{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:59:31Z","timestamp":1783101571368,"version":"3.54.6"},"reference-count":70,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Proc. Nutr. Soc."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition and oral and systemic diseases that contribute to multimorbidity. Diet- and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables and nutrient-poor diets which are similar to diet- and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility and swallowing. Oral dysfunction makes it difficult to eat nutrient-dense whole grains, fruits and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our \u2018canary in the coal mine\u2019 for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy-dense, nutrient-poor foods \u2013 typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multimorbidities. Disruption of this pathway will reduce the risk of multimorbidities and enable individuals to fully engage in society throughout the lifespan.<\/jats:p>","DOI":"10.1017\/s0029665124004683","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T04:42:49Z","timestamp":1715661769000},"page":"332-339","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Oral health and multimorbidity: is diet the chicken or the egg?"],"prefix":"10.1017","volume":"84","author":[{"given":"Teresa A.","family":"Marshall","sequence":"first","affiliation":[{"name":"University of Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riva","family":"Touger-Decker","sequence":"additional","affiliation":[{"name":"Rutgers School of Dental Medicine, Rutgers, The State University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"S0029665124004683_ref44","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2019.0059"},{"key":"S0029665124004683_ref62","first-page":"24","article-title":"Childhood obesity and early childhood caries in a WIC population","volume":"10","author":"Reifsnider","year":"2004","journal-title":"J Multicultural Nurs Health"},{"key":"S0029665124004683_ref64","first-page":"400","article-title":"Relationship between high weight and caries frequency in German elementary school children","volume":"9","author":"Willerhausen","journal-title":"Eur J Med Res"},{"key":"S0029665124004683_ref38","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1177\/00220345231155825","article-title":"Diabetes, edentulism, and cognitive decline: a 12-year prospective analysis","volume":"102","author":"Wu","year":"2023","journal-title":"J Dent Res"},{"key":"S0029665124004683_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jomh.2012.03.001"},{"key":"S0029665124004683_ref53","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-015-3386-5"},{"key":"S0029665124004683_ref30","volume-title":"Clinical Guidelines for Dental Erosion: Diagnosis, Prevention and Management of Dental Erosion","year":"2021"},{"key":"S0029665124004683_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-012-1542-4"},{"key":"S0029665124004683_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31146-8"},{"key":"S0029665124004683_ref61","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2005.10719445"},{"key":"S0029665124004683_ref35","first-page":"182","article-title":"Social and behavioral determinants of oral cancer","volume":"4","author":"Allam","year":"2013","journal-title":"Dentistry"},{"key":"S0029665124004683_ref16","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182413429"},{"key":"S0029665124004683_ref60","doi-asserted-by":"publisher","DOI":"10.14219\/jada.2014.95"},{"key":"S0029665124004683_ref48","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.numecd.2023.02.002","article-title":"Cross-sectional associations of dietary patterns characterized by fat type with markers of cardiometabolic health","volume":"333","author":"Brayner","year":"2023","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"S0029665124004683_ref52","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2006.050082"},{"key":"S0029665124004683_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2016.10.001"},{"key":"S0029665124004683_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12926"},{"key":"S0029665124004683_ref70","doi-asserted-by":"crossref","first-page":"587","DOI":"10.3390\/nu10050587","article-title":"Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UI (2008\u20132014)","volume":"10","author":"Rauber","year":"2018","journal-title":"Nutrients"},{"key":"S0029665124004683_ref3","unstructured":"3. 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