Comparative evaluation of the effect of different commercially available biscuits on plague ph. A clinical Trial

1. PRESENTED BY: SOR2

2. SESSION OVERVIEW
STUDY TITLE
INTRODUCTION
OVERVIEW OF INDIAN BISCUIT INDUSTRY
AIMS & OBIECTIVES OF STUDY
PURPOSE OF STUDY
MATERIAL AND METHODS
RESULTS
CONCLUSION

3. STUDY TITLE
COMPARATIVE EVALUATION OF THE
EFFECT OF DIFFERENT COMMERCIALLY
AVAILABLE BISCUITS ON PLAQUE pH:
A CLINICAL TRIAL

5. The concept of health has prevailed for
centuries and dietary habits are apparently
changing with modernization . With improved
socioeconomic status and busy modern life of families, there
has been an increased intake of readymade food with
fermentable carbohydrates among the masses.

6. Among all commercially available refined carbohydrates
biscuits have become one of the most loved fast food
products for every age group specially children as
it is easy to carry,
tasty to eat, and
reasonable at cost.

7. OVERVIEW OF INDIAN BISCUIT INDUSTRY
India Biscuits Industry came into limelight
and started gaining a sound status in the
later part of 20th century when the
urbanized society called for ready made
food products at a tenable cost.

8. Industry Research
• Of the people who
consume biscuits 25%
people prefer cream
biscuits,
• 12% prefer wafer biscuits,
• 34% prefer sweet plain
biscuits and
• 29% of people prefer
namkeen or salty biscuits.
9/20/2015 8
Source:- Indian Biscuit Manufacturers’ Association (IBMA),2011

9. Industry Research
• The number of people
who eat biscuits include
37% of people who eat
them everyday,
• 29% eat twice a week,
• 14% eat four times a week,
• 8% eat once in 15 days,
• 6% eat once in 10 days and
once in a month.
9/20/2015 9
Source:- Indian Biscuit Manufacturers’ Association (IBMA,2011)

10. It is widely accepted that all foods containing
“fermentable carbohydrates” have the potential to
contribute to caries formation.
There are different methods for evaluating cariogenic
potential of foods and drinks . One of them is
Acidogenicity assessment of consumed food.

11. CHOICE OF STUDY METHOD
Measuring the
decrease in
dental plaque
pH after
exposure to
fermentable
carbohydrates
is the basis of
plaque pH
studies.
Acidogenicity
tests measure
plaque
responses and
are the only
indirect tests of
cariogenicity.
In general,
plaque pH
studies have
excellent
reproducibility,
but they are
expensive and
complex.
‘Strip method’
is inexpensive
and easy to
handle, may be
applicable for
assessment of
plaque
acidogenicity in
the clinic

12. The majority of plaque pH studies have
compared one type of biscuit or cookies with
the other commonly consumed products with
refined carbohydrates and assumptions were
made about their relative cariogenicity.
There are no available studies evaluating and
comparing cariogenic potential among
biscuits having different composition.

13. AIM OF THE STUDY
ASSESS THE EFFECT OF FIVE VARIETIES OF
COMMERCIALLY AVAILABLE BISCUITS WITH
DIFFERENT CONTENT ON PLAQUE pH AT DIFFERENT
TIME INTERVAL AMONG 6- 11 YEARS OF CHILDREN.

14. OBJECTIVES
• To estimate the endogenous pH of five
different commonly consumed biscuits.
• To assess the effect of these test
biscuits on plaque pH at various time
intervals
• To compare between the biscuits for
their effect on plaque pH.

16. LIST OF ARMAMENTARIUM
• Mouth mirror, Explorer, Spoon excavator
• Gloves ,Face mask
• Test tube , Test tube racks
• Distilled water
• Pipette , Stirrer
• Merck universal pH indicator paper

17. Five types of sample biscuits
ARMAMENTARIUM
Cream biscuit Plain sweet biscuit
Chocolate biscuit Salty biscuit Oat biscuit

18. STUDY AREA STUDY SAMPLE

19. STUDY DESIGN
Healthy children with an age range 6 to 11 years ,caries free , with
presence of permanent molars and incisors. The consent of the
principal, parents of the study sample and institutional ethical clearance
was obtained.
Subjects with caries , restored tooth ,missing molars and incisors were
excluded. The volunteers were asked to refrain from oral hygienic
procedures for 48 hours and from having food or drinks for at least 2
hours prior to the procedure.

20. On the examination day, the groups were allocated
randomly for 5 different test biscuits.Each group
contain 10 subjects except the last group having 11
subjects and the intrinsic pH of the test biscuits was
measured by the MERCK pH INDICATOR PAPER

21. Plaque was collected at the baseline with a spoon
excavator from all accessible surfaces of the upper
central incisors, the buccal surfaces of the upper
first molars, the lingual surfaces of the lower
molars and the incisors. The collection was done
within a period of 30 – 60 seconds.

22. Subjects were asked to consume the test
biscuit in two minutes and to chew the
biscuit carefully around the teeth
before swallowing in order to maintain a
uniform method in eating

23. Post consumption, the plaque samples were collected at
baseline and at 5, 10, 15,20 and 30 minutes and the pH was
estimated.
The sample was pooled in 5ml of distilled water and was kept
in a test tube and the pH was determined immediately after
collection using a pH strip immersed into the tube.

24. Post consumption plaque sample
collection
Plaque pH measurement
Plaque pH at different time
interval

25. After the collection of the last sample, the subjects were
allowed to brush and a 3 day wash out period was given, after
which a similar experiment as detailed above, was done for the
next test biscuit.

26. RESULT OF THE STUDY

27. This was a observational study. Total
number of subjects in this study was
51 with power 81%. Subjects were
randomly chosen from a school of
Kolkata during the period MAY 2013
to JUNE 2013

28. STATISTICAL ANALYSIS
Statistical Analysis was performed with help of Epi Info (TM)
3.5.3. EPI INFO is a trademark of the Centers for Disease
Control and Prevention (CDC). Using this software basic cross-
tabulation was performed.
Descriptive statistical analysis was performed to prepare
different frequency tables and to calculate the means with
corresponding standard deviations. t-test was used to compare
the means. p≤0.05 was taken to be statistically significant.

29. Mean ± S.D. pH of plaque after intake of commercially available biscuits at
different time interval among 6-11 years of children
Type of biscuit
Baseline After eating
Before
eating Immediate 5 minutes 10 minutes
15
minutes
20
minutes
30
minutes
Salty biscuit 6.33±0.21 6.11±0.34 5.23±0.19 5.28±0.47 5.82±0.16 6.24±0.26 6.16±0.28
Chocolate
biscuit 6.50±0.54 6.31±0.89 5.83±0.98 5.66±0.81 6.91±0.82 6.33±0.81 6.20±0.54
Oat biscuit 6.11±0.27 6.00±0.64 5.01±0.44 5.23±0.63 5.72±0.16 6.17±0.43 6.02±0.03
Cream biscuit 6.60±0.54 6.27±0.70 5.40±0.54 5.42±0.55 6.60±0.89 6.31±0.71 6.50±1.09
Marie biscuit 6.46±0.42 6.20±0.25 5.04±0.31 5.27±0.82 5.66±0.42 6.22±0.73 6.08±0.11

30. t-test showed that mean pH was significantly higher for cream
biscuit after eating than that of others (p<0.01). But there was
no significant difference between the mean pH of cream and
chocolate biscuits after eating (p>0.05).
For oat biscuit the mean pH was significantly lower than that of others
(p<0.01). Significant decrease was observed at 5 minute after eating for
oat biscuits. Also no significant difference was observed between oat
and marie biscuit at 5 minute after eating (p>0.05).

31. Maximum pH was observed for chocolate and cream biscuits at 30
minutes after eating which was statistically significant (p<0.05).
Mean pH of plaque after intake of commercially available biscuits at
different time interval among 6-11 years of children
4.00
4.50
5.00
5.50
6.00
6.50
7.00
7.50
Before
eating
Immediate 5 minutes 10 minutes 15 minutes 20 minutes 30 minutes
Time Interval
pH
Salty biscuit Cream biscuit Oat biscuit Chocolate biscuit Marie biscuit

32. 0
1
2
3
4
5
6
7
pH
Before eating
Immediate
5 minutes
10 minutes
15 minutes
20 minutes
30 minutes
Time Interval
Mean pH of plaque after intake of Cream Biscuit at different time
interval among 6-11 years of children
0
1
2
3
4
5
6
7
pH
Before eating
Immediate
5 minutes
10 minutes
15 minutes
20 minutes
30 minutes
Time Interval
Mean pH of plaque after intake of Chocolate Biscuit at different
time interval among 6-11 years of children

33. 0
1
2
3
4
5
6
7
pH
Before eating
Immediate
5 minutes
10 minutes
15 minutes
20 minutes
30 minutes
Time Interval
Mean pH of plaque after intake of Oat Biscuit at different time
interval among 6-11 years of children
0
1
2
3
4
5
6
7
pH
Before eating
Immediate
5 minutes
10 minutes
15 minutes
20 minutes
30 minutes
Time Interval
Mean pH of plaque after intake of Salty Biscuit at different time
interval among 6-11 years of children

34. 0
1
2
3
4
5
6
7
pH
Before eating
Immediate
5 minutes
10 minutes
15 minutes
20 minutes
30 minutes
Time Interval
Mean pH of plaque after intake of Maire Biscuit at different time
interval among 6-11 years of children

35. DISCUSSION

36. • It is now clear that sucrose is not the only
dietary contributor to dental decay
• Many other sugars, whether refined in the
form of sweets and confection or occurring
naturally in fruits and juices are equally
cariogenic
• The substrate that causes a prolonged acidic pH
is more detrimental to teeth than its sugar
content alone.

37. • Oat biscuit was found to have a least drop in
plaque pH and found to be least cariogenic
• Cream biscuit was found to have a maximum pH
drop , making it most cariogenic.

38. CONCLUSION
Diet has an important role in prevention of dental caries. Our target
should be customized dietary modifications rather than dietary
restrictions and result of present study will help in the process.
It is mandatory for us as preventive dentists, to provide appropriate diet
counseling which is tailored for a particular individual to maximize the
compliance.

39. “To eat is a necessity, but to eat intelligently is an art."
- La Rochefoucauld

41. REFERENCES
www.google.com
www.mofi.nic.in
www.fbmi.in
www.economictimes.com
www.yahoo.com
www.britannia.com
www.parle-producuts.in
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QUESTION
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