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DS1101 - S1 Y1 > Week 13 - Caries and Carbohydrates > Flashcards

Week 13 - Caries and Carbohydrates Flashcards

1
Q

What are carbohydrates

A

Organic compounds composed of carbon, hydrogen and oxygen atoms and serve as a primary source of energy for living organisms.

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2
Q

What are simple carbohydrates

A
  • Monosaccharides - simplest form of carbohydrates (1 sugar unit) e.g. glucose, fructose, galactose
  • Disaccharides - composed of 2 sugar units e.g. sucrose, maltose, lactose
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3
Q

What are complex carbohydrates

A

large sugar molecules
- Oligosaccharides - 3-10 sugar units
- Polysaccharides (>10 sugar units)

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4
Q

What are sugars classified as (2)

A
  • Intrinsic
  • Extrinsic
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5
Q

What are intrinsic sugars

A
  • Occur naturally within cellular structures of food e.g. sugar in fruit
  • Not thought to have adverse effects on general and dental health
  • Found in whole foods (fruits, vegetables and unprocessed grains)
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6
Q

Examples of intrinsic sugars

A
  • whole fruits
  • whole vegetables
  • unprocessed grains
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7
Q

What are extrinsic Sugars

A
  • Includes milk sugars and “free sugars”
  • They can be naturally occurring but are not bound within the cellular structure of foods e.g. fruit juices and fruit concentrates
  • Free sugars the sugars which are added to foods and beverages by manufacturers, cooks or consumers e.g. in soft drinks, cakes, biscuits
  • Free sugars are detrimental to health and contribute to both dental caries and obesity
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8
Q

Examples of extrinsic sugars

A
  • honey
  • syrups
    -fruit juices
  • fruit juice concentrates
  • sweets
  • cakes
  • biscuits
  • sugary drinks
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9
Q

What are dental biofilms

A

microbial biomass on a tooth surface composed of resident oral bacteria in a proteinaceous pellicle

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10
Q

What are dental caries

A

localized chemical dissolution of a tooth surface brought about by metabolic activity in the dental biofilm

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11
Q

What are fermentable carbohydrates

A

Sugars that can be metabolized by bacteria in the biofilm
e.g. sucrose, lactose, glucose

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12
Q

How do caries form

A
  1. The bacteria metabolizes these sugars and produce acids as a by-produce
  2. These acids lower the biofilm pH
  3. When the biofilm pH drops below 5.5 (critical pH) demineralization occurs on the tooth surface
  4. Remineralization occurs when the biofilm pH increases after approximately 60min as saliva flows in to buffer acidity
  5. De and remineralization occurs at the tooth surface numerous times each day (state of dynamic equilibrium)
  6. When there is more demineralization than remineralization eventually enough tooth mineral is lost and caries form
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13
Q

What percentage of minerals needs to be lost for caries to form

A

30-40%

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14
Q

Define critical pH for enamel

A

the pH at which enamel begins to demineralize

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15
Q

What is the critical pH

A

5.5

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16
Q

How long does it take for pH of the oral cavity to return to normal levels and what causes this

A

60 min as saliva flows in to buffer acidity demineralizing the tooth surface

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17
Q

What is aciduric bacteria

A

acid tolerant bacteria

18
Q

What is acidogenic bacteria

A

acid producing bacteria

19
Q

What are the main bacterial species which cause caries formation

A

streptococcus mutans
lactobacilli

20
Q

What are 3 factors which influence the carbohydrates capacity to cause caries

A
  1. Cariogenic potential
  2. Frequency of intake
  3. Food form
21
Q

How does cariogenic potential influence

A

Cariogenic potential refers to the capacity of the carbohydrate to cause caries
- Simple carbohydrate = harmful - diffuse into plaque and are metabolized by biofilm bacteria
- complex carbohydrates = less harmful

22
Q

what is the most cariogenic sugar

A

sucrose

23
Q

what are examples of cariogenic sugars

A
  • glucose, fructose
  • sucrose
  • lactose
  • starch
24
Q

How does frequency of intake influence capacity for carbohydrates to cause caries

A

Repeated and frequent consumption of sugar leads to sustained low pH, increasing the amount of time during which demineralization is occurring. As a result the teeth are demineralizing more than they are demineralizing over time (shift equilibrium towards demineralization) resulting in:

  • cumulative loss of tooth mineral
  • caries formation
25
Q

how does food form influence capacity for carbohydrates to cause caries

A

Referring to sticky, hard or soft which influences the duration of exposure and retention of carbohydrates on teeth.

High starch foods (potato chips, doughnuts) remain on teeth longer - extending the periods of acid production and demineralization

26
Q

What is some advice for patients to reduce caries

A
  • Reduce total amount of sugar intake - around 6 teaspoons (25g) per day
  • Reduce frequency of sugar intake and avoid snacking in between meals
  • Avoid sticky or retentive foods
27
Q

What are some high caries risk groups

A
  • Infants and toddlers provided with bottles of milk (contains sugar lactose)
  • Patients who frequently consume snacks or drinks which contain added sugar
  • Athletes using sports drinks
  • Those with xerostomia
28
Q

What are some safe snacks and drinks

A
  • Cheese
  • Nuts
  • Water and milk
  • intrinsic sugars in fruits are not generally considered harmful and the dietary fibres are good for you
29
Q

What are the two types of sugar substitutes

A
  • Non-nutritive (non caloric) sweeteners
  • Nutritive (caloric) sweeteners
30
Q

What are examples of no-nutritive (non caloric) sweeteners

A
  • Saccharine
  • Acesulfame-K
  • Aspartame
  • Thaumatin
31
Q

What are examples of nutritive (caloric) sweeteners

A

Nutritive (caloric) sweeteners are sugar alcohols so they mostly end in -ol
-Sorbitol
- Xylitol
- Mannitol
- Hydrogenated glycose syrup (Lycasin)
- Isomalt (palatinit)

32
Q

What are non nutritive sweetners

A
  • Much sweeter than sucrose
  • Cannot be fermented by biofilm bacteria, hence is safe for teeth
  • Not suitable for infants/young children
  • No effect on blood sugar
  • Acidic and can contribute to dental erosion
  • No suitable for infants/young children

e.g saccharine, acesulfame-K, Aspartame, sucralose

33
Q

What are nutritive sweeteners

A
  • Increase blood sugar
  • used in sugar free sweets, chewing gum, toothpaste and medicine
  • Xylitol cannot be fermented by oral bacteria and hence is safe for teeth
  • Sorbitol and mannitol may be slightly fermentable

e.g. Xylitol, sorbitol, mannitol

34
Q

Is xylitol safe for teeth

A

yes as it cannot be fermented by oral bacteria

35
Q

Is Saccharine safe for teeth

A

Yes, it cannot be fermented by biofilm bacteria

36
Q

Is sorbitol safe for teeth

A

No, may be slightly fermentable

37
Q

Is fresh fruit good for teeth

A

Fruit contains intrinsic sugars. These are thought to be not particularly harmful in whole fruit.
The fiber is also beneficial for health.
However the overconsumption of acidic fruits are not recommended (lemon, limes)

38
Q

Is canned fruit good for teeth

A

No, as canned fruits often contain sugar sprue which are extrinsic/ free sugars which is causes acid fermentation

39
Q

Is fruit juice good for teeth

A

No, because the blending/juicing process releases the intrinsic sugars into free sugars from the fruit.
It also removes all fiber
The fruit sugar is more concentrated as there’s more than 1 fruit in a serving of fruit

40
Q

If dried fruit good for teeth

A

No, dried fruit contains super-concentrated sugar due to the reduced water content
Dried fruit is also normally sticky thus it can remain in the mouth for a longer period of time acting as a reservoir for bacteria

41
Q

Are dairy products good for teeth

A

Cow’s milk contains lactose - probably the least cariogenic of all the dietary sugars.

Casein in milk is thought to have a protective effect on teeth.

Cheese and milk are safe snacks and drinks.
some dairy products such as yogurt are not good for the teeth as they contain hidden extrinsic sugars which are harmful to teeth

However, parents should be told that infants should never be put to bed with milk in a bottle.

42
Q

Is honey good for teeth

A

no, honey is a naturally occurring free sugar and sugar is highly concentrated in honey

DS1101 - S1 Y1 (63 decks)

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