The cariogenic effect of starch on oral microcosm grown within the dual constant depth film fermenter.

Evidence on the link between starch intake and caries incidence is conflicting, therefore the cariogenicity of starch compared with sucrose was explored using a dual Constant Depth Film Fermenter (dCDFF) biotic model system. Bovine enamel discs were used as a substrate and the dCDFF was inoculated using human saliva. CDFF units were supplemented with artificial saliva growth media at a constant rate to mimic resting salivary flow rate over 14 days. The CDFF units were exposed to different conditions, 2% sucrose or 2% starch 8 times daily and either no additional fluoride or 1450 ppm F- twice daily. Bovine enamel discs were removed at intervals (days 3, 7, 10 and 14) for bacterial enumeration and enamel analysis using Quantitative Light Induced Fluorescence (QLF) and Transverse Microradiography (TMR). Results showed that in the absence of fluoride there was generally no difference in mineral loss between enamel exposed to either sucrose or starch when analysed using TMR and QLF (P > 0.05). In the presence of fluoride by day 14 there was significantly more mineral loss under starch than sucrose when analysed with TMR (P < 0.05). It was confirmed that starch and sucrose are similarly cariogenic within the dCDFF in the absence of fluoride. With the aid of salivary amylase, the bacteria utilise starch to produce an acidic environment similar to that of bacteria exposed to sucrose only. In the presence of fluoride, starch was more cariogenic which may be due to the bacteria producing a more hydrophobic intercellular matrix lowering the penetration of fluoride through the biofilm. This is significant as it indicates that the focus on sugars being the primary cause of caries may need re-evaluating and an increase in focus on carbohydrates is needed as they may be similarly cariogenic as sugars if not more so.

Development of a quantitative method to monitor the effect of a tooth whitening agent.

This study demonstrated a quantitative method for assessing the effect of a tooth whitening agent. Forty human teeth were stained with a tea solution, and randomly assigned to two groups (A, B) of twenty teeth. The teeth were subsequently treated with either sodium hypochlorite (NaOCL) or deionized distilled water (DDW) by intermittent immersion (60 seconds on each occasion) in a 1:10 dilution of NaOCL (group A) or DDW (group B). Prior to whitening and following each immersion, the color of the teeth at the stained spot was measured using ShadeEye-Ex Dental Chroma Meter and quantitative light-induced fluorescence (QLF). ShadeEye-Ex instantly gave a numerical value for the stain intensity, chroma (C), which is the average of three measurements taken automatically by the machine. QLF gave a quantitative value for the stain, delta Q (% mm2), following analysis of the fluorescence image of the tooth. Immersion was stopped after four readings when one specimen, in group A, was observed to have regained its natural color. There was a good correlation between C and delta Q with either NaOCL (Pearson correlation coefficient (r) = 0.974; p < 0.05) or DDW (r = 0.978; p < 0.05). With NaOCL, an inverse relationship observed between stain measurements, C (Linear fit correlation (R) = -0.982; p < 0.05) or delta Q (R = -0.988; p < 0.05) and exposure time correlated to a linear fit, but not with DDW. ANOVA showed a significant difference between the means (n = 20) of the reading at the measurement intervals (0, 60, 120 and 180 seconds) for both C (p < 0.001) and delta Q (p < 0.001) with NaOCL but not with DDW. In conclusion, the study highlighted the potential of ShadeEye-Ex Dental Chroma Meter as a tool for the quantitative assessment of the gradual change in shade of discolored teeth by tooth whitening products.