Turku sugar studies V: Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man

Abstract

The purpose was to study differences in the caries increment rate as influenced by various sugars. The trial involved almost complete substitution of sucrose (S) by fructose (F) or xylitol (X) during a period of 2 years. There were no significant initial differences as to caries status between the prospective sugar groups; 35 subjects in the S-group, 38 in the F-group, and 52 in the X-group. During the entire study 10 subjects discontinued or were excluded. The clinical and radiographical observer error was reported and discussed. After 2 years the mean increment of decayed, missed and filled tooth surfaces was 7.2 in the S-group, 3.8 in the F-group, and 0.0 in the X-group. The weakness of the DMFS-index in not showing the development of new secondary caries and the increase in size of the lesions was overcome by expressing the caries activity in terms of indices showing the total quantitative and qualitative development. The results showed a massive reduction of the caries increment in relation to xylitol consumption. Fructose was found to be less cariogenic than sucrose. It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva.

Health promotion and dental caries

“…Although many classic studies have already demonstrated the association between sugar consumption and caries (Turku Sugar Study, 24 Hopewood House Study, 25 Hereditary Fructose Intolerance 26 and Experimental Caries in Man 27 ), the Vipeholm Study definitively established that the more frequently sugar is consumed, the greater the caries risk. 9 For some decades, a linear relationship between sugar consumption and caries experience has been observed, 28 and restricting sugar intake has played an important role in caries prevention.…”

Dental Plak Oluşumundan Sorumlu Mikroorganizmalar ve Bunların Tüketilen Gıdalarla İlişkisi

“…Finlandiya'da 1970'lerde gerçekleştirilen Turku çalışmasında, günlük diyette sakkarozun yerine fruktoz veya ksilitol bulunması durumunda diş çürüklerinin oluşma durumu araştırılmıştır. Çalışma sonuçlarına göre; sakkaroz ve fruktozun diyette bulunduklarında diş çürüğüne sebebiyet vermeleri arasında bir fark gözlenmezken, günlük diyette sakkaroz yerine ksilitol kullanımının önemli oranda diş çürüğünü azalttığı tespit edilmiştir [36,39].…”

Nurse unfairness

“…In 2011, over 1,400 students were admitted into the dental colleges of Kerala. 2 The private sector remains the major employment provider for these graduates as the total existing job opportunities in government is 243 of which 144 are in government run dental colleges. 1 The demand for dental treatment in Kerala is high owing to a low dentistto-population ratio and increased awareness among the population.…”

“…2 The private practice sector in these cities has become saturated whereas the majority of rural populations do not have access to primary dental care. 3 This co-existence of plenty and scarcity simultaneously makes it likely that dentist protests like that in Kerala may happen in other parts of India in the near future.…”