Sugars – The Arch Criminal?
- 21 May 2004
- journal article
- review article
- Published by S. Karger AG in Caries Research
- Vol. 38 (3), 277-285
- https://doi.org/10.1159/000077767
Abstract
Numerous lines of evidence have conclusively established the role of sugars in caries etiology and the importance of sugars as the principal dietary substrate that drives the caries process has not been scientifically challenged. While sugars appear to differ little in acidogenic potential, sucrose has been given special importance, as the sole substrate for synthesis of extracellular glucans. Water-insoluble glucans might enhance accumulation of mutans streptococci on smooth tooth surfaces and appear to enhance virulence by increasing plaque porosity, resulting in greater acid production immediately adjacent to the tooth surface. Data indicating that the sugar consumption/caries relationship is now weaker have led to suggestions that recommendations to restrict sugar consumption are no longer necessary. Clearly, fluoride has raised the threshold of sugar intake at which caries will progress to cavitation, but fluoride has its limits, and caries remains a serious problem for disadvantaged individuals in many industrialized countries and is a rising problem in many developing countries. A weakening of the sugar/caries relationship may also be explained by many technical, biological, behavioral and genetic factors. Future research should aim to determine the biologic and behavioral factors that influence caries risk. Measures to educate the public on the dangers of frequent sugar consumption, combined with recommendations for proper oral hygiene and fluoride use, are still warranted. Individual dietary counseling is highly recommended for patients at high caries risk. As dental caries is a preventable disease, each country must decide: what level of disease is society willing and able to tolerate?Keywords
This publication has 8 references indexed in Scilit:
- Relationship among Dental Plaque Composition, Daily Sugar Exposure and Caries in the Primary DentitionCaries Research, 2002
- Biochemical Composition and Cariogenicity of Dental Plaque Formed in the Presence of Sucrose or Glucose and FructoseCaries Research, 2000
- Guidelines for sugar consumption in Europe: Is a quantitative approach justified?European Journal of Clinical Nutrition, 1999
- Sugar consumption and dental caries: evidence from 90 countriesBritish Dental Journal, 1994
- The role of sugar in the aetiology of dental caries: 6. Evidence from experimental animal researchJournal of Dentistry, 1983
- Cariogenic effects of cooked wheat starch alone or with sucrose and frequency-controlled feedings in ratsArchives of Oral Biology, 1982
- The effect of frequent sucrose mouthrinsing on the induction in vivo of caries-like changes in human dental enamelArchives of Oral Biology, 1978
- The effects of sucrose, fructose, and a mixture of glucose and fructose on the incidence of dental caries in monkeys (M. fascicularis)British Dental Journal, 1977