Dental caries-protective agents in milk and milk products: investigations in vitro.

Objectives: To characterise and identify the anti-dental caries components that exist in milk and milk products.

Methods: Standard enamel or hydroxyapatite demineralisation tests were devised to simulate the action of acid on tooth mineral, and they were used to show which constituents of milk possessed a potential protective action against acid attack.

Results: Milk and milk products were fractionated and tested, revealing that minerals, including calcium and phosphorus, played a part in this protective process.

Properties of maltodextrins and glucose syrups in experiments in vitro and in the diets of laboratory animals, relating to dental health.

The objective of the study was to examine the cariogenic potentials of maltodextrins and glucose syrups (two glucose polymers derived from starch) using a range of techniques in vitro and in laboratory animals. The experimental methods used were: (1) measurement of acid production from glucose syrups and maltodextrins by human dental plaque micro-organisms; (2) evaluation of the role salivary alpha-amylase in degrading oligosaccharides (degree of polymerisation > 3) in the glucose polymers, estimating the products by HPLC; (3) assessment of the fermentability of trioses relative to maltose; (4) measurement of dental caries levels in three large-scale studies in laboratory rats fed on diets containing the glucose polymers. It was found that acid production from the glucose polymers increased as their higher saccharide content fell.

Lessening dental erosive potential by product modification.

Current interest in dental erosion has led to increasing attention to ways in which potentially erosive products might be modified. Information on how this could be achieved has been hard to gather, and has focused chiefly on possibilities in reformulating soft drinks. The bulk of the work published on this relates to calcium and phosphate supplementation, ranging from early experimentation on saturation of a demineralising medium with tricalcium phosphate, through tests of more soluble phosphates and other calcium salts providing various levels of Ca2+ and PO4(3-), to a calcium citrate malate additive specially formulated to curb erosion by soft drinks.

Methods of assessing erosion and erosive potential.

Methods for use in vitro are reviewed first, classified under the examination of extracted teeth, chemical and physical methods, digital image analysis, scanning electron microscopy and other potentially useful techniques. Methods for recording erosion in laboratory animals are dealt with next, including techniques that can also be used in vitro, Restarski's system and various modifications of it, and digital image analysis. Thirdly the main systems and indices that have been designed for clinical use are arranged under case histories and clinical examination, scales of severity and indices of diagnosis of varying complexity.

Laboratory studies of sweets re-formulated to improve their dental properties.

Objectives: To evaluate the potential dental effects of ten new types of sugar-free sweets formulated with Lycasin or isomalt as bulk sweeteners instead of sugars.

Methods: Examination of the sweets for their acidity, fermentability by oral microorganisms, influence on the demineralisation of dental enamel, and their influence on human interdental plaque pH, compared with conventional sugar-containing sweets.

Findings: The importance of reducing the levels of flavouring acids in the sweets was demonstrated.

Dental properties of antiseptic throat lozenges formulated with sugars or Lycasin.

Thirteen different formulations of throat lozenges were examined for their acidity, demineralizing action on hydroxylapatite, and fermentability by human dental plaque micro-organisms. Their flavouring acids gave them low pH values in the range 2.6-3.

The use of high-phosphorus supplements to inhibit dental enamel demineralisation by ice lollies.

Five new formulations of water ice lollies with a high-phosphorus (low Ca) supplementation ratio were tested for their erosiveness of dental enamel or hydroxylapatite in vitro. Compared with the basic unsupplemented lolly, all five formulations that had been prepared with additional calcium and phosphorus, but in a low Ca/P ratio, as potential inhibitors of demineralisation, were associated with significantly less attack on dental mineral, as measured by the dissolution of calcium and phosphorus.

The use of sanguinarine in mouthwashes and toothpaste compared with some other antimicrobial agents.

Dental practitioners say that they get information to answer patients' queries on mouthwashes chiefly from their studies in periodontology and from articles in the British Dental Journal. Most practitioners who were asked about this knew of the benefits of Corsodyl (chlorhexidine) and fluoride-containing rinses, but few were aware of the active ingredients and effectiveness of the wide range of mouthwashes now on the market. The majority said they would welcome more information on this.

Precise control of the frequency and amount of food provided for small laboratory animals by a new electronic metering technique, used to evaluate the cariogenic potential of chocolate.

A new electronic system was set up for accurately regulating the amount and frequency of food dispensed to laboratory rats so that investigations of the cariogenic potential of foods can be carried out under strictly controlled conditions according to the stipulations of the San Antonio Consensus Conference, 1985. The system was used to evaluate the cariogenicity of sucrose incorporated into plain and milk chocolate. The results suggested that 18.

Erosion by soft drinks of rat molar teeth assessed by digital image analysis.

A digital imaging analysis (DIA) procedure for recording and assessing erosive changes on teeth was developed and evaluated against an older subjective method. Results after exposure of rats' teeth to various soft drinks showed that the DIA system was superior to the conventional method, with improved precision. The system provided a direct and highly sensitive means of quantifying the erosion of dental hard tissues by three different soft drinks, showing that it could be used to evaluate erosiveness and other dental damage.

Update on low-calorie sweeteners to benefit dental health.

Ten different types of high-intensity, low-calorie sweeteners that have potential dental applications as sugar substitutes are appraised, taking into consideration their general properties, safety and toxicological assessment, metabolic fate in the body, regulatory status and any dental research that has been carried out on them. Attention focuses on the continuing expansion in the wide diversity of types of sweeteners becoming available, the multiple sweetener concept, the growing interest in materials of natural origin, and the distinction between non-cariogenic and actively anti-cariogenic properties of the individual sweeteners.

Advances in non-caloric sweeteners with dental health advantages over sugars.

Many factors have to be considered in developing new intense sweeteners to replace sugars in the diet for the benefit of dental health. These include their general properties, safety and toxicological evaluation, metabolic fate in the body, regulatory status and dental research documentation. The choice of new sweeteners with improved properties is expanding, with particular attention being paid to multiple sweetening, materials of natural origin and calorie control, as well as dental health gains, the distinction between non-cariogenic and anti-cariogenic properties, securing regulatory approval and developing an attractive range of foods and drinks containing the new materials.

Soft drinks, infants' fruit drinks and dental health.

Dr Trevor Grenby and his fellow research workers have recently completed a research project on the dental properties of adults' and infants' soft drinks. Here, he uses these findings as a basis for giving his personal opinions on the drinks and their possible influence on dental health.

[In vitro experiments on effect of soft drinks on dental enamel].

The composition and dental properties of eight different soft drinks, representing some of the most popular types used in the U.K., were examined.

Potential dental effects of infants' fruit drinks studied in vitro.

Eighteen different infants' drinks from five manufacturers were examined for their carbohydrate, calcium, phosphorus and acid contents, and their attack on tooth mineral. Seven of the drinks were compared with nine varieties of adults' soft drinks, and demineralization was studied with and without the presence of a cariogenic oral streptococcus. The influence of the acids already in the drinks in dissolving Ca and P outstripped that of any acid generated in these studies in vitro by microbial fermentation of the sugars they contained, giving an indication of their relative erosiveness rather than their cariogenic action.

Snack foods and dental caries. Investigations using laboratory animals.

The nation's eating habits are undergoing major transformation, with a swing away from traditional meals to a huge increase in snack consumption, but very little is known of the nutritional and dental implications of this change. The research project reported here evaluated a range of snack foods in caries-active laboratory animals, comparing them, as dietary ingredients, with noncariogenic and cariogenic (sugar) diets. The findings showed the very low cariogenicity of salted peanuts, followed by ready-salted and salt and vinegar crisps, extruded maize, mixed-starch and prefabricated/fried potato products, and cheese-filled puffs.

Laboratory studies of the dental properties of soft drinks.

The composition and dental properties of eight different soft drinks, representing some of the most popular types used in the UK, were examined. Demineralization experiments were conducted on hydroxylapatite, the basic component of dental enamel, determining calcium dissolving by atomic absorption spectroscopy and phosphorus by u.v.

The possible dental effects of children's rusks: laboratory evaluation by two different methods.

In response to concern over the sugar content and possible dental effects of infants' rusks, a programme of research was undertaken to compare six different kinds of rusk with respect to (a) their cariogenicity in caries-active laboratory rats; (b) their capacity to serve as substrates for acid production by oral microorganisms, and the attack of this acid on dental mineral; (c) the adhesiveness of the rusks to the enamel surface. The caries scores in the animal experiments ranged from very high, with rampant dental destruction, for 31%-sucrose rusks, down to virtually non-cariogenic on a zero-sucrose variety. With only one anomaly, cariogenicity correlated well with sucrose content.

Latest state of research on lactitol and dental caries.

Research on the dental properties of lactitol as a bulk sweetener to replace dietary sugar is reviewed under three headings: microbiological experiments in vitro, investigations in laboratory animals, and studies in man. Lactitol was not easily metabolized by acidogenic and polysaccharide-forming oral micro-organisms, its enamel-demineralizing potential in vitro intra-oral acid development and dental plaque formation from lactitol in man were substantially lower than from sucrose. The indications for dental health benefits are promising.

Dental and metabolic effects of lactitol in the diet of laboratory rats.

1. Because so little is known about the properties of lactitol as a possible alternative bulk sweetener to sucrose, it was tested in two large-scale experiments in laboratory rats. Matched groups of caries-active Osborne-Mendel rats were fed on uniform diets containing lactitol and compared with a sucrose control in both experiments, plus a xylitol control in the first experiment.

Studies of the dental properties of lactitol compared with five other bulk sweeteners in vitro.

Standardized mixed cultures of dental plaque microorganisms were incubated for 24 h in media containing six different bulk sweeteners as energy source. The attack of the acid generated on tooth mineral was measured by calcium and phosphorus analyses. Demineralization was most severe with glucose and sucrose.