Cariogenicity of a Milk-Based Drink Used as a Dietary Supplement for Older Adults Using a Root Caries Experimental Model.

The aim of this study was to evaluate the cariogenicity of a milk-based drink intended for older adults that was used as part of a governmental initiative in Chile to improve their nutritional conditions. This drink contains a high concentration of sugars, which can contribute to root caries development. To test this hypothesis, an experimental biofilm/caries model was used. Dentin slabs were used to grow biofilms of Streptococcus mutans UA159. Slabs/biofilms were exposed 3× per day to bovine milk with different fat content, the milk-based drink, and the milk-based drink supplemented with 10 g of sucrose added per serving. Slabs exposed to 10% sucrose or 0.9% NaCl were used as positive and negative controls, respectively. Biofilms were analyzed for bacterial counts and acidogenicity. Dentin demineralization was estimated by the loss of surface microhardness and integrated mineral loss. Results were compared by analysis of variance and Tukey's test. The milk-based drink showed higher acidogenicity than milk with its entire (whole) or reduced total fat content (skim). The milk-based drink supplemented with -sucrose had similar acidogenicity as the 10% sucrose positive control (p = 0.506). Whole milk exposure elicited lower bacterial counts than the positive control, the milk-based drink, and the milk-based drink supplemented with sucrose (p = 0.002; 0.006 and 0.014 respectively). Although skim milk induced higher demineralization than whole milk, both milk types produced lower demineralization than the milk-based drink. Regarding integrated mineral loss, demineralization induced by the milk-based drink and the milk-based drink supplemented with sucrose was similar to that induced by the positive control and skim milk (p > 0.05). Sugar-containing milk-based drinks used as dietary supplements for older adults may be highly cariogenic and could represent a potential risk for root caries.

The role of human milk and sucrose on cariogenicity of microcosm biofilms.

This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

The role of human milk and sucrose on cariogenicity of microcosm biofilms

Abstract This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Galla chinensis Compounds Remineralize Enamel Caries Lesions in a Rat Model.

OBJECTIVES: To investigate the effect of Galla chinensis chemical compounds on enamel caries remineralization in rats. METHODS: A total of 40 rats were inoculated with Streptococcus sobrinus 6715 and fed a cariogenic diet (Keyes 2000). The rats were randomly divided into 4 groups and treated topically twice a day with each of the following extracts (or control) for 5 weeks: distilled and deionized water (DDW, negative control); 1,000 ppm NaF (positive control); 4,000 ppm G. chinensis crude aqueous extract (GCE), or 4,000 ppm gallic acid (GA). After the experimental period, Keyes' caries diagnosis and scoring technique was applied as a preliminary evaluation on the molar teeth. For more accurate remineralization data, the residual enamel volume of the first molar and the mineral density (MD) of the enamel were further analyzed by micro-CT. RESULTS: The severity of molar enamel caries decreased in the following order of treatment groups: DDW > GA > GCE > NaF (p < 0.05). In addition, the residual first molar enamel volume and MD values increased in the order of DDW, GA, GCE and NaF treatment groups (p < 0.05). In most molars, remineralization layers were observed on the surface of lesions. CONCLUSION: G. chinensis compounds remineralize enamel caries lesions in a rat model.

Teeth and the past in Portugal: pathology and the Mesolithic-Neolithic transition.

Carious lesions are considered an important marker of dietary change at the transition from hunting and gathering to horticulture. Within the context of the transition to the Neolithic in Central Portugal, this paper discusses factors which must be taken into consideration in reporting dental pathology frequencies. Three sites are examined, two late Mesolithic shell middens and one early Neolithic burial cave dating before 5500 calBP which is taken to b e the end of the transition period. Comparability of results across different burial types and depositional environments requires close attention to methodology. Despite inclusion of necessary detail on caries type, age of onset of pathology and age distribution within the sample, factors such as the use of teeth as tools and post-mortem alteration of teeth may make it impossible to be certain of rates of pathology. Inter-site differences in dental pathology may result, not only from diet, but from differing adult age distributions: when burial modes and deposits are dissimilar, differing diagenesis and taphonomy may further bias pathology rates, as well the use of teeth as tools which can affect attrition, trauma and tooth loss rates.

Risks for early childhood caries analyzed by negative binomial models.

Because of the high incidence of early childhood caries (ECC), a longitudinal study to identify risk factors from the prenatal period to the child's first birthday among 9- to 18-month-old children was conducted with negative binomial modeling. Overall, 495 children had dental examinations at ages 9, 12, and 18 months. Mothers were interviewed during the 2nd trimester of pregnancy and when the children had dental examinations. The highest incidence of caries was found among children who were born to mothers with >or= 10 decayed teeth and who never received calcium supplements during pregnancy, and children who were not fed supplementary foods at age 3 months, had sweet-tasting foods at 5 months, started snacking at 5 months, had sugary snacks, had soft drinks, and did not have their teeth brushed daily at 9 months. Thus, prenatal care and child-rearing-practices during and after birth are important risk factors for the incidence and incremental rate of ECC.

Effects of protein deficiency induced by raw soy with and without sucrose on dentine formation and dentinal caries in young rats.

OBJECTIVES: The effects of protein deficiency and sucrose on formation and mineralization of dentine and dental caries in the molars of young rats were investigated. MATERIALS AND METHODS: Two groups of weaning Wistar rats received raw soy flour to induce protein deficiency with sucrose or starch as the carbohydrate source; the other two groups received skim milk powder as the protein source with sucrose or starch as the carbohydrate source. At the onset, tetracycline was injected to mark the dentine formed at that moment. After 6 weeks, lower molars were sectioned sagittally, and the areas of dentine formation and dentinal caries developed during the experiment were quantified separately in the first and second molars. Dental caries was also classified according to Schiff's reaction. Calcium (Ca), phosphorus (P) and total mineral elements were analyzed using an electron probe microanalyzer. RESULTS: Rats in both protein-deficient groups and normal protein sucrose group had significantly larger areas of dentine formed compared with rats fed with normal protein starch diet. Ca, P and total mineral elements in dentine were significantly reduced by normal protein sucrose diet. P content was significantly reduced in dentine of rats in protein-deficient sucrose group. Rats in normal protein sucrose group had significantly more and larger dentinal caries lesions than in any other group. CONCLUSION: This study suggests that protein deficiency induced by soy prevents the progression of dental caries even in highly cariogenic environment.

Breast-feeding and early childhood caries: an assessment among Brazilian infants.

OBJECTIVES: The purpose of the present study was to evaluate early childhood caries among 12-36-month-old children from families living in poor socio-economic conditions in the city of Recife, Brazil, its association with the type and duration of feeding (e.g. natural, sugared, bottle and glass), as well as the relationship between a supplementary diet and the occurrence of this type of caries. METHODS: The present study consisted of a visual clinical examination of teeth that had been previously cleaned with gauze. This was carried out under natural light in a waiting room. Four calibrated examiners performed the examination and the kappa test value was 8.0. The parents or guardians were interviewed for the following information: name, address, age, type of feeding, number of sugary meals, sugar intake and habitual diet. Some 468 children were included in this study. Their ages ranged from 12 to 36 months. The sample was comprised of 222 (47.4%) males and 246 females (52.6%). RESULTS: Of the 468 children included in this study, 133 (28.4%) had caries. Only 59 (12.6%) of the children examined had been breast-fed, 20 (33.9%) of whom presented with caries. Three hundred and twenty-seven (69.9%) subjects had been bottle-fed with sugared milk, 86 (26%) of whom had caries. Two hundred and eight children had five or more sugary meals per day, 70 (33.6%) of whom had caries. No statistically significant relationship was seen between breast-feeding and the prevalence of tooth decay. CONCLUSIONS: The results of the present study show that the prevalence of early childhood caries in 12-36-month-old children from poor backgrounds in Recife is in accordance with the rate found in other Brazilian cities and is extremely high compared with that of the world population as a whole. Early childhood caries was not clearly related to the type of feeding in this sample. The prevalence of early childhood caries increased with age, and the number of sugary snacks between meals and a cariogenic diet were strongly related to early childhood caries. The lack of fluoridated water and high rates of early childhood caries in lead the authors to suggest that fluoride dentifrice should be introduced at 12 months of age as a fluoride supplement and an important aid in the prevention of childhood caries. Additional studies in different cultures and societies need to be undertaken before a definitive conclusion can be drawn.

Diet counseling during the infant oral health visit.

Diet counseling is an integral part of anticipatory guidance during the infant oral health visit. Similar to dietary instructions for children of all ages, the primary emphasis is on sugar intake frequency. There are, however, other infant-specific dietary issues that must also be addressed during the infant oral health visit. Breast-feeding should be promoted during the first year of life, although ad libitum nocturnal breast-feeding should be discouraged after the first primary tooth erupts. Bottle-fed infants should not be put to sleep with the bottle. Weaning from the breast or the bottle should be encouraged by 12 to 14 months of age. Infants older than 6 months and with exposure to less than 0.3 ppm fluoride in their drinking water need dietary fluoride supplements of 0.25 mg fluoride per day. Only 4 to 6 oz of fruit juice should be consumed by infants per day. Infants should not be given powdered beverages or soda pop, as these drinks pose increased risk for dental caries. Iron-fortified infant cereals, along with breast milk or infant formula, should be consumed by infants who are at least 6 months of age. Cow's milk should be completely avoided in the first year of life and restricted to less than 24 oz per day in the second year of life. Parents should be cautioned regarding the potential of various foods to constitute a choking hazard for infants.

[Effect of cariesogenic diet and age on selenium distribution between blood and mineralized tissues in rats]. / Vliianie kariesogennoi diety i vozrasta na raspredelenie selena mezhdu krov'iu i mineralizovannymi tkaniami krysy.

The distribution of Se in the blood and teeth (in the jaw and femoral bones) was evaluated using a new coefficient of relative radioactivity (RRA), representing the ratio of (75)Se in the teeth (bones) and blood. Changes in all RRA were studied during 1-192 hours after intraperitoneal injection of [(75)Se]selenate in one-month-old rats receiving common fodder; a biphasic pattern of changes was observed, with peaks 6 and 48 h and lowering 24 and 192 h postinjection. The first peak was mainly due to Se adsorption on hydroxyapatite, the second to chemo-adsorption on it and Se binding to protein. In 3-month-old rats receiving common fodder the peak of all RRA was delayed to 12-48 h postinjection, the values decreasing by 192 h. The peak of specific activity (SA) of (75)Se protein in the bones was recorded 24 h and its decrease 192 h postinjection. In one-month-old rats receiving sucrose-casein diet during 2 months all RRA and SA after 6 and 12 h and part of RRA after 24 h were higher than in the control, that is, Se absorption by bones and teeth from the blood decreased.

The effect of fluorine and homeopathic medicines in rats fed cariogenic diet.

Although some sectors of dentistry have benefited from technological advances, dental caries is still a major problem. Prevention and treatment of dental caries by fluorine is considered a major advance in public health. Nevertheless fluorosis, caused by ingestion of excessive amounts of fluorine during the period of teeth formation, is of great concern. In accordance with the homeopathic doctrine, minimum doses of fluorine and other substances could prevent and/or treat caries. In this experiment, we compared the preventive action of fluorine and evaluated the effect of homeopathic medicines on the teeth of rats fed a cariogenic diet. None of the groups included in this study developed caries. However, microscopy revealed the presence of precipitate and/or deposit in the groups treated with homeopathic medicines. This phenomenon might be due to deposit in the dental surface or precipitation of bacterial plaque or calcium salts. It was not possible to identify the composition of the deposit/precipitate due for technical reasons. In one of the groups treated with homeopathic medicines fur loss was observed in 40% of animals. These reactions might be caused due to the action of the homeopathic medicines.

Black tea extract and dental caries formation in hamsters.

Several studies have suggested that green tea and Oolong tea extracts have antibacterial and anticariogenic properties in vitro and in vivo. The aim of the present study was to determine the effect of a standardized black tea extract (BTE) on caries formation in inbred hamsters on a regular and a cariogenic diet. Eighty hamsters were divided into four groups of 20 animals each. Two groups received a pelleted regular diet (LabChow) with water or BTE ad libitum. The other two groups received a powdered cariogenic diet (Diet 2000, containing 56% sucrose) with water or BTE ad libitum. The animals were kept for 3 months on their respective diets and then were sacrificed. The heads were retained, the jaws were prepared and stained using alizarin mordant red II, and were then scored for dental caries according to the Keyes method. This is the first study indicating that BTE, as compared with water, significantly decreased caries formation by 56.6% in hamsters on a regular diet and by 63.7% in hamsters on a cariogenic diet (P < 0.05). In the cariogenic diet group BTE, reduced the mandibular caries score of the hamsters slightly more than the maxillary caries score. The fluoride content of the standardized BTE solution was frequently monitored during the experiment; the mean fluoride concentration was found to be 4.22 ppm. A frequent intake of black tea can significantly decrease caries formation, even in the presence of sugars in the diet.

Anticariogenic effects of black tea (Camellia sinensis) in caries prone-rats.

OBJECTIVE: Black tea (Camellia sinensis) may have anticariogenic properties. The present study was designed to determine whether consumption of black tea influences cariogenesis in young, caries-prone rats. METHOD AND MATERIALS: Eighteen-day-old Sprague-Dawley rats (n = 24; eight per group) fed a cariogenic diet (MIT 200) were randomly assigned to three groups to receive deionized, distilled fluoride-free water, tea, or fluoridated water (25 ppm), ad libitum, for 14 days. In addition, an initial control group of rats was studied at 20 days of age. Teeth were stained with silver nitrate to detect caries and cut mesiodistally. First and second molars were assessed for caries. RESULTS: The initial control group had negligible caries. Caries-prone rats consuming fluoride-free water had significantly more caries lesions (6.75) than did the tea (3.12) and the fluoridated water (0.85) groups. CONCLUSION: Consumption of black tea for 2 weeks attenuated development and progression of caries in caries-prone young rats.

Nursing-bottle syndrome caused by prolonged drinking from vessels with bill-shaped extensions.

Our investigating 186 infants between the ages of one and six with carious destruction of the maxillary primary incisors, it was learned which risk factors were responsible for the condition known as nursing bottle syndrome. One hundred and twenty-eight infants (68.8 percent) were given a nursing bottle, twelve (6.5 percent) a feeding cup or other bottles with bill- shaped extensions, and forty-one (22.0 percent) both a nursing bottle and vessels with bill-shaped extensions; in all cases the feeding was excessive and prolonged beyond the first year of life. An additional five infants (2.7 percent) were breast-fed excessively beyond the first year. The results confirm the risk of tooth destruction, typical of nursing bottle syndrome, by prolonged and frequent consumption of cariogenic beverages from vessels with bill-shaped extensions. It is important, therefore, that a warning regarding dental health hazards of such feeding methods be issued.

The role of diet in caries prevention.

Over the last three decades the condition of the teeth of children has improved tremendously. This has generally been attributed to the increased use of fluoride toothpaste. During this period the total amount of sugars disappearing into the population per capita has hardly changed. This suggests that the relationship between diet and caries has to be reassessed, which provokes different opinions among dental experts. Some suggest a maximum threshold level for the daily amount of sugars to prevent caries. Others propose that in general the amount of sugars eaten is not an important determinant of caries experience. The scientific evidence for the various opinions on the role of diet in caries development will be discussed. It is concluded that the role of diet is not so much related to the diet itself but to the individual behaviour of people. Where oral hygiene and fluoride supplementation are adequate, the diet has become a lesser factor in caries prevention. However, those diets may cause caries when there is too little fluoride. It is a mistake to classify a diet as cariogenic it may be potentially cariogenic. When one wants to decrease this potency, one should modify those factors that are actually controlling it, which is, in most cases, the topical presence of fluoride and not the composition of the diet. A model is proposed to guide caries prevention. The (insufficient) use of fluoride, (insufficient) oral hygiene and (insufficient) clearance by saliva form a window of risk. The total burden of cariogenic food that can be seen through the window constitutes the actual caries risk.

The British Nutrition Foundation Oral Task Force report--issues relevant to dental health professionals.

A recent report on diet and oral health by the British Nutrition Foundation reviews the anatomy, microbiology and pathology of a number of oral diseases including dental caries, tooth-wear, oral cancer, periodontal disease and enamel defects. The role of nutritional factors in the aetiology and prevention of these oral diseases is discussed. The report states that improvements in the levels of caries in the UK are halting and remain unacceptably high in some 'at risk groups'--including the socially deprived. It states that a two-pronged attack, i.e. reduced frequency of consumption of sugary foods and use of fluoride is necessary to address the problem. To address the increased prevalence of oral cancer avoiding tobacco, limiting alcohol and increasing fruit and vegetable consumption are recommended. Recommendations for approaches to improve oral health are made for health authorities, industry, schools and health professionals and it is recommended that the Government make adequate resources available to improve oral health preventive strategies.

The effect of sucrose diet of rat dams on the dentine apposition and dental caries of their pups.

The purpose was to examine whether a sucrose diet in rat dams reduces dentine apposition and enhances dental caries in their pups. Sprague-Dawley rat pups were randomized into four groups on the day of birth. During the lactation period three dams received a standard rodent diet and three a diet containing 41% sucrose. At the age of 3 weeks the pups were weaned and given an intraperitoneal injection of oxytetracycline hydrochloride. During the experimental period, half of the pups of control dams received a sucrose diet (Cnt-Suc pups) and half of the pups of sucrose dams received a standard diet (Suc-Cnt pups). The pups in the other halves received the same diet as given to their dams during lactation (Cnt-Cnt and Suc-Suc pups). Urine samples were collected from dams and pups during the test periods. After 4 weeks the pups were killed, their blood was collected and their jaws sectioned sagittally. Dentine apposition was determined planimetrically and dental caries using Schiffs staining. Ca, K and Na of serum and urine were measured flame photometrically and P using an ultraviolet method. The lactational sucrose diet was associated with decreased P and Na excretion in the dams, and also with reduced dentine apposition in their pups. Reduced dentine apposition and induced Ca excretion with decreased P, K and Na excretions were observed in Suc-Suc pups and Cnt-Suc pups during the experiment period. Fewer intact teeth with more enamel and dentinal caries lesions occurred in sucrose-exposed groups (Suc-Cnt, Cnt-Suc and Suc-Suc pups). It was concluded that the sucrose diet given to dams during lactation changed the function of the pulp dentine complex of their pups leading to reduced dentinogenesis, but also predisposed to a reduction of dentinogenesis in pups during the experimental period and enhanced the occurrence of dental caries.

Caries inhibition efficacy of an antiplaque/antigingivitis dentifrice.

PURPOSE: To evaluate the efficacy of a fluoride dentifrice containing a fixed combination of essential oils (Thymol, Menthol, Eucalyptol, and Methyl Salicylate) in preventing caries in Sprague Dawley rats. MATERIALS AND METHODS: The dentifrice contains 0.76% sodium monofluorophosphate (SMFP) as the fluoride source and a silica abrasive system. A fluoride-free placebo and a clinically proven USP dentifrice reference standard for SMFP/silica were included as controls. Three groups of 45 SDV-free Sprague Dawley weanlings were infected by a cariogenic strain of Streptococcus sobrinus and fed cariogenic diet NIH 2000 ad libitum. Animals were treated twice daily (once on weekends) with the assigned dentifrice using a cotton-tipped applicator, for 5 wks, after which they were terminated and caries scored using Larson's modification of the Keyes method. RESULTS: Analyses of variance were used to compare inter-group means, the total E lesion score was the primary efficacy variable. Compared with the fluoride-free vehicle control, the experimental dentifrice and USP reference standard dentifrice produced a statistically significant reductions of 18.3% and 12.2% respectively for total caries score (P<0.001). Compared with the clinically tested USP positive control dentifrice, the experimental dentifrice produced a statistically significant reduction in the total caries score of 6.9% (P=0.028). The results of this study show that 1) both the new dentifrice containing essential oils and USP dentifrice are statistically significantly effective in reducing caries in the rat model, 2) the anticaries activity of the SMFP dentifrice is not adversely affected with the addition of essential oils.

The role of early dietary habits in dental caries development.

Early Childhood Caries (ECC) is a serious dental condition that occurs during the first three years of life and is associated with the early intake of sugary foods, drinks, or snacks. There is now evidence that early malnutrition episodes could lead to delay in the eruption of primary teeth and possibly to increased caries prevalence. Significant correlations are present between the intakes of carbohydrates, proteins, and fats during infancy and several years later in life. Infants' dietary intake is also significantly correlated with the dietary intake of their mothers. Supplementing milk with vitamins during the first several years of life leads to reduction in the prevalence of linear enamel hypoplasia, a condition that may be associated with future development of dental caries. There are equivocal findings concerning the value of using dietary habits to predict caries incidence during the first three years of life. There is a need for development of educational, nutritional, and prevention programs targeting mothers and infants and for research on effective methods to prevent Early Childhood Caries.