Association between water intake and oral health among Korean adolescents according to their sugar-sweetened beverages consumption.

BACKGROUND/OBJECTIVES: Adolescence is a critical period for developing healthy oral habits and preserving permanent teeth, which largely determine oral health throughout life. This study investigated the association between water intake and oral disease-related symptoms among Korean adolescents based on sugar-sweetened beverages (SSB) consumption. SUBJECTS/METHODS: The Korea Youth Risk Behavior Web-based Survey (18th to 20th) was used, and 159,383 adolescents were analyzed in this study. Daily water intake was categorized as ≤ 2, 3-4, or ≥ 5 cups/day whereas SSB consumption was categorized as 0, 1-2, 3-4, or ≥ 5 times/week. Oral disease-related symptoms include tooth fractures, tooth pain during drinking or eating, aching or throbbing toothache, and gingival bleeding. Stratified analyses, adjusted for sociodemographic, health behavior, and dietary behavior variables, were performed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for oral disease-related symptoms according to their daily water intake within each SSB consumption category, using the ≥ 5 cups/day group as a reference. RESULTS: Compared with adolescents with the highest water intake, those with the lowest water intake had higher odds of at least one oral disease-related symptom when they consumed SSB 1-2 times/week (aOR, 1.134; 95% CI, 1.065-1.207; P < 0.001) or 3-4 times/week (aOR, 1.107; 95% CI, 1.044-1.174; P = 0.002). However, no significant differences were observed among those who consumed SSB 0 times/week and ≥ 5 times/week. CONCLUSION: Low water intake was associated with a higher prevalence of at least one oral disease-related symptom among Korean adolescents consuming SSB 1-4 times per week. Further research using objective oral health outcomes (e.g., actual caries treatment) is needed to better clarify the association between water intake, SSB consumption and oral health.