The ingestion of drinks by kids has changed in the types and measures ( Marshall et.al, 2003 ) , in such a manner that milk and H2O consumptions have decreased and fruit juices and carbonated soft drinks have increased ( Heller et.al, 1999, cited by Sohn et.al 2006 ) . This alteration is of the involvement of the public wellness concern because it is may be associated to both general wellness diseases e.g. fleshiness and diabetes ( Marshall, 2003 ) , and unwritten wellness diseases e.g. dental cavities and dental eroding ( Tahmassebi e.t.al, 2006 ) .
Sugar ingestion has besides increased in developing states ( Ismail et al. , 1997 ) ; this is besides applied to carbonated soft drinks ingestion in the Sultanate as late reported ( WHO, 2005 ) .
However, the effects of these forms of ingestion of soft drinks on dental cavities have non good studied ( Sohn et al, 2006 ) . Furthermore, it is described that the deductions of soft drinks on dental cavities is weak or non existing ( Froshee and Storey, 2004 ) . Main account for this is that fluoride exposure has weakened this relationship ( Karjalainen, 2007 ) . Consequently, some writers concluded that soft drinks are non serious menace to dental cavities, and the schemes to cut down dental cavities should be based on good unwritten hygiene and the usage of fluoridated toothpastes ( Froshee and Storey, 2004 ) .
Although dental cavities is worsening in developed states, the state of affairs is non the same in developing states ( Moynihan and Petersen, 2004 ) . Sultanate of Oman is a underdeveloped state, and the three national studies of the prevalence of dental cavities in schoolchildren in Oman are in consistent with this construct ( Alismaily et al. 1996 ; Alisamaily e.t.al, 1997, Alismaily et al, 2004 ) . And the prevalence is expected to increase in this state ( MOH, 2010 ) .
The school preventative unwritten wellness programme didn & A ; acirc ; ˆ™t discourse the issue of high ingestion of carbonated soft drinks to increase the consciousness among the wellness attention workers in the school particularly the dental squad and the pupils. This is besides applied to the dietetic guidelines in Oman, although they recognised the issue of carbonated soft drinks but there are no guidelines to understate the effects of these drinks other than urging cut downing the ingestion of sugary drinks.
Against this background to develop unwritten wellness publicity programmes to cut down dental cavities prevalence in this group of the population and related to soft drinks ingestion should be based on grounds based relationship between dental cavities and the ingestion of soft drinks.
soft drinks and public wellness
The addition in the ingestion of soft drinks raises the concern of public wellness as it may be related to both general wellness e.g. fleshiness, and unwritten wellness e.g. dental cavities and dental eroding.
1.1.1soft drinks and fleshiness
The rate of fleshiness is associated with overconsumption of soft drinks ( Marshall et al, 2003 ) . This is because of the addition in energy consumption which is related to soft drink ingestion ( Guthrie and Morton, 2001cited by Shenkin et al. , 2002 ) . Obesity is a chief public wellness involvement as it is linked to chronic disease e.g. cardiovascular diseases and diabetes type2, which are historically associated to old age but now are being seen often in kids and stripling ( Shenkin et al. , 2002 ) .
1.1.2. Soft drinks and dental eroding
Dental eroding is the loss of the difficult tissue of the tooth without engagement of bacteriums ( Barbour et al. , 2008 ) . The demineralization of enamel occurs when the PH falls below the critical value 5.5, thereby a drink or a nutrient of PH lower than 5.5 may do eroding ( Moynihan and Petersen, 2004 ) . There is grounds of prevalence increasing of dental eroding in industerlised states, and this is related to increase in tendency of acidic drinks ingestion ( Moynihan and Petersen, 2004 ) .
1.1.3 Soft drinks and dental cavities
Dental cavities is the loss of tooth tissue mediated by bacteriums. It is a multifatorial disease, where the bacterium in unwritten pit ( streptococcus Mutans ) ferments the saccharides ( sucrose and fructose ) this produces acid which lowers unwritten PH below 5.5 and demineralises the tooth construction ( Marshall et al. , 2002 ) .
Soft drinks are rendered cariogenic because they contain high sum of saccharose and fruit sugar, there are 10 spoons of these sugars in one 12 ounce can of sugary sodium carbonate ( Shenkin et al. , 2002 ) . Another factor is its acidogenicity, most of these merchandises have PH below the threshold degree of 5.5, their PH in the scope of 2.5-3.5 ( Milosevic, 1997 cited by Shenkin et al. , 2002 ) , and this may do dental cavities and dental eroding ( Shenkin et al. , 2002 ) .
Although sugar is an aetiologic factor of dental cavities but the extent of its consequence is besides determined by other factors these are ; frequence and sum of consumption, exposure to fluoride either locally e.g. toothpaste, or consistently by H2O fluoridization, and besides the degree of bacteriums ( Shenkin et al. , 2002 ) .
In a systematic reappraisal by Burt and Pai to measure the association between sugar ingestion and cavities risk they found that two surveies out of 36 have strong relation between these two factors whereas the remainder either moderate or no association ( Burt and Pai, 2001 ) . And sing the association between soft drinks ingestion and dental cavities there is incompatibility in the consequences and the relation is less recognized ( Marshall, 2003 ) . This led some writers to urge that the scheme of dental cavities bar should be based on bettering unwritten hygiene than sugar limitation ( Gibson and Williams, 1999 ; Froshee and Storey, 2004 ) .
The tendency of Soft drink ingestion in developed states and in Oman
In USA there is an addition in the ingestion of soft drinks in schools in the last 30 old ages and there is a diminution in dairy ingestion ( Shenkin et al. , 2002 ) . A scope of 56 % -85 % of schoolchildren consume 1 soft drink daily at least ( commission on School Health, 2004 ) .
In Oman the tendency of Soft drink ingestion is besides increasing. International Marketing Economic Service ( IMES ) reported that the ingestion of soft drinks in Oman has increased between 2001 and 2005, in 2005 the market was around US $ 87 million, and the most popular carbonated soft drink was Mountain Dew ( IMES Consulting, 2006 ) . Among school age kids, it was identified by Global School Survey ( GSHS ) in 2004 that 33.4 % of the Omani pupils drink carbonated soft drinks which are specifically Coke, Pepsi, and Mountain Dew two or more times per a twenty-four hours in the last 30 yearss. Actually this was one of the most alarming behaviours found in this questionnaire, and it recommended the execution of national scheme to better the school community & A ; acirc ; ˆ™s wellness ( WHO, 2005 ) .
Table1. Trend of soft drink ingestion in Oman. Source ( IMES, 2006 ) .
The belongingss of carbonated soft drinks in Oman
In a survey done by me in 2000 as an undergraduate pupil in the signifier of Summer Project the belongingss of common drinks in two metropoliss from two states ; Cork metropolis in Republic of Ireland and Jalaan metropolis in Sultanate of Oman related to dental wellness are analysed, and these are the PH and fluoride content ( DOHC, non mentioned ) . The PH and the fluoride content of the common carbonated soft drinks in jalaan metropolis from Oman are summarised in table2.
Carbonated soft drinks
Fluoride ( ppm )
Everves Club Soda
Table.2. PH and fluoride degree of carbonated soft drinks in Jalaan metropolis ( beginning DOHC )
We can see these samples are representative of the hall state as there are merely three local manufacturers and one importer of carbonates in Oman and each manufacturer is for different trade names e.g. Cola and Pepsi trade names ( IMES confer withing, 2006 ) . The mean PH for the carbonated soft drinks was 3.23 which is below the critical value 5.5 as we mentioned earlier which render these drinks as potentially cariogenic and erosive. The mean fluoride degree was 0.25 ppm ; this is below the populace fluoridated H2O in Oman which is 0.5ppm ( Alismaily et al, 2004 ) . Unfortunately there is no information sing the ingestion of bottled H2O in schoolchildren, and if the form that carbonated soft drinks is replacing the usage of bottled H2O so the exposure to fluoride is less than the optimum preventative degree and this will increase the prevalence of dental cavities.
The tendency of dental cavities
Although there is an addition in the ingestion of soft drinks in developed states the prevalence of dental cavities is worsening in the last 30 old ages in these states, and it is increasing in developing states ( Moynihan and Petersen, 2004 ) . This is attributed to the exposure of fluoride ( Karjalainen, 2007 ) .
The tendency of dental cavities in Oman
There were three national studies conducted in Oman to find the prevalence of dental cavities in three group school kids. The prevalence was 84.5 % in 6 old ages old kids ( Alisamaily e.t.al, 1997 ) , and it was 58 % in 12 old ages kids ( Alismaily e.t.al, 1996 ) . When the same cohort was examined three old ages subsequently the prevalence increased to 69 % ( Alismaily et al, 2004 ) . The Mean DMFT has risen from 1.5 to 3.2, and those who were cavities free fallen from 42 % to 27 % ( Alismaily et al, 2004 ) .Actually these figures are alarming if we put in our head that about 35.3 % of the Omani population are under 15 old ages of age ( MOH, 2008 ) so the prevalence of dental cavities is high in the tierce of the population. These studies besides expect the prevalence is on the rise ( MOH, 2010 ) . And since the 2nd study there was a call for the development of preventative unwritten wellness plan ( Alisamaily e.t.al, 1997 ) .
Although the tendency of the prevalence of dental cavities can be recognized in these three studies, the determiners of dental cavities in these age groups e.g. the dietetic wonts of sugar consumption are non determined yet there is an addition of ingestion of carbonated soft drinks. These factors are of import to develop a preventative scheme for dental cavities.
The consequence of dental cavities on quality of life
One of the most common chronic diseases in kids is dental cavities and it can impact school attending ( Marshall et al, 2003 ) . In all over the universe, kids with dental cavities might acquire apprehensiveness from others because of their visual aspect, anxiousness and hurting, malnutrition because eating diet with low fruit, and early loss of the tooth ( Moynihan and Petersen, 2004 ) . For these grounds it is of import to cut down the prevalence of dental diseases in Oman as it is besides a preventable disease.
The current dietetic guidelines in Oman sing dental cavities and soft drinks
The hazard factors presented in the dietetic guidelines which are associated with dental cavities are the sum and frequence of free sugar consumption and undernutrition, and those which are associated with cut downing dental cavities are fluoride exposure, difficult cheese and masticating gum ( MOH, non mentioned ) . Actually these factors are taken from WHO study of Diet, Nutrition and Prevention of Chronic diseases on 2003 ( WHO,2003 ) , nevertheless carbonated soft drinks are non specifically associated with dental cavities in the guideline nor even the best ways to cut down its effects have been discussed ( MOH, non mentioned ) .
Furthermore the Manual Guidelines for Preventive School Oral Health Programme which was developed in 2005 in Oman didn & A ; acirc ; ˆ™t discourse the issue of soft drinks and its impact on dental wellness, and this including besides the unwritten wellness instruction programme in schools ( MOH, 2005 ) .
Review the association between the ingestion of carbonated soft drinks and dental cavities experience among schoolchildren.
Develop unwritten wellness recommendations related to soft drinks ingestion for kids ( in schools ) in Sultanate of Oman.
Conduct a literature reappraisal to measure the relationship between ingestion of carbonated soft drinks and dental cavities experience among schoolchildren. And finding the factors that minimise or cut down the cariogenic consequence of carbonated soft drinks.
Review the grounds base on the bing wellness publicity recommendations for carbonated soft drink ingestion among schoolchildren.
Make recommendations for the ingestion of soft drinks by schoolchildren in Oman.