Sucrose and dental caries

Sucrose is unequivocally implicated in the cause of dental caries. Biochemical, microbiological, animal and human clinical and epidemiological evidence support a causal relationship. The risk of caries is related both to the amount and the frequency of intake of sucrose. The evidence that sucrose is important is that a) extracellular synthesis of polysaccharides by plaque bacteria is dependent on high concentration of sucrose. Without synthesis of polymers S. mutans cannot colonize the mouth in large numbers. b) studies on animals show a relationship between sucrose content of a food and its cariogenicity, c) there is a direct relationship between the quantity of sucrose consumed and caries in humans, d) the relationship between dietary sucrose and caries in humans approximates an S-shaped curve that rises more steeply when the sucrose-containing products are consumed frequently and when newly erupted teeth are present in young children and adolescents. Following the sharp rise, the curve flattens out. Sucrose is much more cariogenic than starch in humans. Reduction in sucrose consumption levels by half will benefit dental health and is unlikely to have any detrimental effects on health.     

Sugars and dental caries

A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.     

Comparative epidemiology of multiple sclerosis and dental caries.

The geographical distribution and other epidemiological characteristics of multiple sclerosis (MS) are compared with those of dental caries. The rates of death due to MS in Australian states are linearly related to the numbers of decayed, missing, and filled (DMF) teeth found in individuals from those states (r=0.97, P less than 0.002). In the United States of America, a strong positive correlation (r=0.55, P less than 0.001) also exists between MS death rates and dental caries indices. The prevalence of MS in 45 countries or areas correlates well with the frequencies of DMF teeth among children of school age in those locations (r=0.78, P less than 0.001). The prevalence of MS also correlates well with the percentage of edentulous individuals in certain countries (r=0.99, P less than 0.001). A review of the literature shows that the risk for dental caries is lower among the following groups: the lower socioeconomic classes in the United States of America; Chinese immigrants to England compared with natives; blacks compared with whites; and males compared with females. The dental caries risk is higher during pregnancy and lactation. All these trends have been described for MS as well. It is suggested that dental caries may be a more accurate epidemiological model for MS than poliomyelitis. It is also suggested that MS and dental caries may share certain aetiological factors, two of which may be dietary excess of certain fats, and vitamin D deficiency.     

Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York.

OBJECTIVES: This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. METHODS: Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. RESULTS: Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. CONCLUSIONS: The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline.     

Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY.

A study was undertaken in New York State to determine the changes in dental fluorosis prevalence from 1955 to 1986 in fluoridated Newburgh and non-fluoridated Kingston children. The frequency and severity of dental fluorosis among 884 7-14-year-old children were measured by two dentists utilizing Dean's Index. Data regarding residential and fluoride history were obtained from the parents of participants. Among the Newburgh residents, the prevalence of dental fluorosis (very mild to moderate) varied from a low of 5 per cent for the 9-10-year-old group to a high of 9.4 per cent for 11-12-year-olds. Except for the 13-14-year-old group, children in non-fluoridated Kingston had the lowest dental fluorosis prevalence rates. A comparison of Dean's Community Fluorosis Indices to the 1955 baseline data obtained from studies conducted after 10 years of fluoridation in Newburgh revealed no changes of consequence among Newburgh residents. However, the changes are apparent for Kingston residents, indicating the availability of fluorides in non-fluoridated areas. The increased risk for dental fluorosis for Kingston residents appears to be from the use of fluoride tablets. An analysis of dental caries data revealed that caries prevalence declined substantially in both fluoridated and non-fluoridated areas.     

Dental caries in the adult population in Finland: I. Prevalence of dental caries

The aim of this study was to describe the prevalence of untreated dental caries in the adult population aged 30 years and over in Finland according to sex, age, region of living, and socioeconomic status. The level of untreated caries per subject also was studied and population estimates were made for prevalence and level of untreated caries. The representative sample used in this study included 5028 dentate subjects. Data were collected using interviews and clinical examination. The prevalence of untreated caries was 55% in women, and the figure for men was 67%. In eastern Finland the figures for women and men differed significantly. The mean number of decayed teeth was 2.5 per person. Men had more decayed teeth per person than women did. The number decreased significantly with increasing socioeconomic status. The data presented in the study provide a reliable picture of the occurrence of untreated dental caries in Finnish adults and form the basis for further analyses.