Should dentists be more aware of the role of dietary supplements when assessing dental caries risk?

The bodybuilding industry has been expanding since its unofficial birth in 1890. The industry saw an exponential increase in popularity in 1980 with the likes of Arnold Schwarznegger taking to the stage. The global sports nutrition market accounted for 28.37 billion dollars in 2016 and is expected to reach 45.27 billion dollars by 2022, growing at a compound annual growth rate of around 8.1% between 2017 and 2022. Following the recognition of the sport by the International Olympic Committee in 1997, bodybuilding competitions became televised and, not surprisingly, the public has been influenced by this sport. Behaviours are changing, influenced by urbanization and a growth in fitness centres. Individuals want to improve the way they look and are influenced by advertising and social media.

What does this mean for the dental profession? The WHO has issued guidelines that recommend intake of free sugars should provide ≤10% of energy intake, and suggest further reductions to <5% of energy to protect dental health throughout life.¹ A systematic review showed that lower dental caries was found when free sugar intake was <5% of energy.¹ According to the Dietary Supplement Health and Education Act 1994, dietary supplements are defined as ‘products that are designed to be taken by mouth’. Any substance that enters the mouth will react with enzymes in saliva, changing the environment in the oral cavity and therefore have the potential to cause dental caries.