Effect on oral pH changes and taste perception in 10-14-year-old children, after calcium fortification of a fruit juice.

AIM: The aim was to determine the effect of calcium fortification of a commercially available mixed-fruit juice on oral pH changes and taste perception in a group of 10 to 14 year-old Indian children. METHOD: A controlled, blinded, non-randomised clinical trial was adopted, consisting of a sample of 100 healthy children (DMFT <3; age 10-14 years), who were exposed to three test juices one by one [Group A: original fruit juice (control group); Group B: calcium-fortified fruit juice and Group C: calcium + vitamin D fortified fruit juice]. Oral pH, collection of saliva and plaque sampling was undertaken, before and after the juice exposure by each subject at 0, 1, 5, 15, 30 and 45 min. The respective pH was measured with a digital pH meter. For taste perception, a scoring system was used after exposure of the juices to the subjects in a blind manner. The statistical evaluation was done using one-way ANOVA for salivary and plaque pH and Kruskal-Wallis test for buffer capacity and taste perception. RESULTS: There was a smaller drop in salivary and plaque pH (p < 0.5) and a significant reduction in perceived taste (p < 0.001) by the subjects after calcium modification of fruit juice. CONCLUSION: The calcium-modified mixed fruit juices was less acidogenic compared with the unfortified juice, and hence will be less cariogenic and erosive towards teeth.

Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) May Be an Alternative Preventive Therapy in Children with Cerebral Palsy.

PURPOSE: To evaluate the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on the buffering capacity of saliva and plaque pH in individuals with cerebral palsy (CP). MATERIALS AND METHODS: A total of 15 3- to 8-year-old subjects with CP living in a governmental institution were included in this study. Dental plaque pH and the buffering capacity of saliva were measured at the first visit (baseline) and accepted as control values. CPP-ACP complex (GC Tooth Mousse) was applied to the children twice a day. Measurements were repeated after the 1st, 2nd, 3rd, 4th, 6th and 8th weeks. RESULTS: Plaque indicator data show decreased acidogenicity in the 8-week period. Although there were no significant differences between the baseline and the 1st, 2nd and 3rd weeks' pH scores, a statistically significant difference was observed between the initial and 4th, 6th and 8th weeks' plaque pH scores. Saliva buffer scores were found to statistically significant increase between baseline and the 3rd, 4th, 6th and 8th weeks. CONCLUSION: Daily application of 10% w/v CPP-ACP paste is effectively changes saliva buffering capacity and plaque pH, thus promoting caries prevention in the primary and mixed dentition of CP children.

Effect of water rinsing after acidulated phosphate fluoride gel on dental plaque acidity: an in situ study.

PURPOSE: This study's purpose was to determine whether rinsing with water or cleansing teeth after topical fluoride therapy affected plaque acidity. METHODS: This randomized, controlled, crossover, in situ study was conducted on 25 dental students who wore an acrylic mandibular appliance containing one enamel block. The patients were subjected to four treatment protocols involving acidulated phosphate fluoride (APF) application followed by rinsing the mouth with water: (1) after 30 minutes (APF-30); (2) after 15 minutes (APF-15); (3) immediately (APF-0); after cleansing the teeth with a cotton roll immediately following APF (APF-cotton); or (4) no fluoride therapy (control). After 48 hours, plaque pH was measured before and five, 10, 15, 20, and 30 minutes after rinsing with 10 percent sucrose solution. RESULTS: The least pH changes, the lowest pH drop, and the fastest pH recovery were found in the APF-30 and APF-15 groups, followed by the APF-0 and APF-cotton groups. CONCLUSIONS: Rinsing with water or cleansing the teeth with a cotton roll immediately after acidulated phosphate fluoride application can reduce its effect on dental plaque acidity; however, the inclusion of a controlled water rinse 15 minutes after APF gel application did not seem to influence the inhibitory effect of fluoride on plaque acidity.

An in vitro and in vivo comparison of the effect of Stevia rebaudiana extracts on different caries-related variables: a randomized controlled trial pilot study.

The effect of Stevia extracts on in vitro Streptococcus mutans biofilm formation and in vivo plaque pH was evaluated in this paper. Three 10% solutions containing stevioside, rebaudioside A or sucrose were prepared. MTT assay was used to evaluate microbiological counts in vitro. Twenty volunteers rinsed for 1 min with each solutions, and plaque pH was measured at 7 time points after each rinse. Higher in vitro S. mutans biofilm formation was observed in sucrose solution (p < 0.01). After 5, 10, 15 and 30 min, the sucrose in vivo rinse produced a statistically significantly lower pH value compared to the Stevia extracts (F = 99.45, p < 0.01).Stevia extracts can be considered nonacidogenic.

The acidogenic potential of different milk formulas on dental plaque pH.

PURPOSE: To investigate the effect of different milk formulas on dental plaque pH. MATERIALS AND METHODS: Six commercial infant milk formulas were selected, with 10% sucrose solution as the positive and deionised water as the negative control, and tested among ten children aged 7-10 years. The plaque pH changes were recorded by using a combination electrode. RESULTS: Mouth rinsing with all infant formulas significantly reduced the plaque pH (Tukey's multiple comparison test, P < 0.05) to levels below the pre-rinse pH value for sucrose solution and also below the pH obtained after rinsing with water. Each milk formula had a significant but variable buffering effect or tendency to decrease the pH. The formula with the least buffering effect was Nestogen (9.21%) followed by Nan (11.92%), and the highest buffering effect was shown by Lactodex (20.13%). The pH drop ranged from 0.72 for Farex to 0.98 for Nan. CONCLUSION: The results of this study underscore the need for parents and clinicians to be fully aware of the potential harm of various infant formulas and their major role in the etiology of ECC. These findings may help in creating a new generation of foods which, if not 'friendly to teeth', may be thought of as 'friendlier' than their predecessors.

Effect of consuming different dairy products on calcium, phosphorus and pH levels of human dental plaque: a comparative study.

AIM: To determine the calcium, phosphorus and pH levels of human dental plaque after consuming different dairy products. METHODS: 68 students (34 with caries and 34 caries-free) aged 17-20 years from a private dental college, Moradabad city, who agreed to refrain from oral hygiene procedures for 48 hours were selected for the study. Calcium and phosphorus levels of harvested dental plaque were measured using an electrolyte analyser while plaque pH was measured using a digital pH meter after consuming different dairy products (cheese, milk, yogurt) and compared with the control (paraffin) group. RESULTS: Cheese and yogurt groups showed a statistically significant rise in mean plaque concentrations of calcium and phosphorus, whereas milk and control groups showed the least rise in plaque concentrations for both caries-active and caries-free subjects. Plaque pH showed a stronger correlation with plaque calcium and phosphorus concentrations in both caries-active and caries-free subjects. CONCLUSION: Cheese and yogurt without any added sugar (sucrose) are non-cariogenic and to some extent cariostatic as they increase calcium and phosphorus concentration in dental plaque. Dairy products without added sugar can be recommended as after meal desserts, especially to school children, which would help to reduce the incidence of dental caries.

The effects of fluoride and mineralising treatments on plaque microcosm Ca, P and F, pH responses and cariogenicity.

OBJECTIVE: To investigate the effects of fluoride (F), calcium-phosphate-monofluorophosphate-urea (CPMU) mineralising solution, and casein on plaque pH and calcium (Ca), phosphate (P) and F content, and the ability of plaque to induce carious lesions in enamel. METHODS: Plaque microcosms were cultured in cariogenic growth conditions on enamel specimens for 28d in a "multiplaque artificial mouth". The plaques were supplied 5 times daily with 10% sucrose (1.5 ml over 6 min) over a 12h period followed by a 12h rest period. Duplicate plaques were pulsed with 0, 1000, 3000 and 5000 ppm F (1.5 ml over 6 min) or 2% w/v casein (1.25 ml over 30 min) twice daily. One of each pair was also pulsed with CPMU (1.5 ml over 6 min). Plaque pH was monitored during growth. After 28 days' culture, plaque Ca, P and F levels were quantified and lesion depth in enamel was measured by backscattered electron SEM. RESULTS: F pulses raised the plaque pH, which was otherwise below 4 during sucrose pulsing, while CPMU hastened and raised the recovery pH. Plaque Ca, P and F levels substantially increased with increasing concentrations of applied F, particularly in the presence of CPMU (P < 0.01). In the absence of either F or CPMU, enamel lesions were formed with extensive enamel loss. CONCLUSIONS: CPMU and F supplied to plaque microcosms substantially reduce plaque cariogenicity to enamel under highly cariogenic experimental conditions. This was associated with an increase in plaque pH, plaque F and Ca levels.

Novel technologies for the prevention and treatment of dental caries: a patent survey.

IMPORTANCE OF THE FIELD: Dental caries is one of the most common preventable childhood diseases; people are susceptible to this ailment throughout their lifetime. In the US, 90% of late adolescents and young adults have dental caries, while 94% of all dentate adults had evidence of treated or untreated coronal caries. Dental caries is often not self-limiting and without proper care can progress until the tooth is destroyed. AREAS COVERED IN THIS REVIEW: In this paper, the etiology of dental caries is briefly introduced. It is followed by a thorough review of patents and literatures on the recent development of various novel technologies for the prevention and treatment of dental caries. WHAT THE READER WILL GAIN: Recent advances in anti-plaque agents, including chemoprophylactic agents, antimicrobial peptides, vaccines, probiotics/replacement therapy and sugar substitutes, and remineralization agents including fluorides and casein phosphopeptides are analyzed. TAKE HOME MASSAGE: Both the discovery of new anti-caries agents and the development of dentotropic delivery systems will be the future focus of this research field.

Morphological and chemical characterization of tooth enamel exposed to alkaline agents.

OBJECTIVES: In this study, morphological and chemical changes in teeth enamel exposed to alkaline agents, with or without surfactants, have been investigated. In addition, chemical effects of the organic surface layer, i.e. plaque and pellicle, were also investigated. METHODS: The present study was conducted using several techniques: Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD) and scanning electron microscopy (SEM). RESULTS: From XPS-measurements, it was found that exposure to alkaline solutions resulted in a massive removal of carbon from the tooth surface, and that the addition of surfactants increased the rate under present conditions. Based on the results from the FTIR-analysis, no substitution reactions between phosphate, carbonate and hydroxide ions in the enamel apatite could be detected. From a minor SEM-analysis, degradation and loss of substance of the enamel surface was found for the exposed samples. From XRD-analysis, no changes in crystallinity of the enamel apatite could be found between the samples. CONCLUSIONS: The findings in this study show that exposure to alkaline solutions results in a degradation of enamel surfaces very dissimilar from acidic erosion. No significant erosion or chemical substitution of the apatite crystals themselves could be discerned. However, significant loss of organic carbon at the enamel surface was found in all exposed samples. The degradation of the protective organic layer at the enamel surface may profoundly increase the risk for caries and dental erosion from acidic foods and beverages.

Atividade antimicrobiana e antiaderente in vitro do extrato de rosmarinus officinalis linn. (alecrim) sobre microrganismos cariogênicos / Antimicrobial and antiadherent activity, in vitro, of rosmarinus officinalis linn. (alecrim) extract tested on cariogenic microrganisms

A atividade antimicrobiana e antiaderente in vitro do extrato do alecrim (Rosmarinus officinalis Linn.) foram avaliadas sobre Streptococcus mitis, S. mutans, S. sanguis, S. sobrinus e L. casei. O estudo foi realizado utilizando-se técnicas bacteriológicas. Os ensaios foram realizados pelas técnicas de ágar difusão em placas para determinação da Concentração Inibitória Mínima (CIM) e técnica dos tubos inclinados para a Concentração Inibitória Mínima de Aderência (CIMA). Os resultados mostraram a potencialidade daRosmarinus officinalis Linn. na inibição do crescimento bacteriano e síntese de glucano, sugerindo a sua utilização, como meio alternativo, no controle de bactérias cariogênicas.

Effects of plaque control on the patency and occlusion of dentine tubules in situ.

To elucidate the nature of dentine hypersensitivity, the effects of plaque control on the patency and occlusion of dentinal tubules were investigated systematically in situ using human dentine slabs embedded in partial dentures. The dentine slabs were divided into three groups. In group I, the dentine slabs were kept in an oral cavity without plaque control. In group II, plaque was removed mechanically by brushing. Plaque control was carried out chemically using chlorhexidine in group III. After being kept in the oral cavities for 1, 2 and 3 weeks, the slabs were removed from the partial denture, followed by SEM observation to determine the morphological changes of the dentinal tubules. When no attempt was made to remove plaque, the diameter of tubule orifices increased to 390% of the original values within 3 weeks. In contrast, dentinal tubules were found to be occluded, i.e. the tubule orifices became <20% of the original value within 1 week when plaque control efforts were made, using either method of plaque control. We conclude that plaque control plays one of the key roles in the patency versus occlusion of dentinal tubules, and thus in the aetiology and natural reparative process of dentine hypersensitivity.

Effects of bovine immune and non-immune whey preparations on the composition and pH response of human dental plaque.

Colostral products from non-immunized cows (CP) and cows immunized with mutans streptococci (IP) were used as mouth rinses in a short-term human study. The acidogenic potential of the products was tested and found to be negligible in vivo before application to subsequent rinsing tests. At first, all the participants received a professional tooth cleaning, after which they rinsed with one of the solutions (IP; CP; water) three times per day for 3 d. After each rinsing period, the resting pH and decrease in plaque pH after sucrose challenge were determined, the amount of plaque was estimated, and all available plaque was collected. No significant differences were recorded in the composition or in the amounts of accumulated plaque. The resting pH values of plaques with low "innate" pH were increased after the IP rinsing period. Surprisingly, the lowest pH values after the sucrose challenge were recorded in IP plaques. The number of cultivable facultative flora or total streptococci were not affected by different rinsings, but the relative number of mutans streptococci significantly decreased after the IP rinsing period when compared to the CP period. Thus, the short term rinsing indicates favourable effects of bovine immune whey on human dental plaque.

Effect of in situ plaque mineral supplementation on the state of saturation of plaque fluid during sugar-induced acidogenesis.

Dental plaque fluid is normally supersaturated with respect to enamel mineral but this may change to a state of undersaturation when plaque pH falls following sugar exposure, placing the adjacent enamel at risk of caries. We have determined the saturation status of the fluid in both resting and fermenting plaque following mineral supplementation. Eleven subjects abstained from oral hygiene and rinsed their mouth 3 times/d for 3 d with a placebo solution or with test solutions designed to enrich plaque with hydroxyapatite or fluorhydroxyapatite. On the morning of day 4, plaque samples were collected before and after exposure to 10% sucrose. Compared to the placebo, use of the test rinses resulted in significantly higher concentrations of Ca, P and F in plaque residue. In plaque fluid, higher post-sucrose Ca2+ free concentrations and saturation levels with respect to enamel mineral and fluorapatite were found after use of the hydroxyapatite rinse compared to the placebo, effects that probably resulted from the release of cell-bound Ca2+ as well as from the dissolution of apatite. Thus, some evidence was obtained that the test mouthrinses can counteract the fall in saturation level found when plaque is exposed briefly to sucrose. Potential long-term benefits of the test mouthrinses deserve further study.

Effect of rinse with calcium enriched milk on plaque fluid.

Previous research has shown that rinsing the mouth with milk significantly diminished the pH in dental plaque fluid; however, the degree of saturation with respect to the dental enamel (DS) was not significantly decreased because of an increase in the calcium ion concentration in plaque fluid. The aim of this study was to investigate the cariostatic effect of adding calcium to milk on the DS value of the plaque fluid after rinsing. Plaque samples were collected from 8 Japanese male dental students. Prior to plaque collection, all subjects refrained from practicing oral hygiene for 48 hr and fasted overnight. Supragingival plaque samples were collected from one side of the mouth of each subject, and then collected from the other side, following a 30-second rinse with 15 mL of calcium-enriched milk, which was prepared by adding calcium carbonate to ordinary milk, and a 10-minute waiting period. The samples were cleared by centrifugation, and the plaque fluid was analyzed for inorganic ions and pH, using an ion chromatograph and pH microelectrode, respectively. The calcium ion concentration of the milk was 6.4 mM, which was about 36% higher than that of ordinary milk. The pH decreased significantly (p<5%) from 6.4 to 6.1 following the rinse with calcium enriched milk, as tested by the paired t-test. The decrease in pH might have caused a reduction of the DS value; however, it was compensated for by a significant (p<0.5%) increase in the calcium ion concentration of plaque fluid.

[Recent findings in the etiopathogenesis of caries]. / Données récentes sur l'étiopathogénie de la carie.

Caries have three main interrelated etiological factors: 1) a bacteriological factor represented by cariogen oral bacteria, mainly Streptococcus mutans, which adhere to the dental surface and initiate the decalcification of the enamel by producing an acid environment through carbohydrate degradation; 2) the quality of the oral biofilm which is colonized more or less rapidly by bacteria after brushing, leading to an adhesive and aggressive dental plaque; 3) the quality of enamel which is reinforced by fluor ion, and of saliva. The early superficial phase of carie constitution is reversible through remineralisation from calcium, phosphate and fluor ions present in the oral cavity. In the absence of remineralisation the destructive and infectious process extends to the inner part of the tooth leading, to its progressive destruction. Prevention is based upon the following pathophysiological data, mainly: 1) family education on oral hygiene by regular brushing, and avoidance of foods or fluids containing sugars between meals; 2) fluoride intake starting at birth and being adapted to age, the prescription of fluoride supplementation, taking into account possible other sources of fluor (salt, water).

A 4-day plaque regrowth study comparing an essential oil mouthrinse with a triclosan mouthrinse.

The adjunctive use of antiplaque mouthrinses with normal oral hygiene procedures may produce a significant beneficial effect on gingival health. At present, numerous products are available with various claims for efficacy. Although for many of these products, well-controlled studies have been carried out comparing the products, against a negative control or placebo, very few studies have been carried out directly comparing the efficacy of one commercial product with another. In this observer-blind, 4-day plaque regrowth, crossover study, the efficacy of a commercial triclosan mouthrinse was compared to that of an essential oil mouthrinse and 2 placebo controls. Starting from zero plaque at the commencement of each trial period, 32 volunteers used only the allocated rinses as the method of oral hygiene over 4 days, and on the 5th day returned for measurement of plaque index and area. The essential oil rinse produced a plaque reduction of 52% for plaque area and 17% for plaque index compared to its placebo, whilst the triclosan rinse produced a 45% reduction for plaque area and 12% reduction for plaque index against its placebo. Analysis of variance and construction of 95% confidence intervals showed that both active rinses significantly reduced plaque compared to their respective placebo. In addition, the essential oil rinse significantly reduced plaque compared to the triclosan rinse for plaque index but not for plaque area. The findings of this study would suggest that of the 2 rinses, the essential oil rinse would be expected to be more effective at reducing plaque formation in the longer term.

The effect of different concentrations of sugars in two foods (yoghurts and baked beans) on plaque pH.

The effect of different concentrations of sugars in two foods (strawberry yoghurt and baked beans) on plaque acidogenicity was investigated using plaque sampling with a 'Beetrode' electrode. Six varieties of yoghurt, four varieties of baked beans and positive and negative control solutions of 10 per cent sucrose and sorbitol, respectively, were tested on six volunteers, selected according to the guidelines agreed at the San Antonio Conference of 1985. Plaque was harvested immediately before a one minute challenge with the test condition and at 5, 10, 15, 20 and 30 minutes thereafter. Parameters investigated were minimum plaque pH reached after a one minute consumption/rinse of the test food or control solution, maximum drop in plaque pH and 'area of the Stephan curve below pH 6.5'. An Acidogenic Potential Index was calculated for each test food and the results did not suggest a linear relationship between sucrose concentration in a food and acidogenic potential.

Effectiveness of calcium lactate added to food in reducing intraoral demineralization of enamel.

Following the demonstration that rinses with solutions of soluble calcium salts reduced sucrose-induced demineralization, a study was undertaken to determine whether a similar effect could be obtained by the supplementation of a solid food with calcium lactate (CL). Subjects wore palatal appliances containing blocks of bovine enamel that were coated with Streptococcus mutans IB 1600 and ate 5-gram portions of cookies made with defined levels of CL. Determinations were made of changes in iodide penetrability (delta Ip) of the enamel, as well as the pH, calcium and inorganic phosphate of the streptococcal plaque. CL at 3.2% (w/w) reduced delta Ip from 12.9 +/- 1.7 to 6.1 +/- 0.9 units, i.e. by 52.7%. Plaque pH was not affected. Demineralization was reduced progressively with increasing concentrations of added CL, and CL was most effective with increasingly sweet cookies. Plaque contained 32.4 +/- 6.0 and 17.1 +/- 4.2 mM calcium after 1 and 5 min, respectively. Calculations showed that the plaque was saturated with respect to enamel during the first 5-10 minutes after food ingestion, in spite of the progressive drop in plaque pH. In conclusion, the present study demonstrated the reduction of the cariogenic potential of solid food by relatively low concentrations of CL. The effect appeared to be related to the ability of the food to maintain high levels of calcium in the streptococcal plaque during the period of active acidogenesis.

Effect of sucralose in coffee on plaque pH in human subjects.

Our earlier work demonstrated that the sweetener sucralose, C12 H19 CI3 O8, mixed with water had no effect on intraoral plaque pH. The current study compared the effect on resting plaque pH of sucralose to sucrose when these sweeteners were used in hot coffee at equivalent sweetness levels. Twelve subjects with an identified acidogenic plaque were tested at dicrete sessions, using coffee as vehicle with: (1) sucrose; (2) sucralose; (3) sucralose plus maltodextrin (SM); (4) sucralose plus dextrose and maltodextrin (SMD), and (5) no additional sweetener. Each subject rinsed for 1 min with the test rinse, expectorated, and plaque pH was measured at six dental sites for 60 min using an antimony touch electrode method. Data were summarized for baseline pH, delta pH (baseline pH minus lowest pH attained), minimum pH, and area under the pH curve (AUC). Baseline pH was not different throughout all tests. Quantification of AUC in the various groups showed that sucralose with coffee had no statistically significant impact on plaque acidogenesis. AUC, minimum pH and delta pH were least changed by coffee and sucralose, while the SM and SMD combinations generally led to intermediate changes as compared with coffee sweetened with sucrose or sucralose. Because of its acidic nature, unsweetened coffee led to a modest pH depression, the effect of which appears to be blunted by sucralose. This study confirms that sucralose is non-acidogenic and indicates that sucralose may reduce the acidogenic potential of coffee.