Dental public health implications of novelty sweets consumption in children

Statement of problem: The expansion of the novelty sweets market in the UK has major potential public health implications for children and young adults as they may cause dental erosion, dental caries and obesity. Aims and objective: To investigate the potential dental public health implications of novelty sweet consumption in children. The objectives of this study were to determine the available novelty sweets available to UK consumers, to determine the erosive potential of the most available novelty sweets, to establish the sensory thresholds in children and to determine any potential link between high sensory threshold individuals and their consumption of novelty sweets. Methodology: A list of the most commonly available novelty sweets was created by undertaking scoping visits of shops in the Cardiff area. Children’s use and knowledge of the ten most available novelty sweets were undertaken using focus groups, amongst 11-16 year old children. The focus groups informed the design of a questionnaire. The questionnaire was distributed to 46 children aged 11-16 years during a sensory analysis assessment involving sensory taste thresholds for sweet and sour, assessed using the intensity ranking method. The pH of the ten most available novelty sweets was assessed using an electronic pH meter; the neutralisable acidity was measured by titration against 0.1M sodium hydroxide; an erosion test was conducted on human teeth using a surfometer; contact angles were measured using a Dynamic Contact Angle Analyser; the viscosity was measured using a rotational viscometer and sugar content of the sweets was measured using a refractometer. Results: A wide range of novelty sweets were available, accessible to children in 73% of shops with an average price of 96p. The children were all familiar with novelty sweets, they reported buying and consuming them regularly. The majority of children (65%) required higher amounts of sugar and citric acid than the absolute taste threshold to recognise the sweet and sour tastes. There was an inverse relationship between the preference of the novelty sweets and perception of sweet and sour sensory thresholds (p<0.05). The pH of eight of the ten novelty sweets was significantly lower than the orange juice (p<0.05). The neutralisable acidity of seven of the sweets was significantly higher than the orange juice (p<0.05). The erosive potential of six novelty sweets was significantly higher than the erosive potential of the orange juice (p<0.05). Delayed ultrasonication by 1 h, reduced the amount of subsurface enamel loss by 0.52-1. 45μm in presence of saliva. Some of the acidic solutions had low contact angles, lower viscosity and higher sugar content than orange juice. Conclusions: A wide range of acidic and free sugar sweetened novelty sweets were easily accessible and affordable to children. Children reported consuming these sweets regularly. The high sensory taste thresholds perception for sweet and sour in children may potentially affect their consumption of novelty sweets. Those personnel involved in delivering dental and wider health education or health promotion need to be aware of and able to advise on current trends in sweet confectionary. The potential effects of these novelty sweets on both general and dental health require further investigation.