March 2022

Background: In recent years, the consumption of sugar sweetened beverages has been declining, while low calorie sweetener and diet beverage consumption is increasing. Evidence about the effect of diet drinks on dental caries is insufficient, and has not accounted for the complexity of beverage consumption patterns. Therefore, the aim of this study is to examine the association between consuming diet drinks and dental caries among US adults. Methods: We analyzed 2011-2014 NHANES dietary data of adults using cluster analysis, with individuals grouped based on their beverage consumption. Clusters were identified based on the R-square statistic and the local peak of the pseudo F statistic. Survey procedure and sample weights were used to account for the complex NHANES sampling design. Results: Four beverage consumption patterns were identified: “high soda”, “high diet drinks”, “high coffee/tea” and “high water”. The “High soda” cluster was the only one associated with higher DMFT after controlling for confounders (β=1.02, 95% CI=0.42 - 1.63), whereas DT was associated with “high soda” (β=0.45, 95% CI=0.25 - 0.64) and “high coffee/tea” (β=0.24, 95% CI=0.01 - 0.47). On the other hand, the “high diet drinks” cluster was neither associated with DMFT (β=0.69, 95% CI=0.51 - -0.35) nor DT (β=0.07, 95% CI=-0.21 0.35). Conclusion: Diet drinks consumption may not be associated with increased risk of dental caries. However, more studies should be conducted in order to confirm this finding. Keywords: Soft drinks, beverages, decay, tooth demineralization, low calorie sweetener, artificially sweetened drinks