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Louzon Y, Vaknin I, Wolfoviz-Zilberman A, Sharon E, Houri-Haddad Y, Beyth N. In Vitro Effect of Streptococcus mutans Biofilm Produced in Sugar-Free Coca-Cola on Enamel. Int Dent J 2024:S0020-6539(24)00146-1. [PMID: 38918119 DOI: 10.1016/j.identj.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/08/2024] [Accepted: 05/16/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE Sugary drinks such as Coca-Cola may expedite dental caries. For this reason, sugar-free drinks like Coca-Cola Zero Sugar (CZ) may be considered advantageous. This research aims to evaluate in vitro the CZ effect in the presence of Streptococcus mutans (S. mutans) biofilm on enamel demineralization. METHODS Ninety-six human enamel slabs (4 × 4 mm) were used. S. mutans UA-159 72-hour biofilm was created over enamel surfaces. The specimens were soaked in CZ, HCl, or 10% sucrose in PBS solution, 3 times a day for 15 minutes over the course of 4 days. Viable counts (CFU/mL) and biofilm biomass (Crystal Violet staining) were evaluated. pH was measured after each exposure. After 4 days, Demineralization was evaluated clinically and by Vickers microhardness tests. Slabs were photographed using a stereomicroscope before and after exposure to caries-promoting conditions. RESULTS Slabs that were soaked in CZ showed an increase in viable counts compared to control and almost similar counts with 10% sucrose in PBS solution exposures (1010and109CFUmL, respectivly). Biofilm biomass tests showed a 25% higher bacterial growth in the CZ group. CZ pH measures were the lowest and the only group to show a decrease in pH over time (pH ∼3). Enamel slabs that were evaluated clinically in the stereomicroscope postexposures had a chalky and matt appearance as opposed to their shiny appearance in the baseline evaluation. CONCLUSIONS CZ creates a favourable environment for the growth of S. mutans. It may be suggested that even though CZ is sugar free it has a cariogenic effect on enamel. CLINICAL SIGNIFICANCE Clinicians need to educate patients that sugar-free carbonated drinks may be just as harmful as regular carbonated drinks, and hence avoided. This research emphasizes the harmful effect sugar-free carbonated drinks on teeth and sheds new light on their cariogenic potential.
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Affiliation(s)
- Yasmin Louzon
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel.
| | - Ido Vaknin
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel
| | - Amit Wolfoviz-Zilberman
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel
| | - Esi Sharon
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel
| | - Yael Houri-Haddad
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel
| | - Nurit Beyth
- Department of Prosthodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, In Partial Fulfillment of DMD Requirements, Hebrew University-Hadassah School of Dental Medicine, Jerusalem 91120, Israel
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The influence of social norms in the context of reducing sugar-sweetened beverages consumption. Public Health 2022; 213:28-33. [PMID: 36332414 DOI: 10.1016/j.puhe.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study aimed to examine the factors associated with low sugar-sweetened beverage (SSB) consumption and intention to avoid these products as well as investigate the role of different types of social norms in the adoption of this behaviour. STUDY DESIGN This study reports the results of a secondary data analysis from a cross-sectional telephone survey. METHODS A total of 1000 adults were randomly recruited in the province of Québec, Canada, using a random-digit dialling procedure. Eligibility criteria were to be aged between 18 and 64 years; able to answer a questionnaire in French or English; and to reside in the province of Québec. SSB consumption, social norms and variables from the theory of planned behaviour were assessed by means of a questionnaire. Logistic regression analyses were conducted to examine factors associated with behaviour and intention. RESULTS Consuming <1 SSB per day was significantly associated with intention, perceived behavioural control, and risk perception about tooth decay. Descriptive (perceived prevalence in the close surroundings of one person) and perceived societal norms (perceived broad societal approval/disapproval of the behaviour) were associated with behaviour. All theory of planned behaviour variables (including injunctive norm) and risk perception pertaining to chronic diseases predicted intention to avoid the consumption of ≥1 SSB per day. Sex, age, income, and risk perception pertaining to chronic diseases were associated with perceived societal disapproval of SSB consumption. CONCLUSIONS This study confirms the importance of social norms in the prediction of SSB consumption but also highlights the need to address motivation and capacities in public health interventions to reduce SSB consumption.
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Goza JL, Ziegler GR, Wee J, Hayes JE, Hopfer H. Salivary α-amylase activity and flow rate explain differences in temporal flavor perception in a chewing gum matrix comprising starch-limonene inclusion complexes. Food Res Int 2022; 158:111573. [DOI: 10.1016/j.foodres.2022.111573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/13/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
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Souza BMD, Vertuan M, GonÇalves IVB, MagalhÃes AC. Effect of different citrus sweets on the development of enamel erosion in vitro. J Appl Oral Sci 2020; 28:e20200182. [PMID: 32813839 PMCID: PMC7433862 DOI: 10.1590/1678-7757-2020-0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
The increased consumption of citrus sweets can contribute to the development of erosive tooth wear (ETW).
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Affiliation(s)
- Beatriz Martines de Souza
- Laboratório de Bioquímica, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | - Mariele Vertuan
- Laboratório de Bioquímica, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
| | | | - Ana Carolina MagalhÃes
- Laboratório de Bioquímica, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brasil
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Tham J, Calache H, Hallett KB. "Setting the scene in early childhood" - an MID approach for life. Aust Dent J 2019; 64 Suppl 1:S10-S21. [PMID: 31144324 DOI: 10.1111/adj.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article presents a discussion paper for both consideration and implementation of Minimal Intervention Dentistry (MID) principles by the general dental practitioner. It argues that if these concepts can be adopted in early childhood by both the community and the profession, "Teeth for Life" can become a reality for all. Oral Health promoting behaviours can be nurtured and supported from infancy and developed into everyday living practice for a lifetime thereby maintaining an optimal quality of life. MID techniques have become more refined and supported by scientific research in the recent times and should be considered an essential clinical guideline for the future disease management.
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Affiliation(s)
- J Tham
- Department of Dentistry, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
| | - H Calache
- Deakin Health Economics, Faculty of Health, Centre for Population Health Research, Melbourne, Victoria, Australia
| | - K B Hallett
- Department of Dentistry, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
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Janket SJ, Benwait J, Isaac P, Ackerson LK, Meurman JH. Oral and Systemic Effects of Xylitol Consumption. Caries Res 2019; 53:491-501. [PMID: 31060040 DOI: 10.1159/000499194] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/26/2019] [Indexed: 11/19/2022] Open
Abstract
Recent results of randomized trials testing the efficacy of xylitol in caries prevention have been conflicting. This narrative review reveals the sources of discrepancy. The following databases were searched for the terms "xylitol" or "artificial sweeteners" restricted to the English language: PubMed, Web of Science, Evidenced-Based Medicine, Scopus, and the Cochrane database. In a separate search, the terms "dental caries" or "cariogenicity" or "glucosyltransferase" or "low glycemic" or "low insulinemic" or "dysbiosis" or "gut microbiome" were used and then combined. In section I, findings regarding the role of xylitol in dental caries prevention, the appropriateness of research methods, and the causes for potential biases are summarized. In section II, the systemic effects of xylitol on gut microbiota as well as low-glycemic/insulinogenic systemic effects are evaluated and summarized. The substitution of a carbonyl group with an alcohol radical in xylitol hinders its absorption and slowly releases sugar into the bloodstream. This quality of xylitol is beneficial for diabetic patients to maintain a constant glucose level. Although this quality of xylitol has been proven in in vitro and animal studies, it has yet to be proven in humans. Paradoxically, recent animal studies reported hyperglycemia and intestinal dysbiosis with artificial sweetener consumption. Upon careful inspection of evidence, it was revealed that these reports may be due to misinterpretation of original references or flaws in study methodology. Any systemic benefits of xylitol intake must be weighed in consideration with the well-established adverse gastrointestinal consequences. The contribution of xylitol to gut dysbiosis that may affect systemic immunity warrants further research.
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Affiliation(s)
- Sok-Ja Janket
- Translational Oral Medicine, Forsyth Institute, Cambridge, Massachusetts, USA
| | - Jaspreet Benwait
- Boston University School of Public Health, Boston, Massachusetts, USA,
| | - Paul Isaac
- Research Externship,Edwin O. Smith High School, Storrs, Connecticut, USA
| | - Leland K Ackerson
- Department of Public Health, University of Massachusetts, Lowell, Massachusetts, USA
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Abstract
Aim Energy drinks are widely consumed worldwide and are recognised for their adverse health effects, usually due to their high caffeine content. However, little is known about their impact on oral and general health. The aim of this investigation was to review the most popular energy drinks sold in the UK, for their possible effect on oral health and contribution to obesity. Materials and methods Five drinks representing 75% of the UK energy drinks market were purposively selected (Lucozade, Red Bull, Monster, Rockstar and Relentless). pH and sugar content were measured and their ingredients reviewed in the context of oral and general health, focusing on dental caries and erosion and obesity. Results All five energy drinks investigated had pH values below the critical value (5.5) associated with dental erosion; the lowest pH was 2.72 (Lucozade) and the highest was 3.37 (Monster). The drinks also contained excessive amounts of free sugars, ranging from 25.5 g (Red Bull) to 69.2 g (Rockstar). Differences in sugar content were mainly explained by portion size. Other ingredients contained within the energy drinks, caffeine and various acids, are also linked to oral and general health. Conclusion Regular consumption of energy drinks could contribute to dental erosion and the development of obesity. Lucozade and Rockstar were found to potentially have the greatest impact on oral health and obesity. Achieving a healthy product by reformulation is highly unlikely due to the very high initial free sugar content. Thus, health professionals need to acknowledge the popularity of these products and help their clients to reduce their use. This is the first study which compares in detail the potential oral and general health consequences of overuse of a selection of energy drinks popular in the UK.
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Shen P, Walker GD, Yuan Y, Reynolds C, Stacey MA, Reynolds EC. Food acid content and erosive potential of sugar-free confections. Aust Dent J 2017; 62:215-222. [PMID: 28107545 DOI: 10.1111/adj.12498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dental erosion is an increasingly prevalent problem associated with frequent consumption of acidic foods and beverages. The aim of this study was to measure the food acid content and the erosive potential of a variety of sugar-free confections. METHODS Thirty sugar-free confections were selected and extracts analysed to determine pH, titratable acidity, chemical composition and apparent degree of saturation with respect to apatite. The effect of the sugar-free confections in artificial saliva on human enamel was determined in an in vitro dental erosion assay using change in surface microhardness. RESULTS The change in surface microhardness was used to categorize the confections as high, moderate or low erosive potential. Seventeen of the 30 sugar-free confections were found to contain high concentrations of food acids, exhibit low pH and high titratable acidity and have high erosive potential. Significant correlations were found between the dental erosive potential (change in enamel surface microhardness) and pH and titratable acidity of the confections. Ten of these high erosive potential confections displayed dental messages on the packaging suggesting they were safe for teeth. CONCLUSIONS Many sugar-free confections, even some with 'Toothfriendly' messages on the product label, contain high contents of food acids and have erosive potential.
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Affiliation(s)
- P Shen
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - G D Walker
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - Y Yuan
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C Reynolds
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - M A Stacey
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - E C Reynolds
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, Victoria, Australia
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Tuncer Budanur D, Yas MC, Sepet E. Potential hazards due to food additives in oral hygiene products. J Istanb Univ Fac Dent 2016; 50:61-69. [PMID: 28955568 PMCID: PMC5573534 DOI: 10.17096/jiufd.72103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 01/22/2016] [Indexed: 11/20/2022] Open
Abstract
Food additives used to preserve flavor or to
enhance the taste and appearance of foods are
also available in oral hygiene products. The aim
of this review is to provide information concerning
food additives in oral hygiene products and their
adverse effects. A great many of food additives in
oral hygiene products are potential allergens and
they may lead to allergic reactions such as urticaria,
contact dermatitis, rhinitis, and angioedema. Dental
practitioners, as well as health care providers, must
be aware of the possibility of allergic reactions due
to food additives in oral hygiene products. Proper
dosage levels, delivery vehicles, frequency, potential
benefits, and adverse effects of oral health products
should be explained completely to the patients. There
is a necessity to raise the awareness among dental
professionals on this subject and to develop a data
gathering system for possible adverse reactions.
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Affiliation(s)
| | | | - Elif Sepet
- Department of Pedodontics, Faculty of Dentistry, Istanbul University, Turkey
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Tsibouklis J, Middleton AM, Patel N, Pratten J. Toward mucoadhesive hydrogel formulations for the management of xerostomia: the physicochemical, biological, and pharmacological considerations. J Biomed Mater Res A 2013; 101:3327-38. [PMID: 23529996 DOI: 10.1002/jbm.a.34626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/17/2013] [Accepted: 01/22/2013] [Indexed: 01/17/2023]
Abstract
Although hydrogel formulations that may be applied to many mucosal surfaces are now readily accessible, little research effort has been concentrated on the development of systems that may be usefully employed for the prolonged hydration of the oral cavity. To this end, and set within the context of oral care in general, this review considers the requirements for the design of hydrogel formulations with an affinity for buccal cells and details methods for evaluating the performance of these formulations as treatments for the management of xerostomia.
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Affiliation(s)
- John Tsibouklis
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, Hampshire, PO1 2DT, United Kingdom
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Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. Int Dent J 2012; 62:223-43. [PMID: 23106836 PMCID: PMC3490231 DOI: 10.1111/idj.12007] [Citation(s) in RCA: 248] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the 'surgical' care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.
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Affiliation(s)
- Jo E Frencken
- Department of Global Oral Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Erosion and polyols. Br Dent J 2011; 211:582; author reply 582-3. [DOI: 10.1038/sj.bdj.2011.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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