public health dentistry

1. SUCROSE AS ARCH CRIMINAL OF
DENTAL CARIES AND DIETARY
STUDIES
BY SRIYA SHARMA
1879089

2. INTRODUCTION;
• DENTAL CARIES
An infectious microbiological disease of the teeth that
localized dissolution and destruction of the calcified tissue.
ACC to WHO
A localized post eruptive pathological process of external
origin involving softening of the hard tissue and proceeding
to the formation of a cavity.

4. WHAT ARE SUGARS ?
• Sugars are form of fermentable carbohydrate.
• Sugars - combination of mono- and diasacchride, highest
% of carbohydrate on a dry weight basis .
• Sugars enters the diet in 2 forms : those found naturally
in foods (eg; fruit ,honey, and diary products) and those
that are added to foods during processing to alter the
flavour , taste ,or texture of the food.

7. Sucrose is regarded as the arch criminal in
dental caries:
The dietary sugars all diffuse rapidly into the plaque and are
fermented to lactic or other acids or can be stored as intracellular
polysacchrides by the bacteria, prolonging the fall in pH and
promoting a suitable environment for other aciduaric and
acidogenic bacteria .
Sucrose is unique because it is the substrate for production of
extracellular polysacchrides (fructan and glucan) and insoluble
matrix polysacchrides (mutans)

8. Thus, sucrose favours colonization by oral
microorganisms and icrease the stickiness
of the plaque allowing it to adhere in larger
qunatities to the teeth
• A combination of soluble starch and sucrose would be
expected be more powerful caries risk factor than sucrose
alone , because the increased retention of the food on the
tooth surfaces would prolong sugar clearance time.

9. INTERVENTIONAL STUDIES
• VIPEHOLM STUDY
• HOPEWOOD HOUSE STYDY
• TURKU SUGAR STUDY
• EXPERIMENTAL CARIES STUDY

11. • The study was conducted in a sweden over a 5 period
ago
• Purpose - to determine the effects of frequency and
quantity of sugar intake on the formation of caries
• Instituitonalized patients were divided into 6 experimental
and 1control group

12. Studies was divided into 3 phases
• 1945-1947 ; preparatory and vitamin period , all subjects
received diet low in sugar
• 1947-1949; Carbohydrate study1 -2 years twice the
normal amount of sugar but only at meals
• 1949-1951; carbohydrate study 2- next 2 years normal
amount of sugars some at meals and other at both and
between the meals

15. CONCLUSION ;
• CARIES INCREASE with
• Increase in consumption of sugar
• Increase in consumption of food with strong retentive
food
• Increased risk if sugar is consumed between meals
• Varies from individual to individual

16. • CARIES DECREASE with
• Withdrawl of sugar - rich foods
• Maximum restrictions of natural sugars and carbohydrates

18. Hopewood study in Bowral , N,S,W
Australia
• 1942 80 children 7 -14 years (10yr period)
• vegeterian diet - largely raw
• Absence of meat nd rigid restriction of refined
carbohydrate
• Caries reduced to a minimal level by dietary means alone
in spite of unfavourable hygiene and fluoride levels .
• Dental caries prevention in young children almost
negligible in primary dentition and approx 1/10 that seen
in the permanent teeth of australian child.

19. When the children old enough to earn
wages in the outside economy, they
deviated in the original diet
• A steep increase of decayed, missing, and filled teeth
• (DMFT) after the age of 11 years indicates that the teeth
• doesnot require any permanent resistance to caries

23. CONCLUSION:
• Substitution of xylitol for sucrose in normal Finnish diets
resulted in low caries
Reduced the number of most microorganisms

33. HEREDETIARY FRUCTOSE
INTOLERANCE
• Nature provided subjects- strict dietary pattern
• Reduced level of fructose 1 phosphate
• Avoid any food that contains fructose and sucrose
• If ingested - nausea,vomiting,malaise tremor,excessive,
sweating,and even coma (fuctosemia)