Outcome 5 - The role of food in plaque control and preventive dentistry Flashcards
(19 cards)
Dental caries results from the interaction of 4 factors in the mouth:
- cariogenic plaque bacteria
- fermentable substrate
- host and tooth factors (including fluoride and other minerals)
- saliva
What happens in mouth when foods are ingested?
Plaque bacteria metabolize the CHO component (which is starches & sugars). This process forms organic acids - lactic, butryic, acetic, formic, and prophionic - on the tooth surfaces. This fermentatino begins within minutes and may continue for hours. These acids lower the pH of the plaque and can dissolve tooth structure. When the substrae is exhaused, acid production stops and plaque pH retunrs to its resting state.
How to estimate the cariogenicity of foods?
Changes in plaque pH have been used to estimate the cariogenicity of food and snacks.l
What pH is Enamel thought to break down at?
5.3-5.7 pH
Breakdown of foods influence on plaque formation
Plaque microorganisms→ fuel on CHO→ produce acids→ pH falls → demineralization→ Ca and P diffuse into plaque
What is a major factor in the decay process?
The retentiveness of food
The oral clearance time or the time it takes for food to leave the mouth
3 Categories of fermentable carbohydrates
- Retentive Sugars (30 mins)
- Moderate Sugars (25 mins)
- Sugars in Solution (20 mins)
How long does it take for Retentive Sugars to clear
takes about 30 mins to clear
- tend to be sticky, or typically stays in the mouth for an extended period of time
How long do Moderate Sugars remain in the mouth?
takes about 25 minutes to clear starchy foods or starch plus sugar combination foods
How long does it take for Sugars in Solutions to Clear?
Takes about 20 minutes to clear liquid sources of CHO, including those foods that are liquid at room temperature
What is the sugar exposure goal?
The goal is less than 2 hours (120 mins) of exposure to sugars in a 24-hour period
Factors affecting retentiveness:
-The stickiness of food - Rasins and toffee are very sticky and it takes longer to clear them from the mouth
-Foods that can stimulate salivary flow includes cheese, sugarless gum, and water. These foods increase saliva flow - saliva neutralizes acids produced by the microorganisms in plaque and helps to remove any residual sugar
Frequency of eating vs the volume/amount of food eaten
The frequency of eating is more important than the volume or amount of food eaten
- EG) Eating three small pieces of cake over the course of a few hours is more cariogenic than eating one very large piece of cake in one sitting. The difference is 20-30 mins of acid production each time some of the cake is consumed vs. 1 20-30 mins of acid production if the cake is eaten all at once.
Risks for decay?
Carbohydrates between meals create a greater risk than carbohydrates eaten at meals because there is nothing to neutralize the acid
Duration of the meal or snack refers to the length of time spent eating. The longer food is in the mouth, the longer the exposure time for bacteria to produce acid
Citrus food and carbonated beverages both contain acids that can act directly on tooth enamel and cause demineralization
Cariogenic foods?
-foods that are most likely to cause decay
-cariogenic foods are broken down in the mouth into sugars that bacteria utlize to produce acids
-simple sugars (refined sugars): sweeteners, honey, pop, candy, fruit juice, and fruit
-fermentable CHO includes complex CHO like starch, that stays in the mouth long enough to be broken down into sugars by salivary amylase (eg. crackers, chips, dried fruits, bread, cake and cookies)
Non Cario-genic foods?
-foods that are not a source of energy for oral bacteria and hence do not stimulate acid production or cause decay
-these are mainly protein and fat foods (eg. meats, eggs, nuts, seeds, butter, oil)
-alternative sweetners include sugar alcohols (sorbitol, mannitol, xylitol) aspartame, cyclamates, saccharin, and sucralose, which have low or no cariogenicity
-if non-cariogenic foods are combined with CHO foods, they may be cariogenic
Anti-Cariogenic foods?
-food that inhibit the acid attack on teeth and thus, inhibit decay
-aged cheddar, montery jack, and swiss cheese do this by stimulating salivary flow
-Other foods that may be anti-cariogenic, but unfortunately are not nutritional include pure chocolate and cocoa products
-Cariogenic foods can be combined with anti-cariogenic foods (cheese and crackers) to limit the effect of cariogenic foods
List three dietary goals of preventive dentistry.
Eat a balanced diet according to Canada’s Food Guide of Healthy Eating
Limit refined sugar intake and the frequency, and duration of eating.
Eat dentally unhealthy foods with meals, not as snacks
