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Cheese Consumption and the Development and Progression of Dental Caries
Abstract
Whereas research into the causes of dental decay has focused on the harmful relationship between dental plaque bacteria and foods, studies into the protective effects of foods have been infrequent and limited in number. Recent investigations showed that milk and cheese could reduce the effects of metabolic acids, and could help restore the enamel that is lost during eating. Postulated mechanisms involve buffering, salivary stimulation, reduction of bacterial adhesion, reduction of enamel demineralization, and/or promotion of remineralization by casein and ionizable Ca and P. Given this information, consumers may be motivated to use milk and cheese to reduce, or reverse the cariogenic effects of many other foods.
... Several mechanisms by which cheese may reduce cariogenicity have been suggested, i.e., (1) the stimulation of salivary flow, and the subsequent buffering effect of salivary compounds, neutralizing plaque acids, (2) inhibition of plaque bacteria reducing bacterial load and consequently reducing acid production [86]. Furthermore, cheese can also reduce cariogenicity through the release of high amounts of calcium and inorganic phosphate in dental plaque, which leads to a reduction in demineralisation and an enhancement in remineralisation [86]. ...
... Several mechanisms by which cheese may reduce cariogenicity have been suggested, i.e., (1) the stimulation of salivary flow, and the subsequent buffering effect of salivary compounds, neutralizing plaque acids, (2) inhibition of plaque bacteria reducing bacterial load and consequently reducing acid production [86]. Furthermore, cheese can also reduce cariogenicity through the release of high amounts of calcium and inorganic phosphate in dental plaque, which leads to a reduction in demineralisation and an enhancement in remineralisation [86]. Moreover, it has been shown that a high maternal intake of cheese during pregnancy was associated with a decreased risk of childhood dental caries [87]. ...
... Another study by Ravishankar et al. [54] found in 68 voluntary students (34 with caries and 34 caries-free) aged 17-20 years that cheese and yoghurt without any added sugar (sucrose) were non-cariogenic as they increase calcium and phosphorus concentration and pH in dental plaque. A high concentration of calcium and phosphate ions in dental plaque may inhibit demineralisation and favour remineralisation of tooth enamel [54,56,71,86]. In order to reduce the prevalence of dental caries (especially in school-age children) the consumption of dairy products (without added sugar) as after-meal desserts have been recommended [54]. ...
The impact of dairy products on dental health has been researched widely and shows an important role of various constituents, as well as the specific product matrix, in maintaining and improving dental health. These include, for instance, the position of lactose as the least cariogenic fermentable sugar, the high levels of calcium and phosphate, the presence of phosphopeptides as well as the antibacterial peptides lactoferrin and lysozyme and high buffering capacity. With plant-based alternatives for dairy products being developed and marketed these days, the specific benefits of dairy products in relation to dental health are often overlooked and most products contain more cariogenic carbohydrates, lack phosphopeptides, and have fewer minerals and less buffering capacity. Comparative studies performed to date indeed suggest that plant-based products do not match dairy counterparts when it comes to maintaining and improving dental health. Careful consideration of these aspects is required in relation to future developments of products and human diets. In this paper, we review the impact of dairy products and plant-based dairy alternatives on dental health.
... These products are the major source of calcium (Ca) and phosphate (P), both of which have beneficial effects on dental plaque and saliva. In this regard, a high concentration of Ca and P may decrease the adherence of caries-associated bacteria to the enamel [7], whereas high Ca intake may increase enamel remineralization, decrease demineralization, prevent alveolar bone loss, and, hence, promote dental health [8,9]. Vitamin D could also influence oral health, protecting against periodontal disease progression and, consequently, against alveolar bone loss. ...
... Twenty five percent smoked, and 52% of smokers smoked more than 10 cigarettes per day. Only 20% (CI 95: 9-29) ate fruit daily, and 15% (CI 95: [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] ate no fruit at all. ...
... An important finding herein, was that the young men who covered RDA of Ca did not consume this kind of beverage daily. It is well known that an optimal CaI prevents alveolar bone loss, benefiting tooth retention [2,8]. Milk provides Ca and other components such as P, lactose, and caseinphosphopeptides which enhance not only Ca absorption but also tooth health [15,31]. ...
... A link was found between higher plaque volumes, increased gingivitis and high sucrose diet (11) . While other types and dite like Milk, Cheese and yogurt, were inversely associated with carries and therefore may have cariostatic properties (8)(9)(10) . In low income African American children aged 3-5 years , the consumption of sweetened drink was a risk factor for dental caries , while the consumption of milk and real fruit juice was linked to decreased severity of dental caries (7) . ...
... Regarding the soft drinks, sweeteners and chips consumption we found that 53 (44.16%), 92 (76.6%) and 87 (72.5%) of pupils were daily consumers of soft drinks, sweeteners and chips respectively and other values are shown in the following three figures (4,5,6). The frequency of dairy products and egg consumption was that 79 (65.83%) and 88 (73.33%) of pupils were dairy products and egg daily consumers respectively, and other fewer percentages were shown in these two figures (7,8). Also there are highest percentage of dental problems is for teeth caries which are 84 (34.4%) of total cases of 244 cases of different dental problems and other fewer percentage shown in figure (9). ...
Introduction: Oral health is the practice of keeping the mouth & teeth clean to prevent dental problems, like caries and ulcers .For this sake a cross sectional study was conducted to determine the extent and effects of dietary pattern on oral health among school aged children in Kirkuk city's primary schools on a sample. Material and methods: Sample size of 120 pupils by selecting 5 pupils from each stage from 4 different schools. The duration of the study was 1 month from the 1st of March 2015 to 31th of the same month and was carried out using a questionnaire which was given to the pupils to be filled by their parents. Results: The most i mportant finding of the study was that there is a relationship betwee n dietary intake and dental problems. Conclusion: That swee teners consumer has the highest percentage of dental problems.
... It has been observed that when access to sugar is limited, caries prevalence is very low [5,8]. In addition, anticariogenic properties of some food groups such as dairy, whole grains, and high-fiber fruits have been documented [9,10]. However, apart from studying the impact of individual foods, diet as a whole must also be studied [6]. ...
... Cheese and yogurt have anticariogenic properties, as well. Several mechanisms have been proposed to explain this, although the most popular ones focus on the fact that milk proteins have a buffer effect on acid formation and promote salivary clearance [9]. ...
Children who show better eating practices are less likely to suffer from severe caries than those who eat a diet rich in sugars. In the present study, we aimed to establish the relationship between the severity of dental caries and adherence to the Mediterranean diet. A cross-sectional study was carried out in which 263 children aged 2 to 14 years old were examined intraorally to analyze the presence and severity of caries. Children's parents/caregivers completed the KIDMED questionnaire to determine their degree of adherence to the Mediterranean diet. The results showed that the prevalence of caries is greater than 80% in children with medium or low adherence to the Mediterranean diet, and remains significant at 67% in the high adherence group (p = 0.010). A statistically significant negative correlation of weak magnitude (r = -0.29; p < 0.001) was found between adherence and the number of carious teeth. Caries severity in the first molars is also influenced by adherence to the diet in a statistically significant way. In conclusion, there is an association between adherence to the Mediterranean diet and the prevalence, extension, and severity of caries in the pediatric population.
... The investigators suggested that hard cheese consumption in those patients ʻmay be regarded as effective to keep initial caries under controlʼ. 168 The Danish European Youth Heart Study found that dairy intake among children and adolescents predicts the future risk of dental caries. Dairy intake at 9 years old was associated with fewer dental caries experiences from 9 to 12 years, as well as from 9 to 15 years while calcium, whey and casein intake were associated with lower caries incidence over 3 and 6 years of follow-ups. ...
... Cheese acts cariostatic by effectively increasing the amount of calcium and phosphate required for dental enamel remineralization and by buffering plaque pH. 168,181 Petti et al. 162 found a protective effect of milk and yogurt against dental decay, including lower numbers of Streptococcus mutans, which may be attributed to different milk components, such as calcium, phosphorus, casein and whey proteins as well as lipids. Caseinophosphopeptides (CPP) and glycomacropeptide (GMP) have been shown to inhibit the growth of several cariogenic bacteria including Streptococcus mutans. ...
Milk and dairy products are an important part of the daily diet in many regions of the world due to their recognised contribution to the recommended intake of a variety of valuable nutrients, the amount of energy (calories) they provide and their ability to compensate for foods in the diet with lesser nutritional value. Since epidemiological research shifted its focus from studying the relationships between specific nutrients (such as calcium, protein or saturated fat) and health towards whole food products (e.g., milk, yogurt, cheese, butter) and health, many unexpected scientific insights were obtained. The anticipated negative health impact of salt and saturated fat was for instance not found in the case of cheese consumption. Besides this observation, many epidemiological studies and intervention trials since then have shown that the consumption of dairy products shows either favorable or neutral associations with non-communicable disease clinical outcomes.
... 11 Moreover, casein phosphopeptides extracted from yogurt and cheese may also inhibit dental enamel demineralization and promote the remineralization of tooth enamel. 12,13 There is limited research on the associations between different types of milk and dairy products and dental caries. [14][15][16][17][18] Previous studies of Italian schoolchildren aged 6-11 years 14 and African American children aged 3-5 years 15 suggested that milk intake was negatively associated with dental caries. ...
... The casein phosphopeptides extracted from yogurt and cheese might play a critical role in caries prevention by preventing demineralization and enhancing remineralization of enamel caries. 12,13,31 Moreover, epidemiologic studies have reported that people with higher levels of calcium and phosphate in plaques have a correspondingly lower risk of caries. [32][33][34] Ravishankar et al. found that the ingestion of cheese and yogurt without added sugar can increase the concentration of calcium and phosphorus in dental plaque and the plaque pH. ...
Background and objectives:
To date, few studies have comprehensively explored the associations between milk and dairy product intake and dental caries. Therefore, this study aimed to simultaneously assess the associations between whole milk, low-fat milk, skim milk, yogurt, milk desserts, cheese, creams, and total fluid milk intake and the risk of dental caries in children and adolescents.
Methods and study design:
Data were from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Two 24-hour dietary recall interviews measured dietary milk and dairy product intake. Primary teeth caries was diagnosed by the dfs (decayed or filled primary tooth surfaces) index, and permanent teeth caries was diagnosed by the DMFS (decayed, missing, or filled permanent tooth surfaces) index. We used logistic regression to explore the associations between milk and dairy product intake and the risk of dental caries.
Results:
A total of 6885 individuals aged 2-17 years were included in this study. In the fully adjusted model, the odds ratios (95% confidence intervals) of dental caries were 0.66 (0.47-0.93) for intake ≥123 g/day of yogurt and 0.82 (0.69-0.98) for intake <22.6 g/day of cheese, as compared with non-consumers.
Conclusions:
Our study indicates that high yogurt and low cheese intake were associated with a decreased risk of dental caries among American children and adolescents. These findings may be applied to update and supplement the evidence that informs public health policies on milk and dairy products and the prevention of dental caries.
... A link was found between higher plaque volumes, increased gingivitis and high sucrose diet (11) . While other types and dite like Milk, Cheese and yogurt, were inversely associated with carries and therefore may have cariostatic properties (8)(9)(10) . In low income African American children aged 3-5 years , the consumption of sweetened drink was a risk factor for dental caries , while the consumption of milk and real fruit juice was linked to decreased severity of dental caries (7) . ...
... Regarding the soft drinks, sweeteners and chips consumption we found that 53 (44.16%), 92 (76.6%) and 87 (72.5%) of pupils were daily consumers of soft drinks, sweeteners and chips respectively and other values are shown in the following three figures (4,5,6). The frequency of dairy products and egg consumption was that 79 (65.83%) and 88 (73.33%) of pupils were dairy products and egg daily consumers respectively, and other fewer percentages were shown in these two figures (7,8). Also there are highest percentage of dental problems is for teeth caries which are 84 (34.4%) of total cases of 244 cases of different dental problems and other fewer percentage shown in figure (9). ...
Dietary patterns and oral health among school children aged 6-12years old in Kirkuk city
... [57][58][59][60] In this study, underweight children had a slightly higher percentage of caries compared with normal counterparts whereas overweight and obese children had slightly lower. Aluckal et al. 62 concluded that the presence of undernutrition or obesity and childhood dental caries are coincidental in many populations. The insignificant association obtained in this study could be explained by this coincidental situation. ...
... The anti-cariogenic characteristics of some food groups, including dairy products in particular cheese, whole grains, fruits rich in fiber have been documented in previous studies. [62][63][64] Apart from individual food items, the total diet should also be considered for its potential in the development of dental caries. HEI-2010 is a useful tool that reflects the overall dietary intake. ...
SUMMARY: İnan-EroğluE, Özşin-ÖzlerC, ErçimRE, BüyüktuncerZ, Uzamış-TekçiçekM, Güçiz-Doğan B. Is diet quality, associated with early childhood caries in preschool children? A descriptive study. Turk J Pediatr 2017; 59: 537-547.Limited evidence about the role of diet quality, an important component of nutritional status, in the etiology of dental caries has been reported. The aim of this study was to examine the association between diet and dental caries in children by using the dietary intake data, anthropometrical measurements and dental examination. A total of 395 children (52.7% boys and 42.8% girls) who were 36-71 months of age (mean age 58.7±8.6 months) and attended one of the eleven preschools within a district of Ankara participated in this descriptive study. Dental examinations were performed in the schools under day-light by a pediatric dentist; decayed, missing and filled teeth as well as surfaces were recorded. Data related to socio-demographic characteristics and 24-hour dietary recall of children were gathered via a structured, pre-tested questionnaire which was conducted by the research dietitian. The Healthy Eating Index-2010 (HEI-2010) and Mediterranean Diet Quality Index for children and adolescents (KIDMED) were used to assess dietary intake. Anthropometric measurements including weight, height, upper arm circumference and head circumference were taken by the same researcher. The percentage of Early Childhood Caries (ECC) was increased by age (p<0.001) whereas no significant difference was observed by sex, socioeconomic status, tooth brushing frequency and body mass index (p>0.05). Although children who had bad KIDMED scores had slightly higher mean values of decayed missing and filled teeth (dmft) (5.39± 4.6) and decayed missing and filled surface (dmfs) (8.45± 8.69), compared to the scores of children with good or medium KIDMED scores, the differences were not statistically significant (p>0.05). On the contrary to the KIDMED findings, the mean value of tooth decay was significantly higher among children with bad HEI-2010 score (4.2±4.3) compared to children with medium HEI-2010 score (2.47±2.9) (p=0.043). It is concluded that a healthy eating pattern and high diet quality is essential for the prevention of early childhood caries in preschool children. Further studies are required to develop dietary strategies for the prevention of dental caries.Key words: dental caries, childhood, preschool, diet quality, body measures.
Is diet quality associated with early childhood caries in preschool children? a descriptive study. Available from: https://www.researchgate.net/publication/324853472_Is_diet_quality_associated_with_early_childhood_caries_in_preschool_children_a_descriptive_study [accessed May 07 2018].
... Most recently, Moynihan et al. (1999) reported that cheese-containing meals increased plaque calcium concentrations to a significantly greater level than control meals lacking cheese. Indeed, findings that cheese and milk casein phosphopeptides appeared to enhance remineralization, in addition to reducing demineralization, lends further credence to the general conclusion that cheese has a pronounced anti-caries effect (Kashket et al., 2002). Consuming cheese reduces the effect of metabolic acids and helps restore enamel that is lost during eating (Kashket et al., 2002).The mechanism of caries prevention using-cheese involves buffering, salivary stimulation, reduction of bacterial adhesion, reduction of enamel demineralization, and/or promotion of remineralization by casein replacement of Ca and P. Cheese-containing meals increase plaque calcium concentration and thus protect against dental caries (Moynihan et al., 1999). ...
... Indeed, findings that cheese and milk casein phosphopeptides appeared to enhance remineralization, in addition to reducing demineralization, lends further credence to the general conclusion that cheese has a pronounced anti-caries effect (Kashket et al., 2002). Consuming cheese reduces the effect of metabolic acids and helps restore enamel that is lost during eating (Kashket et al., 2002).The mechanism of caries prevention using-cheese involves buffering, salivary stimulation, reduction of bacterial adhesion, reduction of enamel demineralization, and/or promotion of remineralization by casein replacement of Ca and P. Cheese-containing meals increase plaque calcium concentration and thus protect against dental caries (Moynihan et al., 1999). Several investigators have since confirmed that milk, cheese, caseins and whey proteins reduce caries development even in highly susceptible rats, such as desalivated rats. ...
... However, the parents of 26 children did not consent. Finally, we included 224 schoolchildren from 6 to 12 years old; 144 of them had < 3 caries (median 1; range 0-2) and 80 had ≥ 3 caries (median 7; range [3][4][5][6][7][8][9][10][11][12][13][14]. The exclusion criteria were craniofacial malformation or having a chronic disease such as diabetes, renal or other diseases that influence food consumption or BMI. ...
... 5,15 It has also been shown that milk could reduce the effect of acids produced by carbohydrate metabolism and might result in enamel restoration, saliva stimulation and reduction in bacterial adhesion. 14 Milk proteins, such as bovine and human caseins and lactoferrin, inhibit the initial attachment of cariogenic mutans streptococci to hydroxyapatite coated with saliva or purified saliva host ligands. In contrast, both bovine and human milk on hydroxyapatite promotes attachment of commensal Actinomyces naeslundii and other streptococci in vitro, while phosphorylated milk-derived peptides promote the maintenance of tooth minerals, as shown for the -casein-derived casein-phosphate peptide. ...
Purpose:
To determine the association between types of food consumed, nutritional status (BMI) and caries in schoolchildren.
Material and methods:
A cross-sectional study was performed with 224 schoolchildren 6 to 12 years of age. DMFT/ dmft indices, level of oral hygiene, nutritional status as quantified by BMI and types of food consumed were determined in all participants. Data were analysed using multiple linear regression with significance set at p < 0.05.
Results:
Caries prevalence was 36%. In the multiple linear regression analysis adjusted for BMI, variables related to a higher number of caries were younger age and lower intake of vitamin D, calcium and fiber, with higher consumption of phosphorous and carbohydrates (R2 = 0.30; p < 0.0001 for the model). Sweetened softdrinks and chewy candy were risk factors for higher caries prevalence, while consuming milk and carrots were protectors.
Conclusion:
Caries in schoolchildren is highly prevalent in this community and is related to younger age and lower intake of vitamin D, calcium and fiber, but a higher consumption of phosphorous and carbohydrates. No relationship was found between caries and nutritional status.
... The major therapeutic effect of cheese is its antioxidant or radical scavenging activities due to the antioxidant peptides it contains (Santiago-López et al. 2018). It is an excellent source of calcium and, as a result, protects the bones and enamel from demineralisation (Kashket and DePaola 2002). ...
Proteins are the second most essential macromolecules after nucleic acids. This article aimed at the comparative analysis of extraction methods and nutritional benefits of milk and dairy products. Proteins form the body mass and perform several crucial tasks that include acting as a catalyst and carrying out different metabolic reactions in the body. Furthermore, protein acts as a transporter, transmits nerve impulses, provides mechanical support or immune protection, and controls growth. Several sources of proteins are present, but milk holds an important place due to its biological activities. The considerable health benefits of milk and its products are due to proteins. Yoghurt and cheese have significant importance among milk products. Proteins of milk and its products can be extracted by pH adjustment through homogenisation, centrifugation, and deproteinisation. There are several techniques for identifying and quantifying milk and product proteins. The Kjeldahl and spectrophotometric methods are the most widely used methods for quantifying proteins in milk and its products. Furthermore, these techniques include electrophoresis and chro-matographic methods, including native gel electrophoresis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), urea-PAGE, capillary electrophoresis, and isoelectric focusing. A few are chromatographic methods like reverse-phase high-performance liquid chromatography (RP-HPLC), size exclusion chromatography, and ion-exchange chromatography. Each technique has its advantages as well as disadvantages. The selection of the process depends upon the type of protein. The extracted proteins from milk and its products have many health or therapeutic effects that exhibit antimicrobial, antiproliferative, antioxidant, antihypertensive, anticancer, antiviral, and immunomodula-tory effects. Yoghurt has prime importance among milk products because of its therapeutic effects and more protein.
... These antimicrobial effects are also used in commercial products such as toothpaste, gels, mouth rinses [127,128], and chewing gum. Dairy products contain calcium, phosphate, and lipids, which have caries-protective effects [129][130][131]. Cheese harbors casein phosphor-peptides to stabilize calcium and phosphate to amorphous calcium-phosphate, a special textural effect in binding calcium and phosphate in solution, as well as in dental plaque and enamel [132][133][134][135]. Chewing hard cheese stimulates the salivary flow and remineralization of the teeth by increasing calcium and phosphate in the dental plaque [134,136]. ...
Food and fluid supply is fundamental for optimal athletic performance but can also be a risk factor for caries, dental erosion, and periodontal diseases, which in turn can impair athletic performance. Many studies have reported a high prevalence of oral diseases in elite athletes, notably dental caries 20–84%, dental erosion 42–59%, gingivitis 58–77%, and periodontal disease 15–41%, caused by frequent consumption of sugars/carbohydrates, polyunsaturated fats, or deficient protein intake. There are three possible major reasons for poor oral health in athletes which are addressed in this review: oxidative stress, sports diet, and oral hygiene. This update particularly summarizes potential sports nutritional effects on athletes’ dental health. Overall, sports diet appropriately applied to deliver benefits for performance associated with oral hygiene requirements is necessary to ensure athletes’ health. The overall aim is to help athletes, dentists, and nutritionists understand the tangled connections between sports diet, oral health, and oral healthcare to develop mitigation strategies to reduce the risk of dental diseases due to nutrition.
... 29 Also, a diet rich in calcium, phosphate and protein might favour remineralization and could thereby decrease the risk of caries. 30 Milk products are included in the dietary guidelines and contain lactose as a carbohydrate, which is the least cariogenic sugar, and high levels of calcium, phosphate and casein, which may therefore favour oral health. 29,31 The findings of our study are in line with those from the limited number of previous studies that investigated adherence to dietary Notes: Values are means 6 SD for continuous variables, and absolute numbers with valid percentages for categorical variables. ...
Background:
Even though dietary sugars are the most important nutrient for caries development, the disease process is dependent on other dietary practices. The intake of individual nutrient components cannot be evaluated separately from the overall diet which includes other nutrients, foods and habits. Therefore, the aim of this study was to investigate the association between adherence to dietary guidelines and dental caries.
Methods:
This study was embedded in the Generation R Study, conducted in Rotterdam, the Netherlands. In total, 2911 children were included in the present analyses. Dietary intake at the age of 8 years was assessed using food-frequency questionnaires. Diet quality scores were estimated, reflecting adherence to Dutch dietary guidelines. Dental caries was assessed at the age of 13 years using intra-oral photographs. Associations were estimated using multinomial logistic regression analyses, adjusted for sociodemographic characteristics and oral hygiene practices.
Results:
The prevalence of dental caries at the age of 13 years was 33% (n = 969). Better diet quality was associated with a lower occurrence of severe dental caries after adjustments for sociodemographic factors [e.g. highest vs. lowest quartile of diet quality: odds ratio (OR) 0.62, 95% confidence interval (CI) 0.39-0.98]. After additional adjustments for oral hygiene practices, this association was not statistically significant (OR 0.65, 95% CI 0.41-1.03).
Conclusion:
Adherence to dietary guidelines has the potential to reduce dental caries in children; however, with proper oral hygiene practices, this relationship might be attenuated. To understand the role of dietary patterns and dental caries, the contributing role of daily eating occasions needs to be studied further.
... 34,35 The role of milk and dairy products in dental caries prevention has been described in various reviews. [36][37][38] El Deeb and Moneim recommend the consumption of milk following every meal containing acidic diet to reverse the demineralization process. 39 GC tooth mousse is a very expensive product and children's compliance is questionable, on the other hand, milk is highly economical, easily available, and is necessary for a child's normal growth and development. ...
Introduction Caries initiation is associated with demineralization of the subsurface tooth enamel. Today, bioactive agents based on milk products have been developed to enhance remineralization under cariogenic conditions. However, there is limited information on the remineralization potential of milk.
Materials and Methods Fifty enamel specimens were prepared from sound human premolars. All enamel specimens were then placed in demineralizing solution for 4 days at 37°C to produce artificial carious lesion. Baseline surface microhardness (SMH) was evaluated using Vickers indenter. Enamel specimens were then randomly divided into three groups. Group 1 specimens were kept in artificial saliva, whereas group 2 and 3 enamel specimens were treated with milk and GC tooth mousse, respectively, for 5 minutes twice daily for 21 days. Post-treatment SMH measurements of all specimens were evaluated on the 7th, 14th, and 21st day. Data was statistically analyzed using one-way analysis of variance test and Tukey honest significant difference post-hoc test.
Results There were no significant differences in the SMH values in the control group at any time interval. There were statistically significant increases in the post-SMH values in milk and GC tooth mousse (p < 0.001) at the end of 21st day of remineralization.
Conclusion Milk showed remineralization potential comparable to that of GC tooth mousse.
... The mostly educated children's mother in the control group was undergraduates (46.66%) followed by higher secondary level (40%), primary (10%) whereas in the case group was higher secondary (53.33%) followed by primary (26.66%), under graduate (16.66%) and postgraduate only 3.33% in both groups. However, a cross-sectional study in Japan reported that dental caries in 3-yearold children was more strongly associated with child-rearing behaviors than mother-related factors, such as health insurance, health behaviors, and dental health status 29 . ...
... However, a higher proportion of animal protein in the diet has a more beneficial effect on dental health [10]. The proteins found in dairy products, especially casein, reduce caries activity by inhibiting bacterial attachment to enamel as well as decreasing the solubility of hydroxyapatite, thus counteracting demineralization [65][66][67]. However, it cannot be ruled out that women preferred foods with a higher starch or sugar content, such as porridge, fruits, and honey. ...
Dental health is closely linked to an individual’s health and diet. This bioarcheological study presents dental caries and stable isotope data obtained from prehistoric individuals (n = 101) from three Early Neolithic sites (c. 5500-4800 BCE) in central Germany. Dental caries and ante-mortem tooth loss (AMTL) were recorded and related to life history traits such as biological sex and age at death. Further, we correlate evidence on caries to carbon and nitrogen isotope data obtained from 83 individuals to assess the relationship between diet and caries. In 68.3% of the adults, carious lesions were present, with 10.3% of teeth affected. If AMTL is considered, the values increase by about 3%. The prevalence of subadults (18.4%) was significantly lower, with 1.8% carious teeth. The number of carious teeth correlated significantly with age but not sex. The isotopic data indicated an omnivorous terrestrial diet composed of domestic plants and animal derived protein but did not correlate with the prevalence of carious lesions. The combined evidence from caries and isotope analysis suggests a prevalence of starchy foods such as cereals in the diet of these early farmers, which aligns well with observations from other Early Neolithic sites but contrasts to Late Neolithic and Early Bronze Age populations in Germany.
... This correlates with the study by Ravishankar et al 32 and Moynihan et al. 18 Kashket and DePaola stated that milk products increase the calcium and phosphorus level in plaque thus diminishing demineralization and favoring remineralization. 34 Also, the casein present in milk products forms casein phosphopeptide on tryptic proteolysis. These form CPP-ACP complexes which stabilize colloidal calcium and phosphates, maintaining their supersaturation in saliva. ...
Aim The present study was performed to assess and compare the changes in pH, calcium, phosphorus, alkaline phosphatase, and the total antioxidant capacity (TAC) of saliva after consuming candies, followed by rinsing with water and consumption of paneer.
Materials and Methods Baseline saliva of 5 mL was collected from 60 children and they were asked to chew on candies. After 10 minutes of intake of candies, 5 mL of saliva was collected. They were then divided into two groups of 30 each and test products were given. Group 1: rinse with water and group 2: chew 20 g of paneer and swallow. Saliva of % mL was collected after 10, 20, and, 30 minutes from the study groups. The saliva samples collected were assessed for pH, calcium, phosphorus, alkaline phosphatase, and TAC. The data were analyzed using the paired t-test and post hoc Tukey's test.
Results The pH, calcium, phosphorus, and alkaline phosphatase decreased from baseline values after consuming candies significantly (p < 0.001). These increased after rinsing with water and consumption of paneer which was statistically significant (p < 0.001). The TAC values increased significantly after consuming candies and decreased after rinsing with water and consumption of paneer which was substantial for both the groups.
Conclusion Consumption of candies created a cariogenic milieu. Both the study groups were effective in the reversal of the cariogenic potential. The consumption of paneer caused remineralizing properties and showed superior results than rinsing with water.
... En el proceso de formación de las caries, los tejidos duros del diente sufren una descomposición y desorganización molecular, existiendo un proceso de descalcificación y disolución progresiva de los materiales inorgánicos y desintegración de su matriz orgánica por acción de los productos del metabolismo bacteriano (González Sanz et al., 2013). El esmalte dental está compuesto principalmente por cristales de hidroxiapatita (HA) de fosfato de calcio (Ca 5 OH(PO 4 ) 3 ) y una pequeña cantidad de proteínas (Kashket y DePaola, 2002). La solubilización de este material se conoce como "desmineralización" y se produce por acción de los ácidos orgánicos que liberan calcio (Ca) y fósforo (P) que son removidos de la boca por el movimiento de la saliva. ...
Caseinomacropeptídeo é um grupo de peptídeos glicosilados que contêm ácido siálico; eles são atribuídos à atividade anticariogênica. No presente estudo, três iogurtes (experimentais) adicionados aos ingredientes-fonte desses peptídeos foram formulados em escala de laboratório: concentrado protéico de soro 80% e caseinomacropeptídeo em diferentes níveis, que foram comparados com um iogurte (controle) contendo apenas leite em pó desnatado. Aos 21 dias, foram determinados a composição físico-química, o ácido siálico e a atividade anticariogênica, esta última com teste de desmineralização in vitro utilizando hidroxiapatita como modelo dentário e dois tampões erosivos. Os iogurtes apresentaram parâmetros físico-químicos normais e níveis de ácido siálico na faixa de 28,4 a 431,7 mg / g. A proteção dos iogurtes experimentais contra o cálcio e o fósforo da hidroxiapatita foi significativamente maior em comparação com o controle; o valor de pH do tampão não influenciou a proteção.
... In Table ( (21,22) . (25) . Also, milk has bioactive peptides, casein phosphor proteins that are strongly absorbed in the surface of enamel and able to reduce the activity and adsorption of glucosyltransferase enzymes, also preventing or reducing the dissolution of the enamel (26) . ...
Aims: The aim of this study was to evaluate the effect of CPP−ACP, raw fresh buffalo milk and cow milk on the microhardness of artificial initial caries lesions. Materials and Methods: 100 sound maxillary first premolars were collected and randomly divided into four groups, the teeth in all groups were subjected to pH cycling procedure then treated with: Group1: n (25) deionized water, group2: n (25) CPP−ACP tooth mousse, group3: n (25) fresh raw cow milk, group4: n (25) fresh raw buffalo milk. Enamel surface was assessed by Vickers microhardness test device at a baseline and after demineralization and after remineralization. Results: In all groups, there were high statistically significant reduction of surface microhardness after demineralization. There was high statistically significant increase in surface microhardness in all groups except deionized water after remineralization, the highest remineralization effect was found in CPP−ACP tooth mousse group followed by the milk groups that showed encouraging results with fresh raw buffalo milk having superior results then fresh raw cow milk. Conclusions: CPP−ACP tooth mousse, raw fresh buffalo milk and cow milk were effective remineralizing agents which were reflected by increasing the surface microhardness of artificial initial caries lesion, but with different abilities, CPP−ACP tooth mousse was the best followed by buffalo milk then cow milk.
... Phosphorus is an important macronutrient in the human diet, as it is involved in mineralisation of bones and teeth and contributes to the maintenance of the acid-base balance in the organism. The intake of increased amounts of basic substances, such as phosphorus or calcium, reduces demineralisation and enhances mineralisation of enamel (18). The was higher than the content of 1.29 g·kg − 1 reported by Barczak and Nowak (26). ...
Background
Nutrition is one of the major determinants of human health. Consuming plant foods provides not only nutrients but also bioactive substances that reduce disease. The health of the oral cavity is determined by the quality of food, including vegetable food.Objective
To study the effects of macro and microelements in vegetables on the status of mineralised dental tissues in relation to the hygiene and nutritional habits in 15-year-old adolescents living in Lublin Province and Lviv Oblast.Methods
The chemical composition of plants was assessed (macro and microelements) of carrots and potatoes, vegetables consumed by 15-year-old inhabitants of Poland and Ukraine. The status of mineralised dental tissues was assessed based on caries severity expressed by the mean D3MFT number and the SIC index value. Another part of the study was a socio-medical survey focused on assessment of patients' eating habits.The respondents answered questions about the frequency of consumption of fruit and vegetables and fruit juices.ResultsThe chemical composition of plants depended on the species and place of cultivation. The present study showed higher caries frequency in the group of the 15-year-olds living in Kraśnik, i.e. 88% vs. 75% in the group from Chervonograd. The intensity of caries measured by the mean D3MFT value in the 15-year-old teenagers from Chervonograd who declared everyday consumption of fresh vegetables and fruit was 3.77, and from Krasnik 5.17.Conclusion
The present results show that carrots are a good source of microelements for humans, whereas potatoes provide potassium and calcium. The impact of the frequency of consuming plant products on the health of the oral cavity, which depended on the place of youth research.
... week had a lower incidence of root surface caries 33 development. several reviews describe the role of milk [34][35][36] and dairy products in dental caries prevention. ...
Caries initiation is associated with demineralization of the subsurface tooth enamel. At this early stage, the caries lesion is reversible via a remineralization process involving the diffusion of calcium and phosphate ions into the subsurface lesion to restore the lost tooth structure. However, children with high caries risk who have an increased and/or repeated episodes of demineralization require additional strategies to enhance remineralization. Today bioactive agents based on milk products have been developed in order to release elements that enhance remineralization of the enamel and dentine under cariogenic conditions. However, there is limited information on the remineralization potential of milk and milk products.
... 19 Rezultati studija na `ivotiwama i in vitro studija ne samo da dokazaju ve} i obja-{wavaju protektivno dejstvo unosa sira u nastanku karijesa. 20 Imaju}i u vidu malu zastupqenost sira u dru{tvenoj ishrani pred-{kolske dece, wegovo u~e{}e treba pove}ati. Preporu~uqivo je da se pripremaju jela koja sadr`e termi~ki obra|en sir, kako bi se smawio epidemiolo{ki rizik. ...
... Probiotic cheese reduces the risk of dental caries (decay) which usually results from the breakdown of tooth enamel by acids produced during the fermentation of sugars and starches by the plaque bacteria [135]. The short-term consumption of probiotic cheese containing Lactobacillus rhamnosus GG and Lactobacillus rhamnosus LC 705 reduced caries-associated salivary microbial counts such as Streptococcus mutans by 20% and salivary yeast by 27% in young adults [136]. ...
... Les fromages, particulièrement ceux à pâte ferme comme le cheddar et la mozzarella, auraient le plus grand effet cariostatique. La consommation de fromage préviendrait la chute du pH de la plaque en augmentant efficacement la concentration de calcium dans la salive [24][25] . Même le lait au chocolat, la boisson de soya aromatisée et les yogourts sucrés auraient un effet protecteur malgré leur teneur en sucres [26] . ...
... Among fermented dairy products, cheese is known as a cariostatic food due to its ability in stimulating salivary flow, increasing rate of sugar clearance, inhibition of plaque bacteria, delivery of high amounts of calcium and inorganic phosphate to plaque, and increasing the pH (Kashket and DePaola 2002). Most of these effects have been shown to be mediated by micellar casein (Guggenheim et al. 1999). ...
Although the region in which milking was first practiced remains unknown, direct evidence for dairying in the seventh millennium BC in northwestern Anatolia has been recently reported (Evershed etal. 2008). Organic (lipid) residues preserved in archaeological pottery have provided further evidence for the use of processed (fermented) milk in the sixth millennium BC in Eastern Europe, and in the fourth millennium BC in Britain (Copley etal. 2006). Therefore, fermentation is without any doubt among the oldest techniques of food preservation. It is also an easy way to derive new products. Indeed, milk can be transformed into a vast array of fermented products (Table 5.1), which are important from both nutritive and economical points of view (Kosikowski and Mistry 1997, Tamime 2002, de Ramesh etal. 2006, Robinson and Tamime 2006). More than 400 generic names are applied to traditional and industrialized fermented milk beverages (Robinson and Tamime 2006), and 500-1000 different cheese types have been proposed (Kosikowski and Mistry 1997) (Figures 5.1 through 5.3). Although the list of presentation still continues to be increasing, the real number of different varieties is thought to be much shorter.
... The difference was significant between the rural and urban area, showing the greater presence of dental caries among the children living in a rural environment [27]. Kashket S., et al. after analyzing the results obtained from the study on dietary habits and the presence of dental caries in children aged 3 -5, concluded that the consumption of sweetened juices is a risk factor for the appearance of caries while consumption of milk and unsweetened Juices are associated with a reduction of the caries appearance [28]. ...
Objective: The purpose of this study is to determine the correlation between the dmft/DMFT index of 6-year-olds and the concentration of fluoride in drinking water from the populated areas where children live. Material and Method: The survey covered 95 students, from 1 central and 4 regional primary schools, at which the dmft/DMFT index was determined. Children live in the city of Strumica and four different villages. Five water samples were taken from the test area to determine the fluorine concentration by electrochemical method using the pH/ISE meter-Thermo-Orion with a special F-electrode (Thermo Orion Ion Plus Fluoride Electrode) at the Institute of public health. A Spearman method was used to determine the correlation between the specified variables. Results: The total number of children in the examined sample was 95, out of which 52 (54.7%) were female and 43 (45.3%) were male. The average dmft index in this group of children was 5.29, with a standard deviation of ± 4.3 for primary dentition, and an average DMFT index of 0.07 ± 0.3 for permanent dentition. Maximum concentrations of fluorine in drinking water of 0.14 ppmF were determined in the village of Veljusa and the village of Vodocha (0.11 ppmF), while the minimum (0.08 ppmF) in the city of Strumica and in the villages of Dobrejci and Banica. The correlation between the value of the dmft index from 6 years old children from the Southeast region and the concentration of fluorine in drinking water, was a negative, indirect correlation with the value of the coefficient r =-0-049. Negative, statistically indirect correlation, there is also detected between the value of the DMFT index of permanent teeth in the group of 6-year-olds and the fluorine concentration in the Southeast region (R =-0.085, p> 0.05).
... The increase in pH during consumption appears to be closely associated with increased salivary flow and perhaps buffering capacity, but may involve other factors as well, including the increased supply of nitrogenous substrates. 1,8,10 Although dairy products are proven to be caries protective foods, 13 individuals make food choices in the context of their culture. Paneer (a traditional Indian dairy product) is an unsweetened, unripened form of cheese made by the addition of lime juice to milk, which retains the noncariogenic components of milk. ...
Purpose:
To assess and compare the salivary pH reversal phenomenon and calcium concentration in subjects consuming paneer and cheese after an acidogenic challenge and also to compare the salivary pH measurements using pH strips and a portable pen-type pH meter.
Material and methods:
Sixty caries free undergraduate students were randomly selected and divided into two group: 1. paneer; 2. cheese. After determining the resting salivary pH using pH strips and a pen-type pH meter, participants were subjected to an acidogenic challenge (10% sucrose). Following consumption of test foods (10-gram cubes), salivary pH was measured at intervals of 5, 10, 15, 30 and 60 min to record the time taken for the salivary pH to return to baseline. Colorimetric salivary calcium concentration was estimated (Biochemical Analyzer) at baseline and after 60 min of test food consumption. The statistical tests used were Shapiro-Wilk's test for normality, repeated measures ANOVA, and the independent t-test.
Results:
Test meals reversed the fall in pH after acidogenic challenge starting at 5 min and returning to baseline values after 30 min in both groups (p = 1.000). Colorimetric estimates showed higher salivary calcium concentrations with paneer (p < 0.001). The pen-type pH meter showed superior efficiency in terms of time (p < 0.001) compared to pH strips.
Conclusion:
The salivary pH reversal phenomenon was evident after consumption of both paneer and cheese following the acidogenic challenge. Consumption of paneer significantly increased salivary calcium concentration. The pen-type pH meter proved to be more efficient.
... Probiotic cheese reduces the risk of dental caries (decay) which usually results from the breakdown of tooth enamel by acids produced during the fermentation of sugars and starches by the plaque bacteria [135]. The short-term consumption of probiotic cheese containing Lactobacillus rhamnosus GG and Lactobacillus rhamnosus LC 705 reduced caries-associated salivary microbial counts such as Streptococcus mutans by 20% and salivary yeast by 27% in young adults [136]. ...
... These findings, relative to root caries, are particularly important for older adults, many of whom consume a diet rich in simple sugars and are at risk of root caries. Mechanisms proposed to explain the anticariogenic effects of cheeses are as follows: 1) increased salivary flow and the subsequent buffering effect, which can neutralize plaque acids; 2) inhibition of plaque bacteria and the effect of that inhibition on reducing the amount of bacteria, thereby reducing acid production; and 3) intake of increased alkaline substances, calcium, inorganic phosphate, and casein, which decrease demineralization and enhance remineralization (93). ...
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.
... Kajian Moynihan et al. (1999) menyatakan bahawa kesan perlindungan (dalam pencegahan dimineralisasi dan merangsang remineralisasi) enamel disumbang oleh kalsium dalam keju yang mempunyai bentuk tersedia diserap ke dalam plak. Kajian lepas seperti kajian oleh Kaskhet & DePaola (2002) menunjukkan bahawa susu dan keju dapat mengurangkan kesan asid metabolik dan membantu memperbaiki enamel yang larut semasa makan. ...
... The dental benefits of cheese are less well-known and are due to several mechanisms. Herod [34] stated that chewing cheese leads to an increased stimulation of saliva which results in increased buffering of acids found in dental plaque and also delivers calcium and phosphate which enhances remineralisation [36]. ...
Background
The aim of this study was to determine if paediatric oral health education leaflets with a food and nutritional focus provide messages that are clear and consistent with the current Australian Dietary Guidelines and the Infant Feeding Guidelines. Methods
Forty-three leaflets aimed at parents were sourced from Australian state and territory Health Departments, oral health industry partners and commercial organisations, and a content analysis was performed. Recommendations on food and drink type, consumption frequency and general diet and nutrition advice were considered and cross-referenced with the Australian Dietary Guidelines and the Infant Feeding Guidelines to identify areas of consistency and discrepancy. ResultsTwenty leaflets recommended reducing the consumption of sugary and/or acidic food, while 23 leaflets recommended reducing the consumption of sugary and/or acidic drinks. The majority of the leaflets advised water (n = 35) and milk (n = 23) to drink. Although 33 leaflets encouraged a healthy diet, seven of these did not specify what a healthy diet was. Twenty-eight leaflets provided early childhood-related (0–2 years) feeding advice. Confusing messages were found in nine leaflets, with ambiguous recommendations that were open to individual interpretation. Conclusions
There were some inconsistencies between the leaflets and the dietary and infant feeding guidelines in Australia; and across the leaflets, as not all important messages were included in any one leaflet. Government Health Departments and other relevant agencies should ensure that advisory messages regarding diet, particularly those with dental implications, are clear, complete and consistent across all dental educational leaflets.
... While calcium helps to strengthen the enamel of teeth, reducing risks of tooth caries 41 , consumption of dairy products reduces the effects of metabolic acids and helps restore the enamel that is lost during eating 42 . Previous studies revealed that dietary nutrients and calcium intake, particularly calcium from dairy products, may have an inverse association with number of teeth lost and prevalence of periodontitis for adult men and women 41,43,44 . ...
Objectives:
To assess the dental health status of older Singaporeans by age, gender and ethnicity.
Background:
Poor dental health in elders has been linked to a number of adverse health conditions and is often associated with an increased risk of mortality in older people.
Materials and methods:
Data came from a nationally representative cross-sectional 2009 survey of community-dwelling Singaporeans aged 60 and over. The distribution of the number of natural teeth, chewing ability and the presence of dentures were assessed by age, gender and ethnicity (Chinese/Malay/Indian) using sampling weights.
Results:
With increasing age, there was a decrease in the average number of natural teeth, a decrease in the proportion of people with 20 or more natural teeth and with the strongest chewing ability, and an increase in the proportion that was edentulous or had dentures. Women, vs. men, had a lower average number of natural teeth (10.3 vs. 12.8), and they were more likely to be edentulous (37 vs. 24%) and to have dentures (73 vs. 63%). Across ethnic groups, Indians had the highest average number of natural teeth (17.0). However, among those who had dentures, Indians were the least likely to have the strongest chewing ability.
Conclusions:
The findings demonstrated differences in dental health status by age, gender and ethnicity. They highlight the need for improvements in the dental health status of all older Singaporeans, especially older women. The data presented herein may serve as a baseline for policymakers to evaluate the impact of recent schemes launched by the Ministry of Health (Singapore) to subsidise dental treatment.
... Cheese calcium is highly bioavailable due to the complex form between the cheese peptides and calcium, this prevents the calcium against precipitation and aid in absorbtion of the intestine [56]. The cheese consumption helps to prevent the tooth caries by enhancing remineralization and reducing demineralization process [57]. It also acts as a good source of calcium for the lactose intolerant individuals, where most of the lactose is metabolized and largely removed in whey [58]. ...
Cheese serves as a one of the good sources for essential nutrients, such as proteins, lipids, minerals and vitamins. It can enhance health benefits by the production of certain peptides and free amino acids which has various bioactive properties, such as anti-microbial, anti-carcinogenic, anti-thrombotic and so on. Certain biologically active lipids, such as conjugated fatty acid (CLA) and milk fat globule membrane (MFGM), present in cheeses are also found to be health beneficial. Thus, it plays a very important role in the diet of human; however, it suffers from adverse nutritional image due to the presence of saturated fatty acid, cholesterol and salt content. It can be overcome by the production of cheese with low fat or cholesterol removal and by the addition of certain functional living materials, such as probiotic bacteria. The non-starter lactic acid bacteria (NSLAB) used in the cheeses found to be bioactive, such as inactivation of antigenotoxins and production of gamma-aminobutyric acid generation of bioactive peptides. This chapter describes the nutritional significant of cheese components, and their role in enhancing the health benefits.
... Among fermented dairy products, cheese is known as a cariostatic food due to its ability in stimulating salivary flow, increasing rate of sugar clearance, inhibition of plaque bacteria, delivery of high amounts of calcium and inorganic phosphate to plaque, and increasing the pH (Kashket and DePaola 2002). Most of these effects have been shown to be mediated by micellar casein (Guggenheim et al. 1999). ...
... Transcription of trkA (SMU.1708) and trkH (SMU.1709), involved in potassium uptake, was upregulated, consistent with the role of potassium as the major counter-ion for outward-driven proton pumping via F-ATPases (Sato et al., 1989;Dashper & Reynolds, 1992;Iwami et al., 1997;Kashket & DePaola, 2002;Sheng & Marquis, 2006;Gong et al., 2009;Krastel et al., 2010). Regulation of phosphoenolpyruvate:phosphotransferase system (PTS) genes was complex, with the genes encoding the HPr kinase (SMU.754) and components of the b-glucoside (bglP, SMU.980) and cellobiose (ptcC, SMU.1596) PTS upregulated and manL (SMU.1877) and manM (SMU.1878) ...
The aciduricity of Streptococcus mutans is an important virulence factor of the organism, required to both out-compete commensal oral microorganisms and cause dental caries. In this study, we monitored transcriptional changes that occurred as a continuous culture of either an acid-tolerant strain (UA159) or an acid-sensitive strain (fabM::Erm) moved from steady-state growth at neutral pH, experienced glucose-shock and acidification of the culture, and transitioned to steady-state growth at low pH. Thus, the timing of elements of the acid tolerance response (ATR) could be observed and categorized as acute vs. adaptive ATR mechanisms. Modulation of BCAA biosynthesis, DNA/protein repair mechanisms, ROS metabolizers, and PTS occurred in the initial acute phase, immediately following glucose-shock, while up-regulation of F1 F0 -ATPase did not occur until the adaptive phase, after steady-state growth had been re-established. In addition to the archetypal ATR pathways mentioned above, glucose-shock led to differential expression of genes suggesting a re-routing of resources away from synthesis of fatty acids and proteins, and towards synthesis of purines, pyrimidines and amino acids. These adjustments were largely transient, as upon establishment of steady-state growth at acidic pH, transcripts returned to basal expression levels. During growth at steady-state pH 7, fabM::Erm had a transcriptional profile analogous to that of UA159 during glucose-shock, indicating that even during growth in rich media at neutral pH, the cells were stressed. These results, coupled with a recently established collection of deletion strains (Quivey et al., 2015), provide a starting point for elucidation of the acid tolerance response in S. mutans. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
... [4] Several reviews describe the role of milk and dairy products in dental caries prevention. [5][6][7] The purpose of this short study is to know the reasons behind milk avoiding behavior amongst medical students. Two hundred medical students of the age group 18-20 years were contacted for this survey conducted in the form of a questionnaire containing the most common reasons for non-consumption of milk. ...
Background
Early childhood caries (ECC) is a major oral problem affecting the health and wellbeing of children worldwide. Diet quality is a better predictor of ECC risk than single foods or specific nutrients. The purposes of this study were to assess the associations between ECC and diet quality among 2- to 5-year-old Chinese children.
Methods
A total of 150 eligible children were included in this study. The decayed, missing, or filled surface (dmfs) score was recorded for each child by dental examination. All participants were divided into three groups based on their age and dmfs score [the caries-free group, the ECC group, and the severe early childhood caries (S-ECC) group]. Parents were invited to complete a questionnaire on the general characteristics and oral health behaviors of the participants. The information of 24-h dietary intake from each child was captured via a mobile APP. The Chinese diet balance index for preschool children (DBI_C) indicators score, high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) score were calculated to assess the diet quality of study subjects. The associations of ECC with HBS, LBS, DQD score, and DBI_C indicators score were analyzed by Mann-Whitney U test and multivariable logistic regression analysis.
Results
In this study, 21, 31, and 98 children were diagnosed with caries-free, ECC, and S-ECC, respectively. Statistical analysis revealed that the risk of ECC and S-ECC were significantly increased with the DQD score (OR = 1.283 and 1.287, respectively), but both were not associated with HBS and LBS (P > 0.05). In the meantime, the risk of ECC and S-ECC were significantly increased with the Grains score (OR = 1.623 and 1.777, respectively), and significantly decreased with the Food diversity score (OR = 0.271 and 0.315, respectively). Moreover, the risk of S-ECC also significantly decreased with the Vegetables score (OR = 0.137).
Conclusion
Both ECC and S-ECC were associated with a high degree of dietary imbalance and grains intake as well as a low degree of food diversity among Chinese children aged 2–5 years. In addition, S-ECC was also associated with a low degree of vegetable intake.
Eating patterns characterised by low intakes of processed carbohydrates and higher intakes of fat- and Vitamin D-rich foods are associated with protection against dental caries. The aim of this formative study was to evaluate the extent to which the knowledge of children and adults of foods for oral health reflects dietary guideline advice, and the evidence base for foods associated with increased and decreased caries burdens. Using a novel card-sorting task, the participants categorised foods according to their knowledge of each food for oral health. There were no differences between children and adults in the categorisation of fresh, minimally processed foods. Fish, chicken, and red meat were categorised as healthy by significantly fewer children than adults. High-sugar foods were correctly characterised as unhealthy by nearly all participants. More children categorised breakfast cereals as healthy than adults. There were no statistically significant differences between children and adults for the categorisation of brown or wholegrain breads categorised as healthy. The alignment of the participants’ beliefs with dietary guideline recommendations suggests education through health promotion initiatives is successful in achieving knowledge acquisition in children and adults. However, recommendations to increase the intake of refined carbohydrates inadvertently advocate foods associated with increased caries burdens.
Background: Early childhood caries (ECC) is one of the most common chronic diseases among children. Diet quality assessment is better than single food or specific nutrient assessment in predicting the risk of ECC. This study is aimed to explore the correlations between diet quality and ECC among 2- to 5-year-old Chinese children.
Methods: Totally 150 two- to five-year-old children were selected in this study. The decayed, missing or filled surface (dmfs) of each child was examined and recorded. Then the children were divided by ages and dmfs scores into the caries-free group, ECC group, and severe ECC (SECC) group respectively. The information of 24-h dietary intake from each child was captured via a mobile APP. The diet quality of each child was assessed by calculating the Chinese diet balance index for preschool children (DBI_C) indicators scores, high bound score (HBS), low bound score (LBS) and diet quality distance (DQD). Correlations of HBS, LBS, DQD and scores of 10 food group indicators with ECC were evaluated using rank sum test and logistic regression analysis.
Results: The probabilities of ECC and SECC are positively correlated with HBS (OR: ECC=1.102, SECC=1.098) and with DQD (OR: ECC=1.117, SECC=1.114), but not correlated with LBS (P>0.05) among the 2- to 5-year-old children. The severity of caries among the 2- to 5-year-old children are positively correlated with the score of Grains (OR: ECC=1.322, SECC=2.929) and negatively with the score of Food diversity (OR: ECC=0.378, SECC=0.034), but not correlated with other indicators.
Conclusions: The possibilities of ECC and SECC among the 2- to 5-year-old children are positively correlated with the degree of excessive dietary intake and dietary imbalance. The severity of caries among the 2- to 5-year-old children is positively correlated with grains intake and negatively with food diversity.
Treatment of oral disease is extremely costly, and it is the fourth most expensive disease to treat in most industrialized countries. Oral diseases and disorders, although largely preventable, affect the vast majority of the world's population with varying degrees of severity. This article reviews the role of dairy products in the prevention of common oral diseases and conditions including dental caries, periodontal disease, tooth wear, oral candidiasis and oropharyngeal cancer. The oral health benefits of whole dairy products including milk and cheese are considered. The use of dairy-derived bioactive peptides to prevent oral disease is outlined and the addition of probiotics to dairy products to confer health-promoting properties is discussed. The fortification of milk with fluoride to prevent dental caries is also described.
Given the high prevalence of oral diseases and the cost of treating them, the development of even small preventive or therapeutic effects for commonly consumed dairy products has the potential to have an important impact on the burden of oral diseases.
Lactose is the primary carbohydrate in mammalian milk and intestinal lactase is
essential for neonatal development. Besides early neonatal nutrition, galactose combined with other molecules to form essential lipids for neurological, epithelial and immune development. Other substrates of lactose are also important for these pathways. In the absence of lactase production of essential glycosylated fats and proteins require circuitous routes. In adults the mechanism of declining lactase still requires further study. There is limited information on long-term effects of milk and dairy food consumption in LNP populations. In addition to incomplete knowledge about lactose there is even less information on whether other substrates associated with lactase have any impact in LP/LNP population divide.
During cheese manufacture, chymosin hydrolyses kappa‐casein at the Phe105‐ Met106 bond, generating two fractions: para‐kappa‐casein (amino acid residues 1–105) and glycomacropeptide (amino acid residues 106–169), which remains soluble in milk whey. Glycomacropeptide (GMP) comprises 20–25% of the proteins in whey protein isolate (WPI) and whey protein concentrate (WPC) that are produced from cheese whey. In recent years, interest in GMP has increased, as the peptide exhibits biological and nutritional properties which have been linked to a number of health benefits. For instance, the peptide is known to have immunomodulatory, prebiotic, anti‐infective and anticarcinogenic properties and plays a role in the nutritional management of phenylketonuria (PKU) and has also been shown to stimulate cholecystokinin (CCK) release and reduce gastric secretion. Given its potential for use in functional foods, methods of producing this peptide at large scale have also gained interest. This chapter summarises the evidence supporting the associated health benefits of GMP, and gives an overview of the current methods for GMP isolation and detection.
Fermentation is an age-old process aided by microorganisms that, directly or by the action of bioactive components produced by them, impart several health benefits. A plethora of fermented foods have opened new avenues of scientific research for tapping their various health-promoting properties. In addition, globalization has exposed consumers to ethnic fermented products once available only in a local community. Fermented foods are found to alleviate many diseases including gastrointestinal disorders, lactose intolerance, cancer, hypertension, allergy and metabolic syndromes and maintain digestive health and immune functions. Understanding of the complex interactions of diet, gut, microbiota and host in addition to microbiome studies of ethnic populations will reveal much about the mechanisms by which microbiota are associated with human health.
Cheese is a nutrient-rich food, consumed worldwide, that has received significant research attention due to its contribution to nutrition and health. This chapter discusses the different nutrients present in cheese including protein, fat, minerals, vitamins, and the bioactive compounds and reviews both their health benefits and health concerns. Numerous studies have indicated that cheese consumption has beneficial health effects such as improving bone health and reducing dental caries. However, there is a reasonable amount of literature indicating an association between cheese intake and the incidence of chronic diseases such as cancer and cardiovascular diseases, mainly owing to the high-fat content, especially of saturated fat in cheese. Various dietary guidelines have recommended limiting the daily consumption of cheese; however, it is difficult to draw firm conclusion on the benefits of such recommendations as the extent of cheese consumption and cheese type, as well as factors such as the consumers' age, sex, and obesity levels varied significantly across the studies.
Introduction: the Role of the Orthodontist in Nutrition What is an Adequate Diet? Nutrition and the Orthodontic Patient Effective Nutrition Management of the Orthodontic Patient Conclusions References
Inverse associations were demonstrated between DMFT and total calcium, phosphorus, magnesium, strontium, potassium, and fluoride concentrations in individual plaques. Lithium, strontium, fluoride, and zinc contents were inversely related to plaque mass. Consistent interdependence patterns between elements indicate the operation of a mineral level regulating mechanism, effective under diverse environmental conditions.
Telemetry was used to evaluate changes in plaque pH at interproximal sites in the dentition of five human subjects following the ingestion of a variety of reference foods and snacks. Short-term telemetry (30 min) revealed that most of the substrates yielded both pH minima and total responses similar to that obtained with a 10% sucrose rinse. Aged Cheddar cheese and skim milk were much less acidogenic than were the other foods.
Additions of milk solids to laboratory "cakes" made of sucrose and starch reduced in vitro (Orofax) "caries" and the dissolution of granular enamel, but increased the amounts of fermentation acids produced. Withdrawal of the milk component of ice cream, yogurt, and chocolate milk resulted in increased Orofax "caries".
A Nutrition and Oral Health Study was conducted on 141 middle-aged and elderly adults (54% female and 46% male; aged 47-83 y, mean = 67; 51% college educated; and 89% white). This study reports on the relationship between root caries and diet. Nutritional composition was derived from two 3-d food diaries. Root caries was measured according to the 1985 Adult Survey Diagnostic Criteria of the National Institute of Dental Research. When the individuals were segregated by their root DFS (decayed and filled surfaces) status into highest (> or = 7) and lowest (< or = 1) quartiles, the sucrose consumption was significantly higher in the higher DFS group. Mean energy consumption and mean number of teeth were the same in both groups. When the individuals were segregated by sucrose consumption into highest (> or = 89 g) and lowest (< or = 31 g) quartiles, DFS root status was significantly higher (P < 0.01) in the highest quartile group (7 g) vs the lowest group (4 g). By using data from subjects with two food diaries, a stepwise-linear-regression model for root caries showed that 4.2% of the variance for root caries was explained by sucrose, 2.8% by plaque, 3.8% by total number of teeth, and 5.6% by gingival recession. These data suggest that root caries has a similar dietary etiology to coronal caries.
A stepwise multiple logistic regression was computed to assess which of the nutritional variables differentiate the healthy and diseased group of participants in the Forsyth Specialized Caries Center (n = 275). Variables considered as candidates for the model included the consumption per week of sugars, starch, cheese, fruits and fruit juices, noncariogenic foods, and dairy products. Two variables--sugars and cheese--were statistically significant by the stepwise procedure. Increased intake of sugar was associated with being in the root caries group, whereas high intake of cheese was negatively associated with root caries. Thus, cheese seems to have a protective effect after sugar intake is controlled for. Odds ratios were computed to quantify the influence of the variables. An increase of two exposures of sugar per day corresponded with an odds ratio of 1.26. The odds ratio continues to increase with sugar intake so that an increase to five exposures per day gives an odds ratio of 1.79. This model is consistent with past in vitro studies suggesting that cheese protects against caries formation when sugar intake is controlled for and that increasing frequency of sugar intake increases the odds of root caries.
Although not always the case, remineralization has become an accepted area of study within oral care research, and many new study possibilities have arisen. In addition, many in the clinical dentistry community have recognized remineralization as an important factor in maintaining the health of the tooth. This paper, through an extensive review of the dental literature, explores the history of investigations on de- and remineralization.
Casein phosphopeptides (CPP) are multi-phosphorylated peptides from an enzymatic digest of the bovine milk protein casein. These peptides have a remarkable ability to stabilize calcium phosphate in solution as amorphous calcium phosphate (ACP). Through their multiple phosphoseryl residues, the CPP bind to forming nanoclusters of ACP in metastable solution, preventing their growth to the critical size required for nucleation and phase transformations. The casein phosphopeptide-amorphous calcium phosphate (CPP-ACP: Recaldent(TM)) nano clusters have been shown to localize at the tooth surface and prevent caries in laboratory, animal and human in situ caries models. The CPP-ACP have also been shown to remineralize enamel subsurface lesions in vitro and in situ when delivered in a sugar-free chewing gum. The proposed anticariogenic mechanism for CPP-ACP is the localization of ACP at the tooth surface which buffers the free calcium and phosphate ion activities, thereby helping to maintain a state of supersaturation with respect to tooth enamel, depressing demineralization and enhancing remineralization. The CPP-ACP have potential as an additive to foods and oral care products for the control of dental caries.
The role of non-fat dry cow's milk in experimental rat caries was determined from feeding tests in which the milk comprised 39 and 100 per cent by weight of the total diet. At the 100 per cent level, the milk was non-cariogenic for the rat. At the 39 per cent level, the milk had no appreciable effect on the cariogenicity of a high-carbohydrate, high-fat, low-protein diet.
The relationship between nutrition and dental health has been a topic of interest for many years. Recently, the cariostatic properties of cheese have been the subject of intensive research. Most of these studies suggest that the use of cheese as the final food in a meal will help to reduce caries. Several mechanisms by which cheese may reduce enamel demineralization have been proposed.
Chewing cheese stimulates saliva flow. The alkaline nature of saliva buffers the acids formed in plaque. There is also an increased rate of sugar clearance due to the diluting action of cheese-stimulated saliva. Research has also suggested that chewing cheese may reduce the levels of cariogenic bacteria. This may be secondary to the reduced incidence of caries as conditions within a carious lesion tend to promote the growth of these organisms. The high calcium and phosphorus content seems to be another factor in the cariostatic mechanism of cheese. Both casein and whey protein seem to be involved in the reduction of enamel demineralization. Casein phosphopeptides may also be responsible for some anticariogenicity by concentrating calcium and phosphate in plaque.
An overview of the effect of milk on dental caries is also presented in this review.
Dairy products, including milk, cheese, and casein, can reduce the caries-causing potential of cariogenic substrates as measured in various animal, plaque acidity, and in vitro systems. Although the mechanisms responsible for protection are not completely identified, substances containing Ca and P may contribute to the protective potential by reducing demineralization and/or promoting remineralization of enamel. Casein may reduce demineralization by forming a protective coat on the enamel surface. By means of a rat model, this study evaluated the ability of three casein-free milk mineral concentrates with various levels of whey protein, calcium, and phosphate to modify the cariogenicity of a powdered diet containing 20% sucrose. Analysis of these data indicates that there were no significant differences among groups for weight gain, total food consumption, or feeding frequency, as monitored by a computer-based infrared activity monitor. All three mineral concentrates significantly reduced buccal caries, and two of the three reduced sulcal caries by from 10 to 30%. The analysis further shows that casein-free milk mineral fractions can modify the cariogenicity of sucrose-containing foods in a rat model.
In a 2 yr study of the calcium and phosphorus levels of mature plaque collected from male subjects aged 11-12 yr at the commencement of the study, the plaque calcium and phosphorus levels were inversely related to both the new DMFS developing during 2 yr period and the total caries experience of the subjects at the end of the study.
Groups of Osborne-Mendel rats were fed on a cariogenic diet containing 46 per cent sucrose. Eight separate trials were carried out, testing the effects on the level of dental caries of supplementation of the diet with glycerophosphates and calcium salts, alone and in combination. Calcium and sodium glycerophosphates added to the drinking-water were ineffective. Added to the diet at comparable levels, calcium glycerophosphate was more cariesinhibitory than sodium glycerophosphate, but the activity of sodium glycerophosphate was augmented by calcium nitrate. Calcium nitrate alone as a dietary additive also exhibited strong caries-inhibitory activity.
The in situ rehardening effect was compared between Cheddar cheese consumption and saliva secretion with and without a fluoride pretreatment on softened human enamel. Ten volunteers wearing prostheses which held slices of human enamel participated in this study. Average microhardness of enamel was determined on the surface at baseline, after exposing to an acidic beverage, after exposing to saliva and mastication of cheese, with and without a mouth F prerinse (10 ml Meridol containing 0.025% F). The rehardening was increased in the groups consuming cheese compared to the saliva controls. The effect was increased by an F prerinse; the initial hardness of the intact enamel surface, however, was not reached.
A model system was used to examine the relation between the duration of plaque pH fall and enamel demineralization following the intake of dietary carbohydrate in humans. Subjects wore palatal appliances containing blocks of bovine enamel covered with Streptococcus mutans IB 1600, and rinsed with 5 or 10% sucrose. Changes in iodide penetrability (delta Ip) of the enamel, and the pH and extracellular calcium and inorganic phosphate (Pi) concentrations of the streptococcal plaque were determined. Following rinses with 5% sucrose, delta Ip increased with time and reached a maximum (11.2 +/- 2.2 units) at 45-60 min although the S. mutans plaque remained acidic (pH = 4.8 +/- 0.6). After 10% sucrose, the maximum (14.7 +/- 3.1 units) was reached while the plaque pH was 4.0 +/- 0.3. Second rinses with sucrose increased delta Ip at most by 30%. Thus, demineralization did not persist throughout the period of low plaque pH, but occurred primarily during the early phase of plaque acidogenesis. Enamel demineralization appeared to be limited by factors other than the pH of the streptococcal plaque. Calcium concentrations in the S. mutans plaque rose to a maximum of 10.9 +/- 2.8 mEq/l at 30 min after the 5% sucrose rinses, then fell; Pi reached a stable level of 12.2 +/- 2.3 mEq/l by 60 min. Calculations showed that conditions approached saturation with respect to enamel and dicalcium phosphate dihydrate as demineralization reached a maximum. Demineralization appeared to be limited at low plaque pH, therefore, by the accumulation of high levels of mineral ions in the streptococcal plaque.(ABSTRACT TRUNCATED AT 250 WORDS)
In situ models to assess the ability of oral care products or food components to enhance remineralization and/or inhibit demineralization of tooth enamel or roots must be very carefully designed to minimize the confounding effects of the many variables involved. Controlling these variables as closely as possible is essential if meaningful answers are to be obtained from the models. We have developed an in situ model which combines the experience of several groups. Detailed screening of subjects is essential. Selection criteria should include good general health, good dental health, mandibular partial denture, at least eight natural teeth, no active caries lesions, known fluoride history, normal salivary function, and no medications that affect salivary function. Each subject carries a sound enamel slab and an enamel slab with a pre-formed caries-like lesion (demineralized in vitro) in his/her denture on each side of the mouth for test periods of two or four weeks. The demineralization challenge is controlled by extra-oral immersion of the appliances in sucrose daily. Daily product exposure or daily food component exposure is used as desired. Compliance indicators and a diet diary are included. Whole saliva flow rate (unstimulated), plaque acidogenicity, and salivary fluoride are monitored during the test periods. At the end of the test period, the test slabs are assessed for mineral change, after being sectioned, by means of cross-sectional microhardness or microradiography. The mineral loss or gain (delta M, microns x vol%), compared with adjacent control sections retained in the lab, is calculated as change in delta Z (microns x vol%), namely, delta M = delta ZTEST - delta ZCONTROL.(ABSTRACT TRUNCATED AT 250 WORDS)
This two-part study was undertaken to examine the effects of processed cheese on human plaque pH and de- and remineralization of enamel and root lesions in a human in situ caries model system. In the first part of the study the selected processed cheese (Kraft American Singles Processed Cheese Food) was eaten alone and followed by a 10% sucrose rinse after the acidogenicity of the plaque was demonstrated. A 10% sucrose rinse alone resulted in a mean minimum pH of 4.26. The cheese alone showed a mean minimum pF of 6.32 and cheese followed by sucrose resulted in a mean minimum pH of 6.48. The plaque pH of cheese eaten alone stayed at pH above 5.7 (the "safe for teeth" level). Cheese consumption also prevented the acid challenge when followed by sucrose. The second part of the study utilized the thin-sections of artificially created caries-like lesions on enamel and root, and sound root sections. One-month periods were used in a cross-over design to examine the effect of eating the cheese q.i.d. Polarized light microscopy was used to determine changes in the size of lesion areas. The addition of the processed cheese to the diet resulted in statistically significant reductions in enamel lesion size as well as a reduction in progression of root lesions. Lesions created on the sound root surfaces were approximately one-third the size of those created during the control period. This study indicates that processed cheese is hypoacidogenic, anti-acidogenic, and prevents demineralization as well as enhances remineralization.
The biochemical composition of both types of plaque and the subsequent caries increment were investigated in 39 males aged 11-12 years at the time of plaque collection. The calcium concentration of free smooth-surface plaque was inversely related to both total and approximal 3-year DFS increment (p less than 0.01). A relationship between calcium concentrations in approximal plaque and subsequent caries was restricted to the 3-year increment on approximal surfaces (p less than 0.05). There was evidence for a direct relationship between caries increment and both magnesium and organic phosphorus concentrations in plaque on the free smooth surfaces only (p less than 0.05). In contrast, a direct relationship between total caries increment and both total and intracellular carbohydrate concentrations reached statistical significance for approximal plaque only (p less than 0.05). Regression analysis indicated that the combination of the calcium and inorganic phosphorus concentrations of free smooth-surface plaque and the intracellular carbohydrate concentrations of approximal plaque explained 40% of the variation in subsequent caries increment.
In previous telemetric and animal experiments, cheese has been shown to be a food of low acidogenic and cariogenic potential. In vivo intraoral tests were carried out to confirm the low cariogenic potential of this substrate in humans and to explore the enamel-softening effects of toasted breadcrumbs and those of a mixture of breadcrumbs and cheese. The results confirmed the cariostatic nature of cheese and established a considerable enamel-softening effect of toasted breadcrumbs. A mixture of breadcrumbs and cheese failed to show a statistically significant difference to breadcrumbs despite a substantially lower mean value for the breadcrumbs and cheese mixture.
The influence of Extra-Old Cheddar cheese on experimental caries in human subjects was determined using the 7-day intra-oral cariogenicity test (ICT). Cheese eaten immediately after 6 sucrose rinses a day reduced the demineralization caused by sucrose by an average of 71% (p < 0.001) in 5 subjects, as measured by microhardness changes. The mean resting pH of the ICT plaque was higher during the sucrose-cheese weeks (6.24) than in the sucrose-control weeks (5.96), but the difference was not significant. The mean minimum pH after a sucrose rinse was significantly higher (p < 0.01) during the experimental weeks (5.44) than during the control weeks (4.73). Cheese had no detectable influence on the bacterial composition of ICT plaque. These results confirm, in human subjects, the hypothesis that cheese may be anticariogenic.Copyright © 1986 S. Karger AG, Basel
The caries-inhibitory potential of four cheeses with different permutations of texture, aging, levels of butterfat, protein, calcium, phosphate and lactose were evaluated in a rat caries test using a controlled frequency feeding machine in a design similar to that of Edgar et al. [Caries Res. 14: 384–389, 1982]. Test substrates were alternated with a cariogenic powdered diet and each was fed 14 times daily for 28 days to albino rats superinfected with Streptococcus mutans. An additional group was fed an agar gel with 25% lactalbumin and 25% soybean oil to assess the caries inhibition provided by a moist, cheese-like substrate without butterfat or casein and low in calcium and phosphate. Food consumption, weight gains, plaque S. mutans levels and enamel caries lesions were recorded. Compared to the cheddar and gel control groups, alternate meals of processed cheese spread and mozzarella cheese substantially reduced caries incidence on buccal, but not sulcal tooth surfaces. The cream cheese group had more buccal caries than the gel group. S. mutans levels were lower in the mozzarella and cheddar cheese groups than in the cream cheese group. These results support previous reports of the cariostatic potential of cheese and suggest that a substantial portion of the protection may be related to textural influences and casein and/or calcium-phosphate content of the cheese. The amount of butterfat, aging or carbohydrate in the test substrates had no apparent effect upon the amount of caries inhibition observed in this model.Copyright © 1986 S. Karger AG, Basel
Rats that had had their submandibular/sublingual glands removed surgically, and their parotid ducts tied, developed fewer and less severe caries lesions on coronal and root surfaces when fed cheese snacks in addition to a cariogenic diet than when fed additional cariogenic snacks or no additional snacks. The effects of cheese snacks were particularly dramatic on root-surface caries. These observations may be relevant for elderly humans who are most likely to develop root surface caries.
Populations of Streptococcus mutans did not differ among the groups. Actinomyces viscosus was not detected at the end of the experiment in any of the groups. The results of this study demonstrate that cheese exerts a protective effect against coronal and root-surface caries in rats with a severely limited salivary function.
In order to isolate and identify the most active anti-cariogenic components(s) of aqueous cheese extract (CE), we separated it into low (LMW) (MW less than 500), medium (MMW) (500 less than MW less than 10,000), and high (HMW) (MW greater than 10,000) molecular weight fractions by means of the Amicon ultrafiltration system. These fractions were then tested in vitro with a bacterial system containing S. mutans, adapted from that of Turtola (1977). The LMW fraction reduced the demineralization caused by the fermentation of sucrose by 96% (p less than 0.001) as compared with the water control; this was not significantly different from a 50% concentration of the CE. The MMW and HMW fractions reduced demineralization by 36 and 42%, respectively. The concentrations of acid-soluble calcium and phosphorus in CE, LMW, MMW, and HMW were 1509 and 462, 991 and 310, 231 and 7, and 162 and 3 micrograms/mL, respectively. A solution containing the same levels of calcium and phosphorus as CE was somewhat more effective in reducing demineralization in vitro than was CE itself (p less than 0.01). In vivo, the addition of these same calcium and phosphorus levels to a 10% sucrose solution reduced its cariogenicity by 67% (p less than 0.001), as judged by the intra-oral cariogenicity test (ICT). Plaque calcium and phosphorus concentrations were significantly higher in the ICT plaque samples subjected to the sucrose-Ca,P solution (p less than 0.01) than in the sucrose control. The resting pH, minimum pH, and shape of the pH curves produced by the sucrose control and sucrose-Ca,P were similar.(ABSTRACT TRUNCATED AT 250 WORDS)
The effect of water-soluble components of extra-old Cheddar cheese on experimental caries was tested by means of the seven-day intraoral cariogenicity test (ICT). Two bovine enamel blocks were placed in each buccal flange of the dental appliances of five volunteers. One side of each appliance (experimental) was dipped in a 25% water extract of the cheese for five min, while the other side (control) was dipped in de-ionized water. Immediately thereafter, the appliance was returned to the subject's mouth, and two 60-second rinses with 10% sucrose were performed. These procedures were repeated six times per day.
The cheese-extract dippings reduced the cariogenicity of the sucrose by an average of 55.7% (p<0.01), as assessed by enamel microhardness. Neither the mean resting pH nor the mean minimum pH in response to sucrose was significantly different between the experimental and control sides.
The concentration of calcium was significantly higher in plaque from the experimental side (32.44 μg/mg) as compared with the control side (19.36 μg/mg, p<0.01). The concentration of plaque phosphorus was higher on the experimental side (12.90 μg/mg) than on the control side (9.61 μg/mg); however, the difference was not statistically significant. These results show that cheese has one or more water-soluble components which reduce experimental caries in human subjects.
. The effect of fluoride on experimental cariogenicity in man was investigated by using bovine enamel surfaces mounted in oral prosthetic appliances. Samples of sound and presoftened enamel were exposed to simulated cariogenic or noncariogenic conditions for 1 week. The samples were periodically immersed in vitro in solutions containing 1 ppm fluoride. For the cariogenic condition, the immersion solution was 3% sucrose, for the noncariogenic condition, water. After the experimental period, the sample enamel was assessed for hardness change and fluoride incorporation. Under the non-cariogenic condition, partial remineralization and high fluoride incorporation were found in the presoftened enamel; both hardness change and fluoride incorporation in sound enamel were minor. The cariogenic condition contributed to higher enamel softening and higher fluoride uptake by both types of samples. The findings suggest a mechanism through which intermittent cariogenesis and remineralization in the presence of fluoride may contribute to increased tooth resistance to caries.
In extension of previous experiments, a study was devised to test the effect on caries activity of adding calcium glycerophosphate to the diet of monkeys. Five experimental and 6 control animals were fed a high carbohydrate diet. Both groups of animals received icing sugar 5 times daily but that fed to the experimental animals contained 1% calcium glycerophosphate. After 30 months it was observed that the control animals had 47 carious lesions and the experimental animals 8 (p < 0.01). All the control animals developed dental caries, whereas 3 of the experimental animals remained caries-free. Higher levels of calcium, and lower concentrations of soluble and insoluble carbohydrate were observed in the plaque of experimental animals than in plaque of the control monkeys. No differences were observed in the protein and total phosphate content. Both the fasting pH values of plaque and those observed 20 min after the application of sucrose were higher in the experimental animals. Slightly higher counts of micro-organisms were found in plaque from the experimental animals.Copyright © 1972 S. Karger AG, Basel
A reproducible method for comparing the effects of treatment with milk products on the acid solubility of enamel surfaces is described. Using this method it was found that treatment with cows' milk reduced solubility by more than 20 per cent, regardless of whether it was raw or pasteurized whole or skim milk. Reconstituted whole and reconstituted skim milk gave similar reductions. Similar depressions of solubility followed treatment with cream or whey. Butter gave low and inconsistent reductions. No difference was found in the solubility effects of reconstituted dry skim milk obtained from twenty-three locations in the United States. Tests showed that the protective agent in milk reacts rapidly with the enamel and resists washing. That it is protein in nature is indicated by the finding that the full solubility reduction is given by treatment with casein solutions and mostly removed by washing with a protein solvent.
Casein (bovine milk phosphoprotein) at 2 per cent (w/v) in drinking water reduced the extent of fissure and smooth-surface caries of male Sprague-Dawley rats consuming a solid cariogenic diet. Whey protein (the non-phosphorylated protein group of bovine milk) also at 2 per cent (w/v) in the drinking water produced a smaller reduction and only of fissure caries. There was no significant difference in salivary-gland function (as determined by protein concentration), or in the amount or frequency of cariogenic diet consumed. The finding that a 2 per cent solution of whey protein reduced the extent of fissure caries in animals consuming a solid diet containing 26 per cent whey protein suggests that the anticariogenic action is mediated by the protein being in solution. These results suggest a topical anticariogenic action for dietary protein.
Using standard reference snack foods, we tested a method, using rats fed in a programmed feeding machine, to evaluate the caries-promoting properties of foods. Results, which were expressed in relation to a control food, indicate that the method distinguished differences in caries potential among a number of different snack foods. Buccal and sulcal caries scores of rats fed snacks foods varied in their responses. A gel diet used to provide essential nutrients for the rat growth in this approach contributed minimally to the caries response which was related principally to the food being tested.
The objective of this study was to determine the effect of aged and young cheddar cheese with and without added sucrose on dental caries and the associated recovery of implanted Streptococcus mutans. Very little caries was observed in rats consuming cheese without sucrose. There was an increase in caries in rats fed cheeses with 20% sucrose, but this increase was not significant. There was significantly greater caries activity in rats fed standard diets containing 20% or 5% sucrose (SLS or MIT 305) than in rats fed cheeses containing 20% sucrose. Rats fed cheese or powdered diets containing sucrose had significantly higher frequency of recovery and higher levels of S. mutans infection than did rats fed cheese containing no sucrose. This study confirms the low cariogenic potential and possible cariostatic activity of cheddar cheese in rats. Since cheddar cheese with sucrose did not significantly interfere with S. mutans implantation, the cariostatic mechanism is apparently unrelated to a direct antimicrobial effect on S. mutans.
The use of the animal model and the Konig-Hofer program-feeding machine is a valuable tool in the research effort to identify the factors contributing to dental caries. As this methodology provides uniform host, microflora, and frequency components, the food is the variable being evaluated. The relative cariogenicity of food is dependent on variations in the composition, texture, solubility, retentiveness, and ability to stimulate saliva flow. The results of these experiments indicated the equal importance of all food-related parameters on dental caries formation. If the composition of foods was solely responsible for dental caries formation, all three of the granola bars should have had similar relative cariogenicity values. This was not true. Granola bar no. 3, which was crispier in texture and less moist, had a third the relative cariogenicity value of granola bars nos. 1 and 2. As reported by other dental researchers, the production of dental caries is food related, but not simplistic in nature. Dental caries is the outcome of complicated interactions, all of which are equally important in the progress of this disease.
Supplementation of a cariogenic diet with pasteurized bovine milk substantially reduced the incidence of dental caries in both male and female Sprague-Dawley rats. The reduction in caries incidence was not associated with the consumption of less of the cariogenic diet and more milk, nor with the animals having a significantly altered bacterial composition of their dental plaque. The results lead to the hypothesis that the anticariogenic effect of milk is attributable to a direct chemical influence on the caries process in the oral environment of the rat.
Enamel dissolution, Orofax and rat caries studies were carried out to assess the effects of calcium lactate in reducing the cariogenicity of four commercially used candies. When used at the 5% level, calcium lactate was effective in reducing enamel dissolution by as much as 43% in fermenting candy-saliva mixtures. In Orofax studies it reduced the amount of in vitro caries by as much as 87%. In a rat caries study, a test group fed a chocolate caramel candy containing 1.5% calcium lactate produced reductions of 38 and 17% in number and 47 and 31% in severity of smooth surface (buccolingual) and sulcal lesions, respectively, as compared to a control group fed the same candy without additive. These findings plus the fact that calcium lactate is a tasteless, nontoxic chemical compound, commonly used in a number of food products, all indicate that calcium lactate my be considered an effective anticaries food additive.Copyright © 1982 S. Karger AG, Basel
Fewer smooth surface carious lesions developed in rats fed a high-sucrose diet (2000) administered by a feeding machine delivering 22 portions (‘meals’) per day when additional meals of cheese (‘snacks’) were consumed after 12 selected meals. Snacks of peanuts had less effect. Further meals of diet 2000 instead of cheese or peanuts increased caries in smooth surfaces and fissures. Streptococcus mutans, inoculated at the start of the experiment, was recovered at significantly lower levels in the animals receiving cheese than in the groups receiving additional diet 2000 or no additional snacks. Salivary gland weights of all three groups fed supplementary meals were raised, but pilocarpine-stimulated saliva flow rates were increased only in the cheese and peanut groups. The results with cheese confirm expectations based on earlier studies of plaque pH changes in human subjects but the lack of effect of peanuts requires further study.Copyright © 1982 S. Karger AG, Basel
Experiments sought to determine the nature of the binding of milk proteins to hydroxyapatite (HA) and to saliva-coated hydroxyapatite (sHA), and to determine the effect of milk and casein on the adherence of Streptococcus mutans GS-5 to sHA. The binding of radiolabelled alpha-casein to HA was reduced when incubated simultaneously with parotid saliva, and enhanced in the presence of milk. The binding of beta- and kappa-casein to HA was unaffected by the presence of parotid saliva and enhanced by the presence of milk. The in vitro bacterial adherence of Strep. mutans GS-5 to sHA beads was reduced when beads were coated with milk instead of buffer, or when bacteria were added to sHA in the presence of milk instead of buffer. Casein proteins (alpha, beta, kappa) added to sHA simultaneously with bacteria inhibited the adherence of Strep. mutans GS-5 to sHA. kappa-Casein, when bound to sHA, inhibited streptococcal adherence to sHA; alpha- and beta-casein, when bound to sHA, had no effect on streptococcal adherence. Fractionation of kappa-casein by anion-exchange chromatography revealed the anti-adherence activity of kappa-casein was mediated primarily by a 40,000 mol. wt. glycoprotein-containing fraction. These data show that milk, particularly kappa-casein fractions, can modulate the adherence of Strep. mutans GS-5 to SHA surfaces in vitro.
Few dietary studies have been designed to investigate the effects of intake patterns of food items upon the environment of the teeth. This brief review considers evidence about the effects of choice, combination, and sequence of ingested food and drink upon the pH of human dental plaque in vivo. A series of three studies, which were designed to investigate some of the intra-oral biological events associated with cariogenicity during various eating patterns, are discussed. The principal findings show that if a "meal" includes an item which contains carbohydrate such as sucrose, glucose, or fructose which is rapidly fermented by the acidogenic microorganisms in dental plaque, there will be rapid acid production and the plaque pH will fall. However, other items eaten immediately before, during, or after the consumption of the sugary item can influence the plaque pH. If the non-sugary item stimulates saliva, it will have a pH-raising effect. The remineralizing potential may be enhanced if, for instance, calcium or fluoride is released from the food. However, if one sugary item is followed by another, the demineralizing potential may be enhanced. The results of these experiments are discussed in the context of our current understanding of the dynamics of the carious process. Recent preliminary experiments suggest that other factors, such as the individual subject's speed of consumption, may also affect the cariogenic potential of the oral environment.
For many decades, sugars have been the dietary constituents receiving the most attention in relation to their effects on dental caries. Frequently, however, there is little relationship between the amount of sugar in a food and its ability to induce caries. Therefore, it is clear that constituents in the diet can influence the ability of plaque to lower the pH of sugar solutions. For instance, replacing sugar in foods with xylitol, sorbitol, saccharin, or aspartame may lead to a reduction in the incidence of dental caries. All these sugar substitutes are non-cariogenic, and some may possess cariostatic properties. The presence of arginine-rich proteins in the diet may provide a ready source of this amino acid, which is the substrate for the arginine deiminase pathway which can result in a rapid elevation of plaque pH values. Proline can act as an acceptor for protons from lactate in the Stickland reaction. This is a major but much-neglected metabolic pathway in dental plaque. The presence of fat in experimental diets has been shown to affect their cariogenicity. The effects have been ascribed to enhanced clearance of sugars from the mouth. It is also conceivable that several fatty acids express a potent antibacterial effect. The presence of calcium and phosphorus has been shown to influence the cariogenicity of foods; the effect, however, is restricted to the food containing the minerals. Evidence suggests that pyridoxine (vitamin B6) may exert a cariostatic effect by enhancing decarboxylation activity in dental plaque. It is clear that sugar alone is not the sole determinant of whether food is cariogenic. Furthermore, myriad substances may hinder or enhance the caries-promoting properties of sugars in the diet.
Radiotherapy of head and neck malignancies results in severe xerostomia which induces radiation caries. Hard cheese has potent anti-cariogenic effects, even with minimal salivary gland function. Eight patients irradiated for neck cancer volunteered for this study. The saliva flow rate varied between 0.0-0.15 ml/minute. In vitro etched enamel slabs, prepared from human teeth, were exposed intraorally to parafilm stimulated salivary secretion for 5 minutes or, alternatively, to cheese compounds and saliva due to masticating 20 gm hard cheese for 5 minutes. Microhardness measurements were carried out on the enamel surface at start (baseline), after etching and after rehardening. Stimulated saliva or cheese compounds and saliva, due to mastication, induced rehardening of surface enamel in both, non-irradiated and irradiated subjects. The rehardening was significantly increased in the irradiated group consuming cheese as compared to rehardening by stimulated saliva only and not significantly less of that achieved in non-irradiated subjects. Rehardening achieved with stimulated saliva in irradiated patients was of a borderline-significant lower degree in comparison to non-irradiated subjects. The reduced rehardening capacity of a decreased saliva flow in irradiated patients may be complemented by cheese compounds. For xerostomic patients, hard cheese consumption may be regarded as effective to keep initial caries under control.
Our understanding of the chemical events that take place at the tooth-plaque interface has improved greatly through studies of the chemical composition and properties of dental plaque fluid. In the absence of fermentable carbohydrate, plaque fluid has been found to be supersaturated with respect to tooth mineral and other calcium phosphate phases, thus exhibiting the potential to support calculus formation and the remineralization of incipient carious lesions. Following the exposure to fermentable carbohydrate, the degree of saturation of plaque fluid decreases rapidly, primarily due to lactic acid production and the lowering of plaque fluid pH. The extent of these chemical changes has been shown to be associated with differences in caries history. Such studies have been facilitated by the recent development of microanalytical techniques. Unfortunately, little is known about the relationship between the observed chemical changes in plaque fluid and the microbial composition of plaque. Limited information is also available on the association of immune factors in plaque fluid with dental disease.
Sprague-Dawley rats fed diet 2000, infected by Streptococcus sobrinus, and offered milk or lactose-reduced milk as drinking fluids developed essentially similar caries scores as controls given distilled water. In contrast, animals given fructose or sucrose solutions developed enhanced levels of caries. Significant differences were not detected in the S. sobrinus populations among the groups. In further experiments, the addition of sucrose to milk enhanced the severity of caries scores. However, sucrose-milk solutions were significantly less cariogenic than sucrose-water solutions. Animals fed sucrose (2-5%) milk solutions harbored enhanced populations of S. sobrinus. The results, overall, suggest that milk may have modest cariostatic properties when ingested at the same time as a cariogenic challenge.
The in situ rehardening effect by soft cheeses: unsweetened, sucrose-sweetened and strawberry marmalade-flavored, pH 4.5, 4.25 and 4.0 as compared to secreted saliva, was investigated on softened enamel. Ten volunteers wearing orthodontic removal appliances participated in the study. The intraoral test was chosen for measuring microhardness of enamel slabs inserted into the dental appliance. Average microhardness was calculated at three stages: at start (baseline), after exposing the enamel slabs to a citrus beverage (pH 3.3) for 30 minutes in vitro as a softening factor and then intra-oral exposure during 5 minutes to 125 g soft cream cheese mastication, unsweetened and sweetened (experimental), or to saliva secretion, pH 6.8, only by mouth movements (control). Significant rehardening effects on the softened enamel surfaces took place following mastication of the various soft cheeses and salivary secretion. The differences in the rehardening potentials of the cheeses as compared to that of saliva were significant. The rehardening effect of the cheeses decreased (not significantly) in the following order: unsweetened cheese, sucrose-sweetened marmalade flavored cheese and sucrose-sweetened cheese. In spite of the acidic pH of the soft cheese substrates,--the buffering capacity of the protein compounds and the Ca,PO4 ions neutralize a softening effect--the rehardening effect is probably due to an uptake of Ca and PO4 ions by the softened surface enamel from the cheese bolus consumed over the entire 5-minute period.
This paper examines the impact on the development of caries, especially on the proximal and the free smooth surfaces, that follows the reduction in sucrose consumption and the increase in consumption of the monosaccharides in the United States and Great Britain. Laboratory evidence shows that sucrose has a special role in proximal- and smooth-surface caries because of its ability to produce extracellular polysaccharides with the mutans streptococci, thus increasing plaque's ability to adhere to the enamel surface. Evidence from human studies, however, is less clear about the relative cariogenicity of the various sugars, possibly because experimental conditions are difficult to maintain in such studies. In the USA sucrose consumption has been diminishing for some year and is now only 47% of the total sugar consumption of 61 kg per person annually. The change in Britain has been less pronounced, sucrose there in 1984 constituted 83% of total consumption of 47.9 kg per person. Sucrose consumption in Britain is, therefore, higher than in the United States, even though the average total consumption of all sugars is higher in the USA. Limited data suggest that proximal- and smooth-surface lesions also constitute a higher proportion of caries incidence in Britain than in USA, and a cause-and-effect hypothesis between these factors is explored. Dietary education for oral health should harmonize with that for general health by emphasizing sensible food choices, which generally means selection of low-fat, low-sugar foods.