In January 2014, taxes on sugar-sweetened beverages and nonessential energy-dense food were implemented in Mexico to discourage the consumption of these products. Published evaluations have shown reductions in purchases of taxed food and beverages associated with the implementation of this fiscal policy. Although there are some studies on the impact on health based on simulation studies, no evaluations with empirical data on changes in oral health have been published. We used administrative records and data from an epidemiological surveillance system to estimate changes in (1) outpatient visits related to dental caries; (2) having experienced dental caries: Decayed, Missing and Filled Teeth (DMFT) >0 for permanent dentition or dmft >0 for primary dentition (dmft); (3) number of teeth with caries experience (DMFT and dmft), (4) cases with DMFT >0 or dmft >0, and (5) the series of mean DMFT or dmft, associated with the taxes. We estimated probit and negative binomial models for outcomes at individual level, and interrupted time series analysis for population-level outcomes. The implementation of the taxes was associated with negative changes in the trends of outpatient visits, as well as for cases with DMFT >0, dmft >0 and mean DMFT. Taxes were also associated with a lower probability of having experienced dental caries and with a lower number of teeth with caries experience in the samples studied. Our results suggest positive impacts of the implementation of taxes on unhealthy food and beverages in the oral health of Mexicans, which are the first health benefits observed, and add to the health benefits predicted by modeling studies.

1.
Andrade
M
,
De la Cruz
D
.
Indicadores de prevalencia y de predicción de riesgo de caries dental
.
VERTIENTES Rev Espec En Cienc Salud
.
2014
;
17
:
61
72
.
2.
Barrientos-Gutierrez
T
,
Zepeda-Tello
R
,
Rodrigues
ER
,
Colchero
MA
,
Rojas-Martínez
R
,
Lazcano-Ponce
E
, et al.
Expected population weight and diabetes impact of the 1-peso-per-litre tax to sugar sweetened beverages in Mexico
.
PLoS One
.
2017
May
;
12
(
5
):
e0176336
.
[PubMed]
1932-6203
3.
Basu
S
,
Jacobs
LM
,
Epel
E
,
Schillinger
D
,
Schmidt
L
.
Cost-Effectiveness Of A Workplace Ban On Sugar-Sweetened Beverage Sales: A Microsimulation Model
.
Health Aff (Millwood)
.
2020
Jul
;
39
(
7
):
1140
8
.
[PubMed]
0278-2715
4.
Basu
S
,
McKee
M
,
Galea
G
,
Stuckler
D
.
Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries
.
Am J Public Health
.
2013
Nov
;
103
(
11
):
2071
7
.
[PubMed]
0090-0036
5.
Batis
C
,
Rivera
JA
,
Popkin
BM
,
Taillie
LS
.
First-Year Evaluation of Mexico’s Tax on Nonessential Energy-Dense Foods: An Observational Study
.
PLoS Med
.
2016
Jul
;
13
(
7
):
e1002057
.
[PubMed]
1549-1277
6.
Baum
CF
,
Schaffer
ME
. actest: Stata module to perform Cumby-Huizinga general test for autocorrelation in time series. Statistical Software Components S457668 [Internet]. Dep Econ Boston Coll
2013
;Available from: http://ideas.repec.org/c/boc/bocode/s457668.html
7.
Bernabé
E
,
Sheiham
A
.
Age, period and cohort trends in caries of permanent teeth in four developed countries
.
Am J Public Health
.
2014
Jul
;
104
(
7
):
e115
21
.
[PubMed]
0090-0036
8.
Bernabé
E
,
Vehkalahti
MM
,
Sheiham
A
,
Lundqvist
A
,
Suominen
AL
.
The Shape of the Dose-Response Relationship between Sugars and Caries in Adults
.
J Dent Res
.
2016
Feb
;
95
(
2
):
167
72
.
[PubMed]
0022-0345
9.
Briggs
AD
,
Mytton
OT
,
Kehlbacher
A
,
Tiffin
R
,
Elhussein
A
,
Rayner
M
, et al.
Health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study
.
Lancet Public Health
.
2016
Dec
;
2
(
1
):
e15
22
.
[PubMed]
2468-2667
10.
Burt
BA
,
Pai
S
.
Sugar consumption and caries risk: a systematic review
.
J Dent Educ
.
2001
Oct
;
65
(
10
):
1017
23
.
[PubMed]
0022-0337
11.
Burt
BA
,
Eklund
SA
,
Morgan
KJ
,
Larkin
FE
,
Guire
KE
,
Brown
LO
, et al.
The effects of sugars intake and frequency of ingestion on dental caries increment in a three-year longitudinal study
.
J Dent Res
.
1988
Nov
;
67
(
11
):
1422
9
.
[PubMed]
0022-0345
12.
Chu
CH
,
Ho
PL
,
Lo
EC
.
Oral health status and behaviours of preschool children in Hong Kong
.
BMC Public Health
.
2012
Sep
;
12
(
1
):
767
.
[PubMed]
1471-2458
13.
Colchero
MA
,
Contreras-Loya
D
,
Lopez-Gatell
H
,
González de Cosío
T
.
The costs of inadequate breastfeeding of infants in Mexico
.
Am J Clin Nutr
.
2015
Mar
;
101
(
3
):
579
86
.
[PubMed]
0002-9165
14.
Colchero
MA
,
Popkin
BM
,
Rivera
JA
,
Ng
SW
.
Beverage purchases from stores in Mexico under the excise tax on sugar sweetened beverages: observational study
.
BMJ
.
2016
Jan
;
352
:
h6704
.
[PubMed]
0959-8138
15.
Colchero
MA
,
Rivera
JA
,
Popkin
BM
,
Ng
SW
.
Sustained consumer response: evidence from two-years after implementing the sugar sweetened beverage tax in Mexico
.
Health Aff (Millwood)
.
2017
;
36
:
564
71
.
[PubMed]
0278-2715
16.
Costa
SM
,
Martins
CC
,
Bonfim
ML
,
Zina
LG
,
Paiva
SM
,
Pordeus
IA
, et al.
A systematic review of socioeconomic indicators and dental caries in adults
.
Int J Environ Res Public Health
.
2012
Oct
;
9
(
10
):
3540
74
.
[PubMed]
1661-7827
17.
Cumby
RE
,
Huizinga
J
.
Testing the Autocorrelation Structure of Disturbances in Ordinary Least Squares and Instrumental Variables Regressions
.
Econometrica
.
1992
;
60
(
1
):
185
95
. 0012-9682
18.
Executive Board 120: Oral health: action plan for promotion and integrated disease prevention [Internet], Geneva, World Health Organization,
2006
.Available from: https://apps.who.int/iris/handle/10665/21909
19.
Fraihat
N
,
Madae’en
S
,
Bencze
Z
,
Herczeg
A
,
Varga
O
.
Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis
.
Int J Environ Res Public Health
.
2019
Jul
;
16
(
15
):
E2668
.
[PubMed]
1661-7827
20.
Greene
JC
,
Vermillion
JR
.
The Simplified Oral Hygiene Index
.
J Am Dent Assoc
.
1964
Jan
;
68
(
1
):
7
13
.
[PubMed]
0002-8177
21.
Hernández-F
M
,
Batis
C
,
Rivera
JA
,
Colchero
MA
.
Reduction in purchases of energy-dense nutrient-poor foods in Mexico associated with the introduction of a tax in 2014
.
Prev Med
.
2019
Jan
;
118
:
16
22
.
[PubMed]
0091-7435
22.
Holt
RD
.
Foods and drinks at four daily time intervals in a group of young children
.
Br Dent J
.
1991
Feb
;
170
(
4
):
137
43
.
[PubMed]
0007-0610
23.
International Conference on Primary Health Care. Alma-Ata.USSR,
1978
.
24.
Irigoyen
ME
,
Mejía-González
A
,
Zepeda-Zepeda
MA
,
Betancourt-Linares
A
,
Lezana-Fernández
,
Álvarez-Lucas
CH
.
Dental caries in Mexican schoolchildren: a comparison of 1988-1989 and 1998-2001 surveys
.
Med Oral Patol Oral Cir Bucal
.
2012
Sep
;
17
(
5
):
e825
32
.
[PubMed]
1698-4447
25.
Irigoyen
ME
,
Sánchez-Hinojosa
G
.
Changes in dental caries prevalence in 12-year-old students in the State of Mexico after 9 years of salt fluoridation
.
Caries Res
.
2000
Jul-Aug
;
34
(
4
):
303
7
.
[PubMed]
0008-6568
26.
Jamel
H
,
Plasschaert
A
,
Sheiham
A
.
Dental caries experience and availability of sugars in Iraqi children before and after the United Nations sanctions
.
Int Dent J
.
2004
Feb
;
54
(
1
):
21
5
.
[PubMed]
0020-6539
27.
Jevdjevic
M
,
Trescher
AL
,
Rovers
M
,
Listl
S
.
The caries-related cost and effects of a tax on sugar-sweetened beverages
.
Public Health
.
2019
Apr
;
169
:
125
32
.
[PubMed]
0033-3506
28.
Jevdjevic
M
,
Wijn
SR
,
Trescher
AL
,
Nair
R
,
Rovers
M
,
Listl
S
.
Front-of-Package Food Labeling to Reduce Caries: economic Evaluation
.
J Dent Res
.
2020
Dec
;
•••
:
22034520979147
.
[PubMed]
1544-0591
29.
Lee
JG
,
Brearley Messer
LJ
.
Contemporary fluid intake and dental caries in Australian children
.
Aust Dent J
.
2011
Jun
;
56
(
2
):
122
31
.
[PubMed]
0045-0421
30.
Linden
A
.
Conducting interrupted time-series analysis for single- and multiple-group comparisons
.
Stata J
.
2015
;
15
(
2
):
480
500
. 1536-867X
31.
Listl
S
,
Jürges
H
,
Watt
RG
.
Causal inference from observational data
.
Community Dent Oral Epidemiol
.
2016
Oct
;
44
(
5
):
409
15
.
[PubMed]
0301-5661
32.
Lopez J, Cummins S, Gasparrini A: Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2016;46:348–55.
33.
Martínez-Mier
EA
,
Soto-Rojas
AE
,
Ureña-Cirett
JL
,
Stookey
GK
,
Dunipace
AJ
.
Fluoride intake from foods, beverages and dentifrice by children in Mexico
.
Community Dent Oral Epidemiol
.
2003
Jun
;
31
(
3
):
221
30
.
[PubMed]
0301-5661
34.
Martinez-Mier
EA
,
Zandona
AF
.
The impact of gender on caries prevalence and risk assessment
.
Dent Clin North Am
.
2013
Apr
;
57
(
2
):
301
15
.
[PubMed]
0011-8532
35.
Pan American Health Organization
. Ultra-processed food and drink products in Latin America: Sales, sources, nutrient profiles, and policy implications, Washington, D.C.,
2019
.
36.
Petersen
PE
.
The World Oral Health Report 2003: continuous improvement of oral health in the 21st century—the approach of the WHO Global Oral Health Programme
.
Community Dent Oral Epidemiol
.
2003
Dec
;
31
Suppl 1
:
3
23
.
[PubMed]
0301-5661
37.
Popkin
BM
,
Hawkes
C
.
Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses
.
Lancet Diabetes Endocrinol
.
2016
Feb
;
4
(
2
):
174
86
.
[PubMed]
2213-8587
38.
Preisser
JS
,
Stamm
JW
,
Long
DL
,
Kincade
ME
.
Review and recommendations for zero-inflated count regression modeling of dental caries indices in epidemiological studies
.
Caries Res
.
2012
;
46
(
4
):
413
23
.
[PubMed]
0008-6568
39.
Presidencia de la República: Reglamento de Yodatacion y Fluoruracion de la Sal 1981.
40.
Sánchez-Pimienta TG, Batis C, Lutter CK, Rivera JA. Sugar-Sweetened Beverages Are the Main Sources of Added Sugar Intake in the Mexican Population. J Nutr. 2016 Sep;146(9):1888S–96S.
41.
Sánchez-Romero
LM
,
Penko
J
,
Coxson
PG
,
Fernández
A
,
Mason
A
,
Moran
AE
, et al.
Projected Impact of Mexico’s Sugar-Sweetened Beverage Tax Policy on Diabetes and Cardiovascular Disease: A Modeling Study
.
PLoS Med
.
2016
Nov
;
13
(
11
):
e1002158
.
[PubMed]
1549-1277
42.
Schwendicke
F
,
Thomson
WM
,
Broadbent
JM
,
Stolpe
M
.
Effects of Taxing Sugar-Sweetened Beverages on Caries and Treatment Costs
.
J Dent Res
.
2016
Nov
;
95
(
12
):
1327
32
.
[PubMed]
0022-0345
43.
Secretaría de Economía
. MODIFICACIÓN a la Norma Oficial Mexicana NOM-051-SCFI/SSA1-2010, Especificaciones generales de etiquetado para alimentos y bebidas no alcohólicas preenvasados-Información comercial y sanitaria, publicada el 5 de abril de 2010 [Internet],
2020
, [cited 2021 Feb 3].Available from: https://www.dof.gob.mx/nota_detalle.php?codigo=5590668&fecha=27/03/2020
44.
Secretaría de Salud
:
Norma Oficial Mexicana NOM-040-SSA1-1993
,
1995
.
45.
Secretaría de Salud
. Programa de Acción Específico Prevención, Detección y Control de los Problemas de Salud Bucal 2013-2018 [Internet]
2014
[cited 2020 Feb 24];Available from: https://www.gob.mx/salud/documentos/programa-de-accion-especifico-prevencion-deteccion-y-control-de-los-problemas-de-salud-bucal-2013-2018
46.
Secretaría de Salud
.
Sistema de Vigilancia Epidemiológica de Patologías Bucales, 10 años vigilando la salud bucal de los mexicanos
.
Ciudad de México
;
2015
.
47.
Secretaría de Salud
.
Resultados del Sistema de Vigilancia Epidemiológica de Patologías Bucales SIVEPAB 2018
.
Ciudad de México
;
2018
.
48.
Secretaría de Salud
. Servicios SIS [Internet]
2019
[cited 2020 Jan 8]; Available from: http://www.dgis.salud.gob.mx/contenidos/basesdedatos/bdc_serviciossis_gobmx.html
49.
Singh
GM
,
Micha
R
,
Khatibzadeh
S
,
Shi
P
,
Lim
S
,
Andrews
KG
, et al.;
Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCoDE)
.
Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries
.
PLoS One
.
2015
Aug
;
10
(
8
):
e0124845
.
[PubMed]
1932-6203
50.
Sowa
PM
,
Keller
E
,
Stormon
N
,
Lalloo
R
,
Ford
PJ
.
The impact of a sugar-sweetened beverages tax on oral health and costs of dental care in Australia
.
Eur J Public Health
.
2019
Feb
;
29
(
1
):
173
7
.
[PubMed]
1101-1262
51.
STATA Corp
.: Stata Statistical Software: Release 13, STATACorp LP,
2013
.
52.
Stern
D
,
Piernas
C
,
Barquera
S
,
Rivera
JA
,
Popkin
BM
.
Caloric beverages were major sources of energy among children and adults in Mexico, 1999-2012
.
J Nutr
.
2014
Jun
;
144
(
6
):
949
56
.
[PubMed]
0022-3166
53.
The Pennsylvania State University
. Autocorrelation and Time Series Methods | STAT 462 [Internet]. XXX
2018
[cited 2020 Mar 11]; Available from: https://online.stat.psu.edu/stat462/node/188/
54.
Tinanoff
N
,
Palmer
CA
.
Dietary determinants of dental caries and dietary recommendations for preschool children
.
J Public Health Dent
.
2000
;
60
(
3
):
197
206
.
[PubMed]
0022-4006
55.
Urwannachotima
N
,
Hanvoravongchai
P
,
Ansah
JP
,
Prasertsom
P
,
Koh
VR
.
Impact of sugar-sweetened beverage tax on dental caries: a simulation analysis
.
BMC Oral Health
.
2020
Mar
;
20
(
1
):
76
.
[PubMed]
1472-6831
56.
Vos
T
,
Allen
C
,
Arora
M
,
Barber
RM
,
Bhutta
ZA
,
Brown
A
, et al.;
GBD 2015 Disease and Injury Incidence and Prevalence Collaborators
.
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015
.
Lancet
.
2016
Oct
;
388
(
10053
):
1545
602
.
[PubMed]
0140-6736
57.
World Health Organization
.
Oral health surveys: basic methods
. 5th ed.
Geneva
;
2013
.
58.
World Health Organization
. Guideline: Sugars intake for adults and children, Geneva,
2015
.
59.
World Health Organization
:
Sugars and dental caries.
2017
.
60.
World Health Organization / Food and Agriculture Organization
.
Diet, nutrition and the prevention of chronic diseases.
Report of a joint WHO/FAO expert consultation [Internet], Geneva, WHO,
2003
.Available from: http://whqlibdoc.who.int/trs/WHO_TRS_916.pdf
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