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AU 15- Oral Micro > Caries and Diet > Flashcards

Caries and Diet Flashcards

1
Q

True or False: Caries rates are NOT strongly correlated with nutritional status.

A

True, not strongly

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2
Q

Poorly mineralized teeth are more susceptible to demineralization, but they will not decay if the _________ for bacterial acid production is not present.

A

local substrate

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3
Q

Teeth, well-formed and mineralized or not, cannot withstand a strong ________.

A

environmental challenge

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4
Q

What is the most important variable in the caries process?

A

the challenge to teeth from products of bacteria-substrate interactions

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5
Q

What type of caries are primarily associated with industrialized societies?

A

smooth surface caries (processed foods)

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6
Q

In pre-industrialized societeies, caries rates are ____ and primarily confined to ______ and _____ caries.

A

low

root surface and fissure caries

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7
Q

What kind of diet shows an increase in caries rates?

A

diets of refined foods

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8
Q

True or False: The amount of sugar consumed per capita per year correlates with caries rates.

A

True

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9
Q

In a plot of “sugar consumption in non-industrialized nations” against “DMFT” is there a correlation?

A

Yes, decayed-missing-filled teeth increase as sugar consumption increases in NON-INDUSTRIALIZED nations

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10
Q

In a plot of sugar consumption in industrialized nations” against “DMFT” is there a correlation? Why?

A

No, there is no clear relationship (increase in caries with increased sugar) in INDUSTRIALIZED nations. This is different from non-industrialized!!! Why? because when sugar consumption is already high at baseline, increasing above that threshold will have very little influence on caries rates

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11
Q

According to the WHO, there is a _________ between amount of free sugar intake and dental caries for both children and adults.

A

positive assocation

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12
Q

According to the WHO, evidence shows a ______ relationship between sucrose and monosaccharides intake and the progressive lifelong development of caries.

A

log-linear dose-response relationship

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13
Q

Evidence from the WHO resulted in new guidelines for sugar consumption: Sugar intake be reduced to LESS than ____% of total calories or roughly ____teaspoons/____grams per day.

A

10%
12 teaspoons
50 grams
*prior guidelines “no more than 10%”…now, “less than”

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14
Q

True or False: Much of the sugar consumed today is hidden in processed foods that are not usually seen as sweet.

A

True,

ex. 1 tablespoon ketchup= 1 teaspoon sugar

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15
Q

In wartime England (WWII) there was a German blockade of shipments which results in an “accidental experiment.” What were the conclusions?

A

German blockade= restrictions placed on sucrose

  • 1-3 years after blockade: caries rates in children decreased from reduction in sugar
  • 1-2 years postwar: caries rates increased dramatically
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16
Q

Describe the Vipeholm study.

A

From 1945 to 1954 in the mental hospital of Vipeholm in Sweeden: through three phases of the study, diet type and composition were controlled.
1. Vitamins/basic low carb
2. Carbohydrate 1/extreme carbohydrates
3. Carbohydrate 2/average,normal carbohydrates
*CONTROL: no sugar for 3 years
Other groups: Sucrose (300g in solution with meals), Sweetened Bread, Chocolate (between meals), Toffee (between meals), Caramel (snacks)

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17
Q

What were the conclusions of the Vipeholm Study?

A

The most critical changes in caries rates were related to time of sugar exposure (between meals) and texture of sugar source (sticky *toffee and caramel). The amount of exposures is more important than the weight amount per consumption.

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18
Q

What did the Hopewood Study show us?

A

That children living in communal homes, even on a normal diet, usually have lower caries rates than children living with their parents…
*strict dietary control (natural diet with limited between meal snacks) results in fewer cavities, even if hygiene is poor and fluoride insufficient

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19
Q

Which has higher preference for high concentration of sugar in sweet tea: urban or rural children?

A

Urban

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20
Q

Is there learned, genetic, or multiple factors that contribute to sugar preference?

A

Learned and Genetic:

  • sweet preference changes with exposure
  • nontaster/taster/supertaster: non-tasters have more caries
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21
Q

True or False: Supertasters have higher caries rates than non-tasters.

A

False, non-tasters have higher rates! if they can’t taste it, they keep adding more

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22
Q

Dietary modification can reduce ______ counts for extended period of time.

A

lactobacillus

selection of cariogenic bacteria by high carb diet

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23
Q

Rank cariogenicity of sucrose, cooked starches, and fructose from most to least.

A

Most cariogenic: SUCROSE
cariogenic: fructose
Least cariogenic: cooked starches

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24
Q

In the dental student experiment where participants were subjected to 9 daily rinses of 50% sucrose and no oral hygiene, white spot lesions were evident after how many weeks?

A

2 weeks

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25
Q

In the S.mutans experiment, with dental students, sucrose implants with 20% sucrose for 200-270 days, the increase in S.mutans was from 0.5% to _____.

A

18%

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26
Q

True or False: British children consume more sucrose than U.S. children and have higher proportions of fissure caries.

A

False…SMOOTH SURFACE CARIES are greater because they consume more sugar-sweetened tea (SUCROSE = SMOOTH SURFACE)

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27
Q

Why is sucrose more important for smooth surface caries than fissure caries?

A

better formation of biofilms

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28
Q

How much sugar do Americans average per year? Compared to 1816?

A

140 pounds!

15 pounds in 1816

29
Q

What has been the effect of the increased intake of carbonated soft drinks in the United States?

A

fructose (corn sweetener) has surpased sucrose (cane)

30
Q

What is the leading source of added sugar in the daily diet of young americans?

A

soft drinks

31
Q

Do men or women average more in grams of sugar per day from soft drinks?

A

men (57.7grams)*

compared to women (36.2grams)

32
Q

The highest average consumption of fluid milk peaks at ____ per day at age 1 and declines to only _____ per day at 18.

A

2 cups

3/4 cup

33
Q

When does the rapid increase in carbonated soft drinks begin?

A

age 8

34
Q

Dietary guidelines for children: Intake of 100% juice products should be limited to how many ounces per day?

A

4-6 oz

35
Q

Dietary guidelines for children: Consume _____ serving of dairy foods daily.

A

2 or more

36
Q

Compared to a normal diet, long-term exposure to a high-sucrose diet results in a __________ (pH).

A

greater drop in pH below 5.5

37
Q

Sorbitol, Mannitol, Xylitol, and Erythritol are examples of _______.

A

Monosaccharide sugar alcohols

38
Q

What is a polyol?

A

alcohol sugar

39
Q

In what forms can polyols be of?

A

Monosaccharide, Disaccharide, or Polysaccharide

40
Q

Lactitol, isomalt, and maltitol are examples of ________

A

Disaccharide sugar alcohols

41
Q

Hydrogenated starch and hydrolysates are examples of ________.

A

Polysaccharide sugar alcohols

42
Q

True or False: Sugar alcohols are calorie free.

A

False: they are anywhere from 40-75% the calorie content of sucrose

43
Q

Both mannitol and Sorbitol are _____% as sweet as sucrose and have a _____ effect.

A

50-70%

laxative

44
Q

The polysaccharide polyols are _____% as sweet as sucrose.

A

25-50%

45
Q

Lactitol is ____% as sweet as sucrose, Isomalt is ____% as sweet, and Maltitol is ____% as sweet. These are all part of the ________ family of polyols.

A

30-40 Lactitol
45-65 isomalt
90 maltitol

46
Q

True or False: Sugar alcohols do not promote tooth decay.

A

True

47
Q

Sugar alcohols are described as having a ______ mouthfeel with a ______, ______, and _______ taste.

A

smooth

sweet, cool, and pleasant

48
Q

______ gum may be more effective than sorbitol gum at preventing caries.

A

xylitol

49
Q

True or False: Chewing sugar-free gum 3 or more times daily for prolonged periods of time be reduce caries incidence no matter which sugar alcohol is used.

A

True

50
Q

What is the warning associated with xylitol?

A

in dogs: causes rapid and severe increase in insulin levels leading to dangerous hypoglycemia and death

51
Q

What are the five No-Calorie Sweeteners discussed?

A
  1. Aspartame
  2. Saccharin
  3. Acesulfame-K
  4. Sucralose
  5. Stevia
52
Q

_______ is a dipeptide of phenylalanine and aspartic acid, is not safe in people with phenylketonuria and is ____ times sweeter than sugar.

A

Aspartame (Equal)

200 times

53
Q

True or False: Aspartame is not digested and is heat stable.

A

False: it is digested but in such small amounts that it can be considered calorie-free…it is NOT heat stable

54
Q

______ has been associated with a “bitter after taste”, is not metabolized, and is temperature stable.

A

Saccharin (sweet n low)

55
Q

Which zero calorie sweetener is 200 times sweeter than sucrose, has no aftertaste, is not metabolized, is heat stable, and is associated with a major ion?

A

Acesulfame-K

potassium!

56
Q

Which zero calorie sweetener is 600 times sweeter than sucrose and is derived from a chlorination process?

A

Sucralose (splenda)

57
Q

How is sucrose chemically altered in order to make sucralose?

A

three atoms of chlorine are substituted in place of three hydroxyl groups on the sugar molecule

58
Q

Of the five zero calorie sweeteners, only one is digested. Which one?

A

Aspartame (slightly digested only!)

59
Q

______ is derived from plant leaves, is heat stable, non-cariogenic, and is considered a _____ glycoside.

A

Stevia

steviol gylcoside

60
Q

What are the two measurements of cariogenicity?

A
  1. pH (bacteria + food = pH drop)

2. Micro-electrodes on tooth surface (Stephan Curves)

61
Q

How can physical properties of food influence cariogenicity (3 ways)?

A
  1. Adhesion to teeth (ex. cooked starch retained longer)
  2. Salivary stimulation (ex.gum)
  3. Mechanical cleansing (not supported by data)
62
Q

______ which is used in gum has been shown to raise plaque pH.

A

Carbamide

63
Q

Which component of baking soda will raise the plaque pH?

A

sodium bicarbonate

64
Q

Which “foodstuff” has be associated with an inhibition of demineralization and promotion of remineralization?

A

casein phosphopeptide

65
Q

______, such as phytate, will stabilize crystals by reducing solubility and protecting calcium.

A

phosphates

66
Q

_____ and _____ are associated with acid inhibition when consumed with sugar (think about cream in your coffee).

A

Calcium and Fat

67
Q

True or False: Scientific evidence shows that natural sugars in fruits/vegetables are not harmful.

A

False: no scientific studies show that they aren’t harmful. Sugar cane workers? high caries rates

68
Q

What are two downsides to dietary counseling?

A
  1. Effectiveness: lifestyles are very hard to change

2. Targeting

69
Q

To thrive on a smooth surface it’s helpful to be able to elaborate a strong extra-cellular matrix. _________ does this very well using glucosyl transferase with _____ as the substrate

A

Strep mutans
sucrose

*beware of the triple-“s”… s.mutans, smooth, sucrose

AU 15- Oral Micro (11 decks)

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