Priority 16 from the Oral and Dental Health PSP

UNCERTAINTY: How can people be encouraged to reduce sugar consumption for oral and general health? (JLA PSP Priority 16)
Overall ranking 16
JLA question ID 0079/16
Explanatory note

Not available for this PSP
Evidence

Most of the studies about reducing sugar intake focus on reducing children obesity and sugar sweetened beverages (SSBs). Interventions can be categorised into the following three groups:

Health education and promotion
The effectiveness of educational and behaviours interventions is modest. There is evidence to suggest demonstrating children the desired behaviour can reduce SSBs intake but the effect is amongst adolescents and adults is less prominent. The application of Knowledge-Attitude-Behaviour model for understanding sugar is limited as sugar intake behaviour is shaped by multiple factors and knowledge and attitude are only two of them. 
Oral health professionals are in a unique position to reduce SSBs consumption. Further studies are needed to identify effective techniques that can be integrated into preventive patient care.

Changes of the food environment in a particular setting
There is contradictory evidence on the impact of the context of the research, e.g. home or school settings, and the success of the interventions. Some studies also suggest a potential beneficial effect when SSBs are replaced by water or low-calorie beverages.

Taxation
There is moderate quality evidence to suggest sugar tax may potentially reduce sugar consumption in the short-term but is an insufficient tool on its own as its effectiveness is context specific and its long term effectiveness is unknown.

For full details of the evidence checked, please see the spreadsheet of data held on the JLA website.
Health Research Classification System category  Oral and gastrointestinal
Extra information provided by this PSP
Original uncertainty examples The original questions covered the prevalence of sugar in our diet. How can awareness be raised of the ill effects of sugar on dental (and general) health in all age groups? Why is there not more pressure on food and beverage manufacturers to provide transparency on the sugar content of their products? What other means exists to curtail the presence of high sugar products in our day-to-day environments, or does society's acceptance thereof have direct bearing on the rate of progress in improving oral healthcare in children? On a small scale, how can unhealthy snacking between meals be discouraged, can chewing sugar free gum help to maintain healthy teeth?
Submitted by  5 x patients, carers or members of public ,  4 x health professionals
PSP information
PSP unique ID 0079
PSP name Oral and Dental Health
Total number of uncertainties identified by this PSP 38  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 12 December 2018