A questionnaire was sent to 54 experts in
preventive dentistry in 23 European countries in order to make an inventory of existing national dietary guidelines for the prevention of
dental caries. In addition, the experts were asked to give their personal opinion on several issues concerning the relationship between diet and
dental caries. Forty-five experts from 20 countries returned the questionnaire. In 13 European countries dietary guidelines for caries prevention were available issued by a National (Dental) Association or a Government Body. All guidelines emphasised a reduction of the frequency of intakes of cariogenic foods. Two of them included a threshold level for the amount of
sugar. When asked for their personal opinions, almost all experts mentioned reduction of frequency of 'cariogenic' intakes as the principal dietary messages for caries prevention. Four experts, however, explicitly mentioned that proper
oral hygiene with
fluoride toothpaste is more important. There was no agreement among the experts about a daily number of cariogenic intakes in between meals that can be regarded as safe, nor whether the message: 'Use products with
sugar substitutes' should be part of the dietary guidelines for the prevention of
dental caries. There was no agreement amongst experts on
preventive dentistry in Europe on the contemporary validity of the paradigm: '
Sucrose is the arch criminal of
dental caries.' Taking the variation in opinions into account and the fact that a balanced diet may lead to a moderate eating and snacking frequency, the authors propose that the emphasis on good versus bad foods for caries prevention should be replaced by an emphasis on good versus bad diets.