DIPC 5001 - Prevention of Dental Caries by Dietary Management

cariogenic

foods/beverages that contain fermentable carbohydrates that can be metabolized by bacteria to produce acid

- demineralizes enamel

anti-cariogenic

foods/beverages that can prevent cariogenic activity when eaten

cariostatic

foods/beverages that cannot be metabolized by bacteria and do not cause a DIP in salivary pH

most of what we know about the relationship of carbohydrates and dental caries is a result of the

Vipeholm study

purpose of the Vipeholm study

- does an increase in carbohydrate intake cause an increase or decrease in caries?

3 groups of research subjects in the Vipeholm study

1) sucrose group

2) bread group

3) candy group

the sucrose group's basal diet contained _______ during meals

300g of additional sugar in solution (sweetened beverage)

the bread group's basal diet contained ______ during meals

50g of additional sugar with bread

the candy group's basal diet contained ______

in-between snacks of toffee and sugar candy

results of the study showed that an increase in dietary carbohydrate

DID increase the caries activity

the risk of caries is greater if sugar is consumed in the

retentive form on the tooth surfaces

when sugar was consumed between meals, caries formation was noted to be

greater

when dietary sugar is withdrawn, caries activity

diminished

caries rate was highest in this group

candy group

_____ is a PRIMARY factor in caries actvitiy

frequency of sugar eaten

true or false: the form of foods can increase incidence

true

- retentive foods that stay in the oral cavity longer increase rate of caries

oral pH drops within ______ of rinsing with/ eating sucrose

3 minutes

the critical pH is _____ because that's the pH that can demineralize hard tooth structure

5.5. VERY IMPORTANT

stephan curve

true or false: sticky foods are hard to be cleared from the oral cavity

FALSE

- misleading; they're actually easily cleared. ex: caramels, jellybeans, raisins, chocolate bars

examples of retentive starchy foods

cookies, crackers, potato chips (most retentive)

both sticky AND retentive foods are

cariogenic

all food and beverages that contain sugars have the

potential to cause dental caries

- food label will show sugar as one of the main ingredients

true or false: if it doesn't taste sweet, it doesn't have sugar

FALSE

ultra-processed foods that do not taste sweet may have high-fructose corn syrup to improve shelf life

plaque bacteria feed on

carbohydrates and produce acid that demineralizes enamel

- they produce it as long as the carbs remain in the mouth

eating behaviors very detrimental to teeth

sipping and grazing

- every time you eat or take a sip is an opportunity for bacteria to make acid

cariogenic foods

fermentable carbohydrates

- monosaccharides

- disaccharides

- sweeteners used in manufacturing (juice, honey, glucose, starch)

ultra-processed foods contain about ____% sucrose

20%

true or false: sugar is synonymous with sucrose

FALSE

- sucrose is table sugar

- sugar encompasses all mono, di, and polysaccharides

fermentable carbohydrates include

all sugars or cooked starches metabolized by oral bacteria to produce acids

addition of sucrose ___ the cariogenicity of cooked starchy foods

increases

cooked starchy foods have lower cariogenicity potential IF

- sugar is NOT added

- NOT combined with protein

raw and uncooked starches have ____ caries-promoting activity

low

- less refined starchy grains and cereals contain phytate and/or fiber that may protect teeth

examples of cariostatic foods

- cheese/dairy

- nuts

- proteins

- fruits and vegetables

- sugar-free gum or mints made with Xylitol

- appropriate food combinations

examples of highly acidic foods

- citrus fruits

- acidogenic sports drinks

- snacks with citric acid

- carbonated beverages

- lemon-flavored iced tea

both synthetic sweeteners and sugar alcohols are

cariostatic

synthetic sweeteners examples

- aspartame (180x sweeter than sucrose)

- saccharine (300x sweeter than sucrose)

- sucralose

sugar alcohols are ____ chemical based

LESS chemical based

- chemically altered fruits, veggies, and starches

- incompletely absorbed in the intestine

- can have GI effects if more than 3 pieces a day

- reduces calories

- all forms are cariostatic

the most desirable of all sugar substitutes is

xylitol

- not metabolized by bacterial plaque

- reduces S/ mutans in the oral cavity

- has capability to remineralize incipient decay

TEST QUESTION: how to change your diet for caries prevention?

1) change food frequency

2) type of food

3) protective food combinations

cariostatic foods and factors

- water and saliva

- phytates

- proteins

- cheeses

- fats (healthy)

- xylitol

foods to create a neutral oral pH

- combine cooked starches with veggies/dairy

- eat high quality lean proteins

- combine dairy foods w/cooked starch

populations with increased caries prevalence

- low socioeconomic groups

- certain ethnic minorities

- medically compromised people

- people with chronic diseases

- receiving pharmaceutical and medical therapies

- people with physical disabilities

risk factors for caries

- age

- gender

- fluoride exposure

- systemic illness

- medications

- oral hygiene

- salivary function

how to know if someone has a cariogenic vs. cariostatic diet

- grams of sugar per day

- type of carbohydrate consumed

- timing of carbohydrate consumption

- frequency of acid intake events

factors most implicated in early childhood caries

- prolonged use of baby bottles containing highly fermentable sugars

- pacifiers dipped or filled with sweet agents

- snacking on sugary foods

tooth erosion is associated with _____ by athletes

prolonged use of sports drinks

- combination of acidogenic medium with sucrose accelerates erosion and caries

- should combine with sugar-free gum OR have the drinks more periodically

in elderly, ____ are more common

root caries

- due to exposed dentin from gingival recession, associated changes in the oral mucosa, and periodontium

- changes in teeth and masticatory function affect dietary intake

- if treatment is to include oral hygiene along with proper dietary changes, tooth loss is probable

on side 1 of the Nutritional Assessment Form is the

Concise Dietary Assessment

on side 2 of the nutritional assessment form is the

Foods High in Sugar

to determine a patient's nutritional health, they were asked to

detail everything they ate/drank within a 24hr period.

- includes portions, eating times, preparation method, added items, between meal times, and nonfood items

- does not provide accurate picture of nutrient consumption

- useful for dentistry because it shows us the usual eating habits

EXAM QUESTION: a person should eat _____ g of sugar daily

less than 55g

stage I of caries prevention

diet interview

stage II of caries prevention

dietary advice

for ample saliva and to help clear the oral cavity, you should include

one crunchy food with each meal