Role of Diet in Dental Caries Flashcards
What are the two types of human studies conducted to show the evidence of sugar in the development of dental caries?
Observational human studies
Experimental human studies
What are the outcomes of historical studies that linked caries with sugar consumption? What types of studies are these?
historical evidence showed that sugar consumption increased as we approached modern age
with increasing sugar consumption, DMF subsequently also increased
When isolated communities were introduced to sugar, DMF increased
Children removed from environments without added processed sugar, had a marked increase in DMF with similar increase of DMF per year compared to control
observational studies
Mike was born with hereditary fructose intolerance. Based off of ______ studies, what can you infer about his DMF? Why?
Is your answer absolute? (ie. what variables can change it)
Observational studies
Fructose intolerance means that omid would have to limit sugars from his diet, such as processed sugars and fruits. This would mean his sugar consumption (processed) would be lower and therefore have a lower probablity of developing caries
However, this doesn’t mean his DMF will always be lower; people of older age tend to be more prone to developing caries.
Why is bob, a production line confectionary worker, more likely to develop caries compared to stan, who worked in the same company but in retail sales?
Bob likely consumes more sugar off the production line; cannot resist temptation lol
What are two experiemental studies on sugar and caries progression?
Vipeholm Study
Turku Sugar Study
Alan enters your clinic with poor oral healthy and many cavities. You make Alan track his diet on a chart for 3 days before coming in for a follow up. Here’s what Alan’s diet typically looks like:
Monday:
Breakfast: Coffee with sugar cube, biscuits, donut
Snack: Cheese stick
Lunch: Hungry Jacks burger, big soda, onion rings
Dinner: Tomato sauce + pasta, chocolate cake (dessert)
Snack: Caramel apple
Based on studies learned in class, give him advice on how he can change his diet, without affecting his way of life.
If Alan had phenylketouria, what do you need to inform him of? Why?
[Vipeholm]
Remove sticky sugars from between meals
No more caramel apple for after dinner
[Turku Sugar Studies] + Sweeteners chart
Replace sugar cube and soft drink with zero-calorie sweeteners.
Eat cheese stick after breakfast instead of before lunch; cheese may have protective effects
- Avoid Aspartame as an artificial sweetener because it is a diester peptide that is comprised of both aspartic acid and phenylalanine. Phenylketonuria patients cannot metabolize phenylalanine and will get liver damage.
What are the outcomes of the vipeholm study?
1) Sugar solution at mealtimes had no effect on caries incidence
2) Sticky sugar during mealtimes increased caries incidence
3) Sticky sugar between mealtimes greatly increased caries incidence
4) Removal of sticky sugars between mealtimes greatly decreased caries incidence
5) Sugar in any form that is reduced as much as practically possible, subjects still developed caries
What were the outcomes of the turku sugar studies>
Sucrose consumption had the highest DMFS (“S” means surface and allows for 5 surfaces for DMF, for a finer measure)
Fructose had a lower DMFS
Xylitol had the lowest DMFS, with decrease in DMFS near the end of the experiment
Rank each of the sugar items in plaque ph lowering potential from high to low:
Baked potato, Glucose, Maple Syrup, Fructose, Raw Sweet Potatoes
Maple syrup, Fructose, Glucose, Baked potato, Raw Sweet Potatoes .
What are the 4 rules to dietary modifications as consultation advice to preventing dental caries?
1) Limit snacking
2) Avoid sticky-sugar foods
3) Eat more food with protective factors such as dairy, nuts, whole cereals
4) Use non-sugar/artificial sweeteners when possible
