The strengths of the study include our finding that on
re-evaluating the dose-response relationship between
sugar and caries, we found that the sugar-caries relationship
is in arithmetic terms, curvilinear and not sigmoidal
and is evident at average sugar intakes well below 10%E.
Extensive searches of the historical, as well as current literature
on sugars and caries were carried out. The limitations
of the study related to the absence of defined
valid data on the dose-response relationship of adult caries
when sugar intakes change. Therefore our findings
depend on data from children together with longitudinal
data on an annual basis into the fourth decade of life.
However, they are reinforced by the findings of the heavy
burden of dental caries in adults evident despite the widescale
uses of fluorides, so caries progressively increases
with age when sugar intake levels are those commonly
consumed throughout the world.