By Emma Yasinski
Last month, The Lancet published an issue dedicated to oral diseases, which have been neglected by the global health community, despite untreated dental decay being the most prevalent health condition in the world.
Cristin E. Kearns, DDS, MBA, a dental and public health researcher at the University of California San Francisco, and author on the two studies, argues in an accompanying commentary that these issues are unlikely to get the attention and progress they deserve thanks to “Big Sugar,” which funds dental research and conferences, possibly turning the focus away from sugar consumption’s role in the diseases.
“These relationships with industry are ripe for scrutiny,” she writes.
Dr. Kearns’ suspicions began over a decade ago when she noticed a distinct lack of discussion on sugar at a conference about diabetes and gum disease that she attended. Since then, she’s been investigating the financial ties between the sugar industry and dental research.
In 2015, she presented a paper at the International Association for Dental Research Conference (IADR). She says her colleagues were shocked to find that one of the conference’s sponsors was a chocolate company.
Though Dr. Kearns believes the extent to which conflicts of interest influence dental research on sugar consumption is significant, she’s unsure of its magnitude.
“We examined only a few organizations. However, this is unexplored territory, and it is likely the scope is much larger [than most people realize],” Dr. Kearns told Incisor.
She’s examined documents from as far back as the 1950s showing that sugar companies have been involved in funding or conducting dental research. Some companies even knowingly hid sugar’s involvement in tooth decay. The problem is complicated by the fact that some candy companies—including giants such as Mars Wrigley, Mondelēz, Unilever, and Cloetta—also sell oral health-care products.
In the future, Dr. Kearns hopes to systematically document the consequences of these financial relationships, which she believes may cause both direct and perceived conflicts in dental research.
Since the World Health Organization has released sugar guidelines, and there has been a renewed push to reduce sugar consumption, Dr. Kearns says now is the right time to address these conflicts of interest.
In the commentary, she and Lisa Bero, PhD, a health policy researcher at the University of Sydney, laid out several steps they believe are necessary to improve the efficacy of dental research and divorce it from the influence of sugar companies.
Adopt COI [Conflict of Interest] policies consistent with the 2009 Institute of Medicine Report for the organization and any related entities (e.g., dental journals).
Publicly report industry payments to dentists, researchers, health care institutions, professional societies and continuing dental education providers.
Bar researchers with a COI from doing research with human participants, except when the investigators' expertise is essential to the safe and rigorous conduct of the research.
Prohibit or end relationships with industry that present unacceptable risks of undue influence over professional decision-making or a loss of public trust.
Reduce industry influence in the development of clinical practice guidelines by requiring the majority of guideline committee members and committee chair be free of financial COI.
Establish policies at the board level to identify, limit and manage institution-level COI.
Develop incentives to promote the institutional adoption and implementation of policies recommended by the Institute of Medicine report for medical research, education and practice.
Since the issue of The Lancet was published, Dr. Kearns says she’s received positive feedback, but was disappointed when IADR issued a statement that it does not intend to take any action, because its sponsors do not influence its scientific program.
“This is a typical, and predictable response, unfortunately,” she said. “It will be interesting to see if IADR members begin to voice opinions.”
Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.
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