The Role of Sucrose in Cariogenic Dental Biofilm Formation--New Insight

Faculty of Dentistry of Piracicaba, UNICAMP, Av. Limeira 901, CEP 13414-903 Piracicaba, São Paulo, Brazil.
Journal of Dental Research (Impact Factor: 4.14). 11/2006; 85(10):878-87. DOI: 10.1177/154405910608501002
Source: PubMed


Dental caries is a biofilm-dependent oral disease, and fermentable dietary carbohydrates are the key environmental factors involved in its initiation and development. However, among the carbohydrates, sucrose is considered the most cariogenic, because, in addition to being fermented by oral bacteria, it is a substrate for the synthesis of extracellular (EPS) and intracellular (IPS) polysaccharides. Therefore, while the low pH environment triggers the shift of the resident plaque microflora to a more cariogenic one, EPS promote changes in the composition of the biofilms' matrix. Furthermore, it has recently been shown that the biofilm formed in the presence of sucrose presents low concentrations of Ca, P(i), and F, which are critical ions involved in de- and remineralization of enamel and dentin in the oral environment. Thus, the aim of this review is to explore the broad role of sucrose in the cariogenicity of biofilms, and to present a new insight into its influence on the pathogenesis of dental caries.

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    • "These acids diffuse through the plaque and into the porous enamel, dissolving the minerals, freeing calcium and phosphate into the solution (i.e., demineralization). The weakened enamel then collapses to form a cavity and the tooth is progressively destroyed (Fozo & Quivey, 2004; Marsh, 2006; Paes Leme et al., 2006). This damaging acid production from fermentable carbohydrates has prompted the search for an easily available and acceptable sugar substitute. "
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    ABSTRACT: The aim of this study was to compare arabitol with its better studied isomer xylitol for their inhibitory effects on cell growth and acid production of oral bacteria. Streptococcus mutans, Streptococcus salivarius and Streptococcus sobrinus were used as representatives of oral streptococci and Lactobacillus acidophilus and Lactobacillus fermentum were used for oral lactobacilli. Growth was followed by measuring the absorbance at 660nm, acid production by pH change. Sensitivity of these oral bacteria to arabitol and xylitol was first compared at 1% (65mM) additive concentration with glucose as sugar substrate. For all bacteria tested, the inhibitory effects of the two polyols were comparable; both were significantly stronger on streptococci (with 20-60% inhibition) than on lactobacilli (with 5-10% inhibition). Effects of arabitol and xylitol were also compared for S. mutans and S. salivarius in media with 1% of different sugar substrates: glucose (55mM), fructose (55mM), galactose (55mM) and sucrose (30mM). Inhibition occurred for all sugars: stronger on glucose and galactose (60-65%) than on fructose and sucrose (40-45%). Inhibition dependency on the arabitol/xylitol concentration from 0.01% (0.65mM) to 2% (130mM) was further determined for S. mutans and S. salivarius. Regardless of the concentration, sugar substrate and bacterial species tested, arabitol showed very similar inhibition effects to its isomer xylitol.
    Archives of oral biology 10/2015; 60(12):1721-1728. DOI:10.1016/j.archoralbio.2015.09.004 · 1.74 Impact Factor
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    • "sucrose and are considered virulence factors (Paes Leme et al., 2006). Exopolysaccharide synthesis is catalyzed by a group of bacterial enzymes termed glycosyltransferases (GTF) and fructosyltransferases (FTF), encoded by the genes gtf and ftf, respectively, which under certain conditions can be strongly associated with cell surfaces and which apparently mediate glucan induced agglutination (Li and Burne, 2001). "
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    DESCRIPTION: Expression of adherence genes of Streptococcus mutans in the presence ofLactobacillus acidophilus and glucose
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    • "In this way, repeated conditions of low pH select a more cariogenic microflora (Marsh 1991, 1994), and the extracellular polysaccharides promote changes in the composition of the biofilm matrix (Ribeiro et al. 2005; Paes Leme et al. 2006). The biofilm formed in the presence of sucrose has low concentrations of Ca, Pi, and F, which are critical ions involved in the de-and remineralization of enamel and dentine (Paes Leme et al. 2006). Extracellular polysaccharides also promote bacterial adherence to tooth surfaces (Rölla 1989) and contribute to the structural integrity of dental biofilms while increasing the porosity of the biofilm formed, thereby allowing different sugars to diffuse into the deepest parts of the biofilm, resulting in low plaque pH values due to microbial catabolism (Zero et al. 1986). "
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    ABSTRACT: The importance of sugars as a cause of caries is underemphasized and not prominent in preventive strategies. This is despite overwhelming evidence of its unique role in causing a worldwide caries epidemic. Why this neglect? One reason is that researchers mistakenly consider caries to be a multifactorial disease; they also concentrate mainly on mitigating factors, particularly fluoride. However, this is to misunderstand that the only cause of caries is dietary sugars. These provide a substrate for cariogenic oral bacteria to flourish and to generate enamel-demineralizing acids. Modifying factors such as fluoride and dental hygiene would not be needed if we tackled the single cause-sugars. In this article, we demonstrate the sensitivity of cariogenesis to even very low sugars intakes. Quantitative analyses show a log-linear dose-response relationship between the sucrose or its monosaccharide intakes and the progressive lifelong development of caries. This results in a substantial dental health burden throughout life. Processed starches have cariogenic potential when accompanying sucrose, but human studies do not provide unequivocal data of their cariogenicity. The long-standing failure to identify the need for drastic national reductions in sugars intakes reflects scientific confusion partly induced by pressure from major industrial sugar interests. © International & American Associations for Dental Research 2015.
    Journal of dental research 08/2015; DOI:10.1177/0022034515590377 · 4.14 Impact Factor
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