Food Composition and Food Cariogenicity Factors Affecting the Cariogenic Potential of Foods

Edmondson, E.M.S.

doi:10.1159/000261330

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…However, a critical re-examination of the literature, including some pertinent reviews (Newbrun, 1967; Houte, 1980; Edmondson, 1990;Burt, 1993;Rugg-Gunn, 1993;Kalsbeek and Verrips, 1994; Houte, 1994; PalensteinHelderman et al, 1996), has left us in doubt as to whether this conclusion is justified. One major concern is that the design and interpretation of existing work often does not reflect currently recognized critical features of dental caries causation.…”

Section: Introductionmentioning

confidence: 99%

Food Starches and Dental Caries

Lingström

Houte²,

Kashket³

2000

Critical Reviews in Oral Biology & Medicine

186

165

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Sucrose and starches are the predominant dietary carbohydrates in modern societies. While the causal relationship between sucrose and dental caries development is indisputable, the relationship between food starch and dental caries continues to be debated and is the topic of this review. The current view of dental caries etiology suggests that in-depth evaluation of the starch-caries relationship requires the consideration of several critical cariogenic determinants: (1) the intensity (i.e., the amount and frequency) of exposure of tooth surfaces to both sugars and starches, (2) the bioavailability of the starches, (3) the nature of the microbial flora of dental plaque, (4) the pH-lowering capacity of dental plaque, and (5) the flow rate of saliva. Studies of caries in animals, human plaque pH response, and enamel/dentin demineralization leave no doubt that processed food starches in modern human diets possess a significant cariogenic potential. However, the available studies with humans do not provide unequivocal data on their actual cariogenicity. In this regard, we found it helpful to distinguish between two types of situations. The first, exemplified by our forebears, people in developing countries, and special subject groups in more modern countries, is characterized by starch consumption in combination with a low sugar intake, an eating frequency which is essentially limited to two or three meals per day, and a low-to-negligible caries activity. The second, exemplified by people in the more modern societies, e.g., urban populations, is characterized by starch consumption in combination with significantly increased sugar consumption, an eating frequency of three or more times per day, and a significantly elevated caries activity. It is in the first situation that food starches do not appear to be particularly caries-inducive. However, their contribution to caries development in the second situation is uncertain and requires further clarification. Although food starches do not appear to be particularly caries inducive in the first situation, the possibility cannot be excluded that they contribute significantly to caries activity in modern human populations. The commonly used term "dietary starch content" is misleading, since it represents a large array of single manufactured and processed foods of widely varying composition and potential cariogenicity. Hence, increased focus on the cariogenicity of single starchy foods is warranted. Other aspects of starchy foods consumption, deserving greater attention, include the bioavailability of starches in processed foods, their retentive properties, also in relation to sugars present (starches as co-cariogens), their consumption frequency, the effect of hyposalivation on their cariogenicity, and their impact on root caries. The starch-caries issue is a very complex problem, and much remains uncertain. More focused studies are needed. At present, it appears premature to consider or promote food starches in modern diets as safe for teeth.

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Section: Introductionmentioning

confidence: 99%

Food Starches and Dental Caries

Lingström

Houte²,

Kashket³

2000

Critical Reviews in Oral Biology & Medicine

186

165

View full text Add to dashboard Cite

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“…Demineralization appeared to be limited at low plaque pH, therefore, by the accumulation of high levels of mineral ions in the streptococcal plaque. These findings suggest that the effects on the natural dentition will be limited when consuming a num ber of carbohydrate-containing foods during a meal.The formation of acids by microorganisms in plaque af ter the ingestion of foods or beverages containing fer mentable carbohydrates has been considered as the factor most closely related to the cariogenic potential of foods [Dodds and Edgar, 1988; H arper et al, 1986;Edmondson, 1990], As a result, measurement of the pH of dental plaque has become an accepted way of determining food accept …”

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confidence: 99%

Limitations in the Intraoral Demineralization of Bovine Enamel

Kashket

Yaskell²

1992

Caries Res

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A model system was used to examine the relation between the duration of plaque pH fall and enamel demineralization following the intake of dietary carbohydrate in humans. Subjects wore palatal appliances containing blocks of bovine enamel covered with Streptococcus mutans IB 1600, and rinsed with 5 or 10% sucrose. Changes in iodide penetrability (delta Ip) of the enamel, and the pH and extracellular calcium and inorganic phosphate (Pi) concentrations of the streptococcal plaque were determined. Following rinses with 5% sucrose, delta Ip increased with time and reached a maximum (11.2 ± 2.2 units) at 45-60 min although the S. mutans plaque remained acidic (pH = 4.8 ± 0.6). After 10% sucrose, the maximum (14.7 ± 3.1 units) was reached while the plaque pH was 4.0 ± 0.3. Second rinses with sucrose increased delta Ip at most by 30%. Thus, demineralization did not persist throughout the period of low plaque pH, but occurred primarily during the early phase of plaque acidogenesis. Enamel demineralization appeared to be limited by factors other than the pH of the streptococcal plaque. Calcium concentrations in the S. mutans plaque rose to a maximum of 10.9 ± 2.8 mEq/1 at 30 min after the 5% sucrose rinses, then fell; Pi reached a stable level of 12.2 ± 2.3 mEq/1 by 60 min. Calculations showed that conditions approached saturation with respect to enamel and dicalcium phosphate dihydrate as demineralization reached a maximum. Demineralization appeared to be limited at low plaque pH, therefore, by the accumulation of high levels of mineral ions in the streptococcal plaque. These findings suggest that the effects on the natural dentition will be limited when consuming a number of carbohydrate-containing foods during a meal.

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“…In fact, after 1 h of incubation the pH reached by the fermentation of 'd'á gua' flour was statistically not different from that obtained by the fermentation of the sweet (table 2), whereas the pH obtained by fermentation of 'seca' flour reached a value similar to that with the sweet only after 2 h of incubation. The slow in vitro fermentation of the flours is relevant to another aspect of cariogenic potential: oral retention of the food after chewing and ingestion [Edmondsson, 1990]. It is possible that these foods, if impacted in the oral cavity, may be further fermented, leading to critical pH falls in dental plaque [Bibby et al, 1986].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Cariogenic Potential of Cassava Flours from the Amazonian Region

Vieira

Rebelo²,

Cury³

2002

Caries Res

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Cassava flour is the main dietary carbohydrate source in the Amazonian region. The cariogenic potentials of the two main kinds of cassava flour – ‘seca’ and ‘d’água’ – were evaluated in vivo and in vitro. A sweet made from a regional fruit (cupuaçú) and a species of local fish (tambaqui) were used as positive and negative controls, respectively. For in vivo evaluation of dental plaque acidogenicity, the study had a crossover design, in four legs, with 19 volunteers in four treatment groups. Dental plaque pH was determined by the microtouch method before and for 60 min after food consumption. For in vitro evaluation, stimulated saliva of each volunteer was incubated with the food and pH variation was determined over 4 h. Carbohydrates were chemically determined in the flours and the majority was found to be water-insoluble. In vivo, plaque pH decreased significantly after the consumption of the sweet (p < 0.05), increased after the fish (p < 0.05), but did not change after intake of the flours (p > 0.05). In vitro, the flours were slowly fermented by bacteria present in saliva. The in vivo and in vitro findings suggest that, in the form that the main cassava flours from the Amazonian region of Brazil are customarily eaten, they may be considered to have no or very low cariogenicity.

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Food Composition and Food Cariogenicity Factors Affecting the Cariogenic Potential of Foods

Cited by 22 publications

References 21 publications

Food Starches and Dental Caries

Food Starches and Dental Caries

Limitations in the Intraoral Demineralization of Bovine Enamel

Evaluation of the Cariogenic Potential of Cassava Flours from the Amazonian Region

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