Data from a longitudinal, observational study of diet and dental caries were analysed to assess the relative cariogenicity of starch and sugars. The correlation between 2-year DMFS caries increment and weight of daily intake of sugars was positive and statistically significant, while the corresponding correlation for starch was weakly negative after controlling for confounding variables. The difference in the possible relative cariogenicity of starch and sugars occurred, however, almost entirely in fissure surfaces and was not observed in approximal surfaces. Children (n = 27) with high starch/low sugars intake had lower caries increments than children (n = 32) with low starch/ high sugars intake, but these differences were not statistically significant. The high-starch/low-sugars eaters consumed more energy but ate less frequently than the low-starch/high-sugars eaters. However, partial correlation analyses revealed that differences in frequency of eating could not explain the trend towards a stronger relation between sugar intake and caries than between starch intake and caries development.

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