC) by 0.03 and caries occurrence in children by 2.7% (LMIC) and 2.9% (HIC), over a 10-year period. Best available data suggest a 20% volumetric SSB tax would have a modest impact on prevalence and severity of dental caries in both HIC and LMIC.

UI MeSH Term Description Entries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000073893 Sugars Short chain carbohydrate molecules that have hydroxyl groups attached to each carbon atom unit with the exception of one carbon that has a doubly-bond aldehyde or ketone oxygen. Cyclical sugar molecules are formed when the aldehyde or ketone groups respectively form a hemiacetal or hemiketal bond with one of the hydroxyl carbons. The three dimensional structure of the sugar molecule occurs in a vast array of biological and synthetic classes of specialized compounds including AMINO SUGARS; CARBASUGARS; DEOXY SUGARS; SUGAR ACIDS; SUGAR ALCOHOLS; and SUGAR PHOSPHATES. Sugar
D000080845 Sugar-Sweetened Beverages Liquids or drinks sweetened with added sugars of various forms. Sugar Sweetened Beverage,Sugar-Added Beverage,Sugar-Added Beverages,Sugar-Sweetened Soda,Sugar-Sweetened Sodas,Sugar-Sweetened Soft Drink,Sugar-Sweetened Soft Drinks,Sweetened Beverage,Sweetened Beverages,Sweetened Drink,Sweetened Drinks,Beverage, Sugar Sweetened,Beverage, Sugar-Added,Beverage, Sugar-Sweetened,Beverage, Sweetened,Beverages, Sugar Sweetened,Beverages, Sugar-Added,Beverages, Sugar-Sweetened,Beverages, Sweetened,Drink, Sugar-Sweetened Soft,Drink, Sweetened,Drinks, Sugar-Sweetened Soft,Drinks, Sweetened,Soda, Sugar-Sweetened,Sodas, Sugar-Sweetened,Soft Drink, Sugar-Sweetened,Soft Drinks, Sugar-Sweetened,Sugar Added Beverage,Sugar Added Beverages,Sugar Sweetened Beverages,Sugar Sweetened Soda,Sugar Sweetened Sodas,Sugar Sweetened Soft Drink,Sugar Sweetened Soft Drinks,Sugar-Sweetened Beverage,Sweetened Beverage, Sugar,Sweetened Beverages, Sugar
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001628 Beverages Liquids that are suitable for drinking. (From Merriam Webster Collegiate Dictionary, 10th ed) Beverage
D013660 Taxes Governmental levies on property, inheritance, gifts, etc. Institutional Tax,Institutional Taxes,Tax,Taxation,Tax, Institutional,Taxes, Institutional

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