How the Sugar Industry Influenced Dental Research

Newly uncovered “sugar papers” reveal that the sugar lobby played a major role in 1970s dental public health policies


Tooth decay is the most prevalent chronic disease among children in the United States, and one of the ways to prevent it is by reducing sugar intake. Now a new report shows that the sugar industry had a hand in developing federal guidelines about sugar intake and cavities—and that the industry managed to keep the National Institutes of Health from studying the effect of sugar on cavities in the 1970s.

Cristin Kearns, a public health dentist, first became interested in the role of the sugar industry in federal research when she reviewed a pamphlet on diabetes prevention that didn’t mention sugar, reports Francie Diep for Pacific Standard. So she started hunting for documents from the sugar cane and beet sugar industries, eventually uncovering a cache of 319 internal documents.

What she found is being compared to the Cigarette Papers that uncovered the tobacco industry’s attempt to shield the public from the health consequences of its products. Kearns and her team analyzed the documents and found that as early as 1950, the sugar trade industry knew that sugar causes tooth decay.

This led to a deflective strategy on multiple fronts. The sugar industry managed to insert itself into National Institute of Dental Research (NIDR) panels on tooth decay. (In one notable case, a panel overlapped the sugar industry’s own expert panel by all but one member.) They built relationships with NIDR officials and began to fund research into a tooth decay vaccine and enzymes aimed at breaking up dental plaque.

But the industry didn’t stop with deflecting attention from sugar’s link to dental health. Instead, they worked directly with the NIH to set research priorities that favored the sugar industry—at one point, the NIH incorporated 78 percent of sugar industry research priorities into its own request for research proposals. And in 1969, the NIDR downplayed sugar consumption in a statement that all but abandoned any attempts to research a sugar-cavity connection. In a PLOS Medicine paper, Kearns and her colleagues pull one damning quote:

One could say, on logical grounds and good evidence, that if we could eliminate the consumption of sucrose, we could eliminate the problem—because we would be denying these pathogens their primary source of nutrient. We are realists, however, and we recognize the value of sucrose to nutrition. So while it is theoretically possible to take this approach to demonstrate it, and it has been demonstrated certainly in animal models, it is not practical as a public health measure.

Kearns sees the sugar industry’s interference in public health research as a “missed opportunity” for science. “The dental community has always known that preventing tooth decay required restricting sugar intake,” she said in a release. “It was disappointing to learn that the policies we are debating today could have been addressed more than forty years ago.”

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