Article Data

  • Views 194
  • Dowloads 104

Original Research

Open Access

Influence of the consumption of sugary drinks and sleep duration on the association of Internet use and dental caries among 12–19 years old adolescents in Xiamen city, China

  • Mengyang Gao1,†
  • Jiacheng Lin1,†
  • Yanfang Jiang2
  • Guimei Liu1
  • Yangjingling Hua2
  • Zhongrui Peng1
  • Manqi Zhou2
  • Huarong Hong2,*,
  • Lei Li1,*,

1State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, Department of Preventive Medicine, School of Public Health, Xiamen University, 361102 Xiamen, Fujian, China

2Xiamen Center for Disease Control and Prevention, 361021 Xiamen, Fujian, China

DOI: 10.22514/jocpd.2026.021 Vol.50,Issue 1,January 2026 pp.215-223

Submitted: 25 November 2024 Accepted: 21 August 2025

Published: 03 January 2026

*Corresponding Author(s): Huarong Hong E-mail: honghuar@sina.com
*Corresponding Author(s): Lei Li E-mail: li.lei@xmu.edu.cn

† These authors contributed equally.

Abstract

Background: This study investigated the prevalence of dental caries among adolescents aged 12–19 years in Xiamen, China and evaluated its association with Internet usage time. The mediation effect of sugary drinks consumption and sleep duration on the association between dental caries and Internet usage time was also examined. Methods: We recruited 11,361 adolescents using multistage stratified random sampling method in Xiamen. Dental caries assessment was conducted by professional dentists under natural light using disposable mouth mirrors and dental probes, following the World Health Organization (WHO) guidelines. Dental caries was evaluated with the sum of decayed, missing, and filled permanent teeth (DMFT) index. The information about demographic characteristics and lifestyle behaviors was collected by self-administered questionnaire. The association between Internet usage time and dental caries was analyzed using binary logistic regression. The mediation effect of sugary drinks consumption and sleep duration on the association was assessed using mediation analysis. Results: The overall prevalence of dental caries among adolescents aged 12–19 years in Xiamen was 56.9%, which varied among sex, age, residence, and body mass index (BMI) (p < 0.001). Longer Internet usage time (adjusted odds ratios (AOR): 1.16; 95% confidence interval (95% CI): 1.02–1.32) was associated with a higher risk of dental caries. Moreover, higher sugary drinks consumption and insufficient sleep increased the risk of dental caries (sugary drinks: AOR: 1.54; 95% CI: 1.28–1.82; sleep duration: AOR: 1.23; 95% CI: 1.10–1.37). The frequency of sugary drinks consumption and sleep duration mediated the association between Internet usage time and dental caries by 13.89% and 5.56%, respectively. Conclusions: Adolescents aged 12–19 years-old in Xiamen had a high prevalence of dental caries, which was significantly associated with Internet usage time. The association between dental caries and Interne usage time was mediated by the frequency of sugary drink consumption and sleep duration.


Keywords

Adolescents; Eating behavior; Sleep duration; Internet use; Dental caries


Cite and Share

Mengyang Gao,Jiacheng Lin,Yanfang Jiang,Guimei Liu,Yangjingling Hua,Zhongrui Peng,Manqi Zhou,Huarong Hong,Lei Li. Influence of the consumption of sugary drinks and sleep duration on the association of Internet use and dental caries among 12–19 years old adolescents in Xiamen city, China. Journal of Clinical Pediatric Dentistry. 2026. 50(1);215-223.

References

[1] Meyer F, Zur Wiesche ES, Amaechi BT, Limeback H, Enax J. Caries etiology and preventive measures. European Journal of Dentistry. 2024; 18: 766–776.

[2] Wen PYF, Chen MX, Zhong YJ, Dong QQ, Wong HM. Global burden and inequality of dental caries, 1990 to 2019. Journal of Dental Research. 2022; 101: 392–399.

[3] Quan JK, Wang XZ, Sun XY, Yuan C, Liu XN, Wang X, et al. Permanent teeth caries status of 12- to 15-year-olds in China: findings from the 4th National Oral Health Survey. Chinese Journal of Dental Research. 2018; 21: 181–193.

[4] Delgado-Pérez VJ, Patiño-Marín N, Rueda-Ibarra V, Márquez-Rodríguez S, Casanova-Rosado AJ, Casanova-Rosado JF, et al. Epidemiological and oral public health aspects of dental pain: a narrative review. Cureus. 2024; 16: e74908.

[5] Singh S, Talmale P. Impact of dental caries and nutritional status on oral health related quality of life in young Indian adolescents. Journal of Oral Biology and Craniofacial Research. 2023; 13: 506–510.

[6] Yirsaw AN, Bogale EK, Tefera M, Belay MA, Alemu AT, Bogale SK, et al. Prevalence of dental caries and associated factors among primary school children in Ethiopia: systematic review and meta-analysis. BMC Oral Health. 2024; 24: 774.

[7] Yousaf M, Aslam T, Saeed S, Sarfraz A, Sarfraz Z, Cherrez-Ojeda I. Individual, family, and socioeconomic contributors to dental caries in children from low- and middle-income countries. International Journal of Environmental Research and Public Health. 2022; 19: 7114.

[8] Sadjadpour F, Hosseinichimeh N, Pahel BT, Metcalf SS. Systems mapping of multilevel factors contributing to dental caries in adolescents. Frontiers in Oral Health. 2023; 4: 1285347.

[9] Almajed OS, Aljouie AA, Alharbi MS, Alsulaimi LM. The impact of socioeconomic factors on pediatric oral health: a review. Cureus. 2024; 16: e53567.

[10] Su S, Zhang J, Deng R, Wang W, Cui T, Su Y, et al. Oral health status and associated factors among 12 to 15-year-old Chinese adolescents in Southeast China: a cross-sectional study. Medicine. 2024; 103: e37080.

[11] Skinner J, Byun R, Blinkhorn A, Johnson G. Sugary drink consumption and dental caries in New South Wales teenagers. Australian Dental Journal. 2015; 60: 169–175.

[12] Alqaderi H, Tavares M, Al-Mulla F, Al-Ozairi E, Goodson JM. Late bedtime and dental caries incidence in Kuwaiti children: a longitudinal multilevel analysis. Community Dentistry and Oral Epidemiology. 2020; 48: 181–187.

[13] Li J, Wu Y, Hesketh T. Internet use and cyberbullying: impacts on psychosocial and psychosomatic wellbeing among Chinese adolescents. Computers in Human Behavior. 2023; 138: 107461.

[14] Trott M, Driscoll R, Iraldo E, Pardhan S. Changes and correlates of screen time in adults and children during the COVID-19 pandemic: a systematic review and meta-analysis. eClinicalMedicine. 2022; 48: 101452.

[15] Gu HM, Park J, Ryu SY. Health behavior factors associated with sugar-sweetened beverage intake among adolescents. Korean Journal of Community Nutrition. 2018; 23: 193–201.

[16] Yang Q, Xi Y, Liu H, Luo J, Ouyang Y, Sun M, et al. Free sugars intake among chinese adolescents and its association with dental caries: a cross-sectional study. Nutrients. 2021; 13: 765.

[17] Karki K, Singh DR, Maharjan D, K C S, Shrestha S, Thapa DK. Internet addiction and sleep quality among adolescents in a peri-urban setting in Nepal: a cross-sectional school-based survey. PLOS ONE. 2021; 16: e0246940.

[18] Kurtović A, Talapko J, Bekić S, Škrlec I. The relationship between sleep, chronotype, and dental caries—a narrative review. Clocks & Sleep. 2023; 5: 295–312.

[19] Ogawa M, Ogi H, Nakamura D, Nakamura T, Izawa KP. Association between insufficient sleep and dental caries among preschoolers in Japan: a cross-sectional multicentre study. European Journal of Investigation in Health, Psychology and Education. 2021; 12: 1–10.

[20] World Health Organization. Oral health surveys: basic methods. 5th edn. World Health Organization: Geneva. 2013.

[21] National Health and Family Planning Commission of the People’s Republic of China. Screeningstandard for malnutrition of school-age children and adolescents. 2014. Available at: https://hbba.sacinfo.org.cn/attachment/onlineRead/8dfa4f569546fee01d6148f9b3cb86d0 (Accessed: 12 June 2024).

[22] National Health and Family Planning Commission of the People’s Republic of China. Screening for overweight and obesity among school-age children and adolescents. 2018. Available at: https://hbba.sacinfo.org.cn/attachment/onlineRead/a5078dab6fbfd5b6495cdcce69424bbdd128f380aa93c7dbe5c58c67d9d2075e (Accessed: 12 June 2024).

[23] Guo P, Zou C, An N, Huang J, Yang J, Lu Q. Emotional symptoms, dietary patterns and dental caries: a cross-sectional study in adolescents. Oral Diseases. 2024; 30: 2653–2662.

[24] Li Y, Zhao S, Li W, Liu H. Relationship between chinese adolescents’ sleep status and problem behaviors: the mediating role of mental health. Frontiers in Psychology. 2021; 12: 689201.

[25] Zhu J, Zhao R, Yu Z, Li L, Wei J, Guan Y. Machine learning-based prediction model for hypofibrinogenemia after tigecycline therapy. BMC Medical Informatics and Decision Making. 2024; 24: 284.

[26] Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods. 2008; 40: 879–891.

[27] Hu J, Jiang W, Lin X, Zhu H, Zhou N, Chen Y, et al. Dental caries status and caries risk factors in students ages 12–14 years in Zhejiang, China. Medical Science Monitor. 2018; 24: 3670–3678.

[28] Xu J, Naorungroj S, Pahumunto N, Teanpaisan R. Prevalence and associated factors of caries and periodontal diseases among adolescents in Kunming: a cross-sectional study. Journal of Health Science and Medical Research. 2023; 41: e202903.

[29] Ancillotti LHDSF, Abreu MHNG, Marinho AMCL, Santos MPAD. Validating evidence for the knowledge, management and involvement of dentists in a dental approach to sickle-cell disease. Brazilian Oral Research. 2024; 38: e026.

[30] Wen Y, Liu Y, Ning N, Xu H, Zhang J, Zhao H, et al. Prevalence of dental caries and influence factors among students in Beijing: a cross-sectional study. PLOS ONE. 2025; 20: e0322694.

[31] Pan Y, Ma Y, Gui Z, Jin Y, Pan J, Yang C, et al. Dental caries, gingivitis and oral health-related quality of life in 12-year-old children. BMC Oral Health. 2025; 25: 751.

[32] He J, Yuan B, Zhou S, Peng S, Xu Y, Cai H, et al. Socio-demographic factors, dental status, oral health knowledge and attitude, and health-related behaviors in dental visits among 12-year-old Shenzhen adolescents: a multilevel analysis. BMC Oral Health. 2022; 22: 102.

[33] Shi R, Lin C, Li S, Deng L, Lin Z, Xiu L. Obesity is negatively associated with dental caries among children and adolescents in Huizhou: a cross-sectional study. BMC Oral Health. 2022; 22: 76.

[34] Heller D, Nery GB, Bachi ALL, Al-Hashimi I. Positive role of saliva in the oral microbiome. Advances in Experimental Medicine and Biology. 2025; 1472: 103–118.

[35] Ha D, Arora A, Harford J, Luzzi L, Chrisopoulos S, Do LG. Population impact of sugar-sweetened beverages on dental caries and overweight/obesity in Australian children. JDR Clinical & Translational Research. 2023; 8: 224–233.

[36] Wilder JR, Kaste LM, Handler A, Chapple-McGruder T, Rankin KM. The association between sugar-sweetened beverages and dental caries among third-grade students in Georgia. Journal of Public Health Dentistry. 2016; 76: 76–84.

[37] Asaka Y, Sekine M, Yamada M, Tatsuse T, Sano M. Association of short sleep duration and long media use with caries in school children. Pediatrics International. 2020; 62: 214–220.

[38] Chaput J-P, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, et al. The role of insufficient sleep and circadian misalignment in obesity. Nature Reviews Endocrinology. 2023; 19: 82–97.

[39] Lasisi DTJ, Shittu ST, Meludu CC, Salami AA. Differential effects of total and partial sleep deprivation on salivary factors in Wistar rats. Archives of Oral Biology. 2017; 73: 100–104.

[40] Wu Z, Gong Y, Wang C, Lin J, Zhao J. Association between salivary s-IgA concentration and dental caries: a systematic review and meta-analysis. Bioscience Reports. 2020; 40: BSR20203208.

[41] Byun D, Kim R, Oh H. Leisure-time and study-time Internet use and dietary risk factors in Korean adolescents. The American Journal of Clinical Nutrition. 2021; 114: 1791–1801.

[42] Bradbury KM, Turel O, Morrison KM. Electronic device use and beverage related sugar and caffeine intake in US adolescents. PLOS ONE. 2019; 14: e0223912.

[43] Otsuka Y, Kaneita Y, Itani O, Matsumoto Y, Jike M, Higuchi S, et al. The association between Internet usage and sleep problems among Japanese adolescents: three repeated cross-sectional studies. Sleep. 2021; 44: zsab175.

[44] Haghani M, Abbasi S, Abdoli L, Shams SF, Baha’addini Baigy Zarandi BF, Shokrpour N, et al. Blue light and digital screens revisited: a new look at blue light from the vision quality, circadian rhythm and cognitive functions perspective. Journal of Biomedical Physics and Engineering. 2024; 14: 213–228.

[45] Li TMH, Chan NY, Li CT, Chen J, Chan JWY, Liu Y, et al. The associations of electronic media use with sleep and circadian problems, social, emotional and behavioral difficulties in adolescents. Frontiers in Psychiatry. 2022; 13: 892583.

[46] Iwasaki M, Kakuta S, Ansai T. Associations among internet addiction, lifestyle behaviors, and dental caries among high school students in Southwest Japan. Scientific Reports. 2022; 12: 17342.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.3 (2024) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Top