Search

Background & Aims: Oral nutritional supplements (ONS) administered to malnourished elders and other patients contain high-levels of carbohydrates that could be a potential risk factor for dental caries. This study aimed to evaluate the cariogenic potentials of ONS using intraoral plaque telemetry., Methods: Ten ONS were tested on five healthy volunteers (mean age: 76.8 ± 9.15 years). Participants were requested to refrain from performing oral hygiene 3-7 days prior to testing. The pH-value below the dental plaque on the tooth was measured while the ONS was being consumed. After neutralizing the participant's saliva, a control solution (10% sucrose) was administered and telemetry measurements were repeated. Mean relative cariogenicity (RC) was calculated for each ONS. ANOVA and post hoc tests were used for statistical analyses (p < 0.05)., Results: All ten ONS were potentially cariogenic on enamel with an overall RC of 0.519 ± 0.35 (Range: Min = 0.31 ± 0.16; Max = 1.00 ± 0.34). RC differed significantly between the ONS (p = 0.002). RC was lower in ONS that contained high-protein (p = 0.018). RC was not influenced by other factors such as readily consumable (p = 0.102), flavor (p = 0.869), consistency (p = 0.126), fiber containing (p = 0.134), style (p = 0.112), and age of plaque (p = 0.339)., Conclusions: The ONS administered to elders and malnourished patients are potentially cariogenic. It is imperative that the administration of ONS must be based on individual needs to potentiate a maximum benefit. Wherever possible, an attempt to limit the use of high-carbohydrate containing ONS must be practiced along with the adoption of suitable preventive measures to arrest the development and progression of caries., Competing Interests: Conflict of interest AS, IN, TA, MS: declare no conflicts of interest. FW: member of the board of Toothfriendly Switzerland., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study measured the degree of demineralization of starch foods affected by hydrolyzed starch in total starch using the polyacrylamide hydroxyapatite (PAHA) disc., Design: A total of 10 ml of test food was added to a PAHA disc and 5 ml artificial saliva, followed by inoculation with 1 μl of S. mutans and incubation at 37 °C for 180 min. The demineralization effects were then determined using CLSM., Results: The proportion of hydrolyzed starch in total starch in potato increased over time, while hydrolyzed starch in other test food decreased. When the amount of hydrolyzed starch in total starch increased after 180 min (p=0.000), the surface roughness of the PAHA disc in potato was significantly decreased. Wheat-based sugary snacks, such as chips and cookie, had relatively high cariogenic potentials, whereas baked potato had a relatively low cariogenic potential., Conclusions: Hydrolyzed starch in total starch increased over time, and cariogenic potential was notably decreased. Measurement of PAHA disc may be a valid method for assessing the cariogenic potential of hydrolyzed starch foods., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aims of this study were to describe and validate an in vitro multispecies microbial biofilm model for caries development by evaluating the effects of varying medium concentration of sucrose (0.5 and 1.0%) and fluoride (0.4, 0.8 and 1.0 ppm F) in study 1, and calcium (1.0 and 2.0 mM Ca) in study 2. Defined-multispecies biofilms, formed by Lactobacillus casei, Streptococcus mutans, S. salivarius and S. sanguinis, were grown on the surface of salivary-pellicle-coated enamel slabs, with known baseline surface hardness; growth medium was changed daily. Counts of viable cells on biofilms and the percentage of surface microhardness change (%SMC), lesion depth (LD) and integrated mineral loss (IML) on enamel slabs were assessed after 4 days of biofilm formation under the tested conditions. Counts of viable cells on biofilms were significantly affected by sucrose, fluoride and calcium concentrations (p < 0.05). There was a decrease in %SMC in response to increased fluoride and calcium concentrations (p < 0.001). Lower IML (p < 0.001) and LD (p < 0.05) were found in the presence of 0.8 and 1.0 ppm F. A negative correlation was found between the response variables (%SMC, LD and IML) and fluoride and calcium concentrations. The results suggest that the microbial caries model developed was able to show distinct levels of caries inhibition in response to fluoride and calcium concentrations, corroborating clinical observations. An effect of sucrose concentration on caries development was found only in the presence of the lowest fluoride concentration., (Copyright © 2013 S. Karger AG, Basel.)

Objectives: This study aimed to establish a method for measuring the cariogenic potential of foods with high reproducibility in vitro., Methods: Streptococcus mutans (S. mutans) was incubated in test foods with radioisotope polyacrylamide hydroxyapatite (PAHA) for 150 min at 37 °C. Then, the amount of radioisotope (32)P released from PAHA was measured using a liquid scintillation counter and scanning electron microscopy (SEM)., Results: The radioisotope PAHA discs that were soaked in 10% sucrose solutions had a high cariogenic potential and showed a remarkably demineralized surface (p < 0.05). The radioisotope PAHA disc that was incubated with snacks that had a high cariogenic potential showed a remarkably demineralized surface via SEM. Candy had a relatively high cariogenic potential, whereas xylitol gum had a relatively low potential., Conclusions: The cariogenicity of snacks can easily be evaluated by measuring the amount of (32)P released from radioisotope PAHA discs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Unlabelled: Pediatric liquid medicaments (PLM) are popular and are easily accepted by both parents and children. They are widely prescribed and easily available. However the sugar content and properties of these preparations determines their cariogenic potential., Aims and Objectives: This study assessed the pH and viscosity of pediatric liquid medicaments, type and concentration of sugars present in them and their effect on the growth of Streptococcus mutans., Methodology: PLM included two each of the most commonly prescribed analgesics, antibiotics, nutritional supplements, antitussive and antiepileptic preparations. The endogenous pH was measured using a digital pH meter and the viscosity was measured using a digital Brookefield viscometer. Analysis of sugars (sucrose, glucose and sorbitol) was performed using High Performance Liquid Chromatography. The effect of PLM on Streptococcus mutans was done by ditch plate method., Results: The pH of PLM ranged from 3.70 to 7.04 and viscosity varied from 307.33cP to 2408.33cP. Fifty percent of the PLM contained sucrose, glucose and sorbitol, and sucrose was present in nine of the PLM. The antibiotic preparations showed zones of inhibition against growth of Streptococcus mutans., Conclusions: The physical properties of Pediatric Liquid Medicaments as well as the type and concentration of sugars present in them can be indicative of their cariogenic potential.

The consumption of sports and energy drinks by children and adolescents has increased at an alarming rate in recent years. It is essential for dental professionals to be informed about the physiochemical properties of these drinks and their effects on enamel. The present study measured the fluoride levels, pH, and titratable acidity of multiple popular, commercially available brands of sports and energy drinks. Enamel dissolution was measured as weight loss using an in vitro multiple exposure model consisting of repeated short exposures to these drinks, alternating with exposure to artificial saliva. The relationship between enamel dissolution and fluoride levels, pH, and titratable acidity was also examined. There was a statistically significant difference between the fluoride levels (p = 0.034) and pH (p = 0.04) of the sports and energy drinks studied. The titratable acidity of energy drinks (11.78) was found to be significantly higher than that of sports drinks (3.58) (p < 0.001). Five of the energy drinks (Red Bull Sugar Free, Monster Assault, Von Dutch, Rockstar, and 5-Hour Energy) were found to have the highest titratable acidity values among the brands studied. Enamel weight loss after exposure to energy drinks was significantly higher than it was after exposure to sports drinks. The effect of titratable acidity on enamel weight loss was found to vary inversely with the pH of the drinks. The findings indicated that energy drinks have significantly higher titratable acidity and enamel dissolution associated with them than sports drinks. Enamel weight loss after exposure to energy drinks was more than two times higher than it was after exposure to sports drinks. Titratable acidity is a significant predictor of enamel dissolution, and its effect on enamel weight loss varies inversely with the pH of the drink. The data from the current study can be used to educate patients about the differences between sports and energy drinks and the effects of these drinks on tooth enamel.

Fruit juices are popular worldwide with children of all ages as they are sweet and perceived to be healthful. This in vitro study was sought to measure pH of 10 different fruit juices, to find out possible erosive effects on human dental enamel of 40 extracted sound premolars and also to measure fluoride and trace elements of these juices. The estimation of pH of fruit juices was done by using Systronic upH 362 pH meter. The erosive effects of fruit juices were tested by using polarized light microscope. Orion electrode was used to measure fluoride. The trace elements were estimated by using Atomic Absorption Spectrophotometer No. 6501F. The pH values in different juices were observed at different levels, and pH values of these juices were more acidic than baseline after 24 hours. As the time increased, the erosion effect became more in pineapple; grape and sugarcane juices, and they had more cariogenic trace elements like selenium, iron and manganese. So, these juices were found to be cariogenic. To conclude, orange, mousambi, mango, pomegranate, apple, chikku and watermelon juices had no erosive effect on the human enamel, with the presence of highest amount of trace elements like fluoride and phosphorous which are considered as strongly cariostatic.

We compared the effect on enamel demineralisation in situ of both whole and juiced fruits and vegetables. Volunteers wore removable mandibular appliances carrying pre-demineralised human enamel slabs and consumed one of the test foods 7 times a day for 10 days. The test foods were apples, oranges, grapes, carrots, and tomatoes, consumed either whole (sugars located intrinsically) or as a juice (extrinsic or free sugars). Raisins containing 64% sugars, but intrinsic by definition, were also studied. The mineral profile of the enamel slabs was studied before and after the test period using transverse microradiography and showed further demineralisation for all test foods, irrespective of the form of consumption. Significant demineralisation was also observed with raisins. No significant differences were found between the solid and juiced foods. In conclusion, sugars present intrinsically on consumption had a similar demineralising potential as free sugars and could not be considered less cariogenic., (Copyright © 2011 S. Karger AG, Basel.)

Background: Many parents are often unaware of the hidden, added sugars in many foods and drinks including pediatric liquid medicines; thus, hidden sugar in the form of pediatric medications has not been focused upon as cariogenic agents., Objective: (i) assess concentration of sucrose in six pediatric drugs, (ii) determine endogenous pH of these drugs, and (iii) estimate drop in the plaque pH in the oral cavity in first 30 minutes after consumption of the drugs., Materials and Methods: Ten adult volunteers with mean age of 22 years were double blinded for the study. Concentration of sucrose was assessed by volumetric method at Department of Chemical Branch of Engineering. Endogenous pH and drop in the plaque pH after consumption of the drugs were assessed using digital pH meter., Statistical Analysis: SPSS software was used to assess the pH level at different time intervals and expressed as mean +/- SD. Changes in pH were assessed by one-way ANOVA followed by Wilcoxons signed rank test. P-value was set at 0.05., Result: There were varying amounts of fermentable sucrose detected in the drugs; all the drugs were acidic. There is a significant drop of plaque pH after consumption of the drug., Conclusion: These sweeteners along with their low endogenic pH form a high cariogenic formulation. Thus, nonsucrose (noncariogenic) or sugar-free medications are needed to be prescribed along with proper oral hygiene care to the children under medication.

Objective: The aim of this work was to analyze pH and sugar concentration in seven antiretroviral and three antibacterial medications frequently prescribed to HIV infected paediatric patients., Method: Sugars (sucrose, glucose, lactose and fructose) and pH were measured from every one of ten medications with different serial numbers in two samples. The pH was determined by a previously calibrated digital pHmeter (Beckman). Analysis of free sugars was performed using thin-layer chromatography (TLC). The pH results and the amount of sugar originated from the two samples in each lot were added. The arithmetic mean of these results were computed., Results: Two antiretrovirals (Zidovudin and Abacavir Sulphate) had pH below critical level (3.55 and 3.93, respectively). All three antibacterials analyzed had pH above 5.5, and one of them (Azithromycin) had the highest pH level of the ten medications examined (9.28). Sugar was present in seven out of 10 of the medications analyzed. The antibacterials contained the highest concentration of sucrose, ranging from 40% to 54%. Glucose was found in one of the ten, sucrose was present in seven of them and none showed lactose. Fructose was not observed with the technique used., Conclusions: A number of medications frequently used by HIV-infected children may cause a significant risk of both caries and dental erosion.

Objective: This study aimed to determine free sugar concentration and pH of paediatric syrup medicines. Setting Ten paediatric syrup medicines most frequently prescribed in urban centres in Brazil were randomly chosen to be tested., Outcome Measures: Three different bottles from each type of syrup medicine were analysed (n = 30). Analysis of free sugars was performed using normal phase High-Performance Liquid Cromatography (HPLC). Quantification of free sugars was achieved by peak height comparison with standards of sucrose, fructose, glucose and sorbitol (Merck). The results were average of replicates from three bottles of each medicine. The pH of the three different bottles of each medicine was determined using a digital pHmeter (Analion - PM 600)., Results: Sucrose and glucose were detected in seven of the ten types of paediatric syrup medicines, with concentrations varying from 3.7 to 49.4% (w/w) (Median 32.7%) and 2.1 to 23.2% (w/w) (Median = 6.1%), respectively. Only two medicines contained fructose, and three, sorbitol, with respective medians of 12.8% (3.1-22.4%) and 24.6% (22.8-27.4%). The median of pH values was 4.9 (2.6-6.1)., Conclusions: Most paediatric syrup medicines showed high concentration of free sugars and pH below the critical value (5.5), which can increase their cariogenic and erosive potentials.

This study evaluated the effect of some plaque and salivary factors on caries progression in situ. The salivary secretion rate, buffering capacity and mutans streptococci counts from 13 volunteers were determined. For three distinct periods of time, 4, 7 and 10 days, each of them wore a palatal appliance containing 4 bovine enamel blocks. They used a non-fluoridated dentifrice during the experiment and a 20% sucrose solution was dripped onto the blocks 10 times a day. Mutans streptococci (MS), calcium (Ca), and insoluble polysaccharide (IP) were quantified in the dental plaque formed on the enamel blocks, after each period. Enamel demineralization was assessed by surface microhardness, and the percentage of surface microhardness change (%SMC) in relation to the baseline values was calculated. Enamel demineralization occurred after each period of plaque accumulation (p < 0.05), and the %SMC increased with time (from 13.8 to 48.3%). The concentrations of Ca and IP in plaque were not statistically different among the experimental times, but significant correlations were found between these concentrations and %SMC. Neither the salivary factors assessed initially nor mutans streptococci in plaque presented statistically significant correlations to %SMC. The results suggest that enamel demineralization is time-dependent and is more related to the composition of the biofilm formed than to the salivary factors studied.

As the longevity and population of elderly people has increased, the use of regular long-term medication for chronic medical problems has become more common. Medicines with prolonged oral clearance, for example syrups and chewable tablets, are commonly used in the elderly, many of whom retain their natural teeth into old age. These medicines may threaten dental health if they contain acidogenic sugars and are used long-term. As a part of an overall study of medication use in the elderly, three surveys were undertaken to assess the numbers of prescriptions and quantities of prescribed and 'over-the-counter' medicines with prolonged oral clearance dispensed during a 1 y period (1994), nationally and regionally. Of the 0.51 million litres of liquid oral medicines dispensed potentially for regular and long-term use by the elderly in the Northern Region in 1994, 94% was prescribed in primary care and 4% was sold over-the-counter from community pharmacies. When the effect of generic prescribing upon the sugars content of these medicines was considered, 96% of the volume of proprietary liquid oral medicines dispensed in primary care was sugars-free compared with 9% of generic liquid oral medicines. Of the 0.1 million litres of 'over-the-counter' liquid oral medicines sold in the Northern Region during 1994, 49% were sugars-free. In conclusion, although many prolonged oral clearance medicine preparations are sugars-free, due to generic prescribing a large proportion of the quantities dispensed for possible long-term use in the elderly are sugar-containing liquid oral medicines. In view of the increasing numbers of dentate elderly who require long-term medication, this is of some concern. The role of health professionals in raising awareness of the impact of generic prescribing on the sugars content of medicines is crucial if consumers are to benefit from the sugars-free option.

Objective: To assess the changes in prescribing of liquid oral medicines used long-term in children and to observe any patterns of change in sugar-free prescribing., Design: Prescribing patterns in 1992 were compared with those in 1987. Information on these and on the sweetening agent in each liquid oral medicine was obtained from several relevant sources., Setting: The survey covered the Northern region of England, and Great Britain overall., Outcome Measures: Data on numbers (in 1000s) and quantities (1) of liquid oral medicines prescribed and dispensed during 1992. All generic and propriety preparations with equivalent therapeutic effects were included., Results: There was a small percentage reduction in the use of liquid oral medicines among all medicines dispensed in Great Britain in 1992 compared with 1987. The total volume of liquid oral medicines prescribed in the Northern region increased from 320,000 l to 442,600 l of which the total quantity prescribed as sugar-free increased from 35 per cent to 50 per cent., Conclusions: Children who require medicines long-term are often those for whom dental disease and treatment carry the greatest potential risks. Use of solid rather than liquid dose forms of medicine should be promoted and the trend towards the sugar-free options in liquid medicines should be encouraged and sustained.

The acidogenic potential of a group of popular cereal-based foods and fruits and total carbohydrate content of salivary expectorants following their consumption were assessed using an indwelling electrode with telemetry and the anthrone method. Paired t tests indicated that sorbitol did not cause the plaque pH to fall as low as any of the test foods (p <0.05) but there was no significant difference between sucrose and the test foods. Only the fruits produced less acid than sucrose. The breakfast cereals tended to yield the highest levels of total carbohydrate in the salivary expectorants although a greater percentage of original carbohydrate was retained after rice and bread. These results suggest the important effect of carbohydrate retention on plaque pH response.

Five maltodextrins and five corn syrups each, seven instant teas containing maltodextrin and one tea produced on a protein-base were analysed for fermentable carbohydrates using enzymatic analyses test combinations and a spectrophotometer. Analysis of the maltodextrins and glucose syrups demonstrated the heterogenicity of this group of substances and also some incompleteness in the declaration of maltose, maltotriose and glucose, sugars typically contained in these products. In standard samples of the instant teas cariogenic sugars were found in concentrations up to 0.7%. As these sugars were not declared in any of the products, the consumer is not able to assess the cariogenic potential of the ingredient maltodextrin. The intake of products containing maltodextrins or corn syrups must lead to an uncontrolled sugar consumption.

Ten infant formulas containing maltodextrin were analysed for fermentable carbohydrates using enzymatic analysis test-combinations and a spectrophotometer. Besides lactose, sucrose and fructose an assessment was made of sugars typically contained in maltodextrin and corn syrup, namely maltose, maltotriose and glucose. Total carbohydrate was up to 10.3 g in 100 ml standard sample. Cariogenic sugars were found in concentrations between 4.0 and 7.3 g/100 ml. Declaration of the different types of carbohydrates, especially of maltodextrin/corn syrup proved to be insufficient in some products and consequently the consumer is not able to understand their cariogenic potential.

An American Dental Association Scientific Consensus Conference on Methods for the Assessment of the Cariogenic Potential (CP) of Foods was held in San Antonio, Texas, in 1985. The aim was to establish a scientific consensus regarding methods to assess the CP of foods. As a result, a sequential food-testing program was proposed involving Animal Caries, Human Plaque Acidity, and Demineralization/Remineralization Models. Two categories of CP--namely, no CP and low CP--were included. The test protocol has hardly been followed since, primarily because the category of low CP was not considered useful in dietary counseling. It is advocated that research into possible caries-preventive factors of food will be more beneficial for improvements of the oral health of the general population than assessments of low CP.

Knowledge of the normal eating and drinking habits of the rat is indispensable for comparative experiments concerned with the cariogenicity of different diets. At a time six rats were maintained individually in a registration apparatus (Hofer, Switzerland). Food (basal diet "ssniff") and normal tap water was made available ad libitum. The amounts of food and water, as well as the frequency and duration of food intake, were registered by a pen recorder, which was connected to an electronic balance. The experiment began with three week old rats, and lasted 9 weeks. Conclusions on the procedure of short term caries experiments with rats could be drawn from the results.

The presence of fructose, glucose, sucrose, maltose, and isomaltose in commercial tobacco products was identified and quantitated. Gas-liquid chromatographic studies showed that these five types of sugar were present in the water-soluble extracts of pouch and plug chewing tobacco, yet only fructose and glucose were found in extracts of snuff and unprocessed natural tobaccos. The amount of sucrose present in pouch chewing tobacco was twice that in plug chewing tobacco. No detectable amount of sucrose was found in snuff or unprocessed natural tobaccos. The content of maltose and isomaltose was much less than the content of fructose, glucose, or sucrose. All unprocessed natural tobacco leaves studied as controls contained low amounts of fructose and glucose, and no detectable amounts of sucrose, maltose, or isomaltose. The larger amounts of fructose and glucose, and the additional sucrose, maltose, and isomaltose present in pouch and plug chewing tobaccos are probably added during the manufacturing process.

The cell-associated dextransucrase produced by sucrose-grown cells of cariogenic Streptococcus mutans K1-R is derived from soluble dextransucrase. Synthesis of insoluble dextran by soluble dextransucrase gives rise to two dextransucrase fractions bound to the insoluble polysaccharide; a reversibly bound enzyme, which can be eluted in solutions of clinical dextran, and an irreversibly bound enzyme, which cannot be solubilized in this manner. Both of these fractions of dextransucrase are also present on sucrose-grown cells. During the synthesis of insoluble dextran by sucrose-grown cells, dextransucrase is progressively converted from soluble enzyme, first to the reversibly bound fraction and then to the irreversibly bound fraction, and is finally inactivated as insoluble dextran accumulates. The two cell-associated dextransucrase fractions therefore represent two stages in the insolubilization and inactivation of their precursor, soluble dextransucrase. As a result of this process of inactivation, the yield of dextransucrase from cells cultured on sucrose is markedly decreased by high concentrations of sucrose in the culture medium.