DIET + DENTAL CARIES

DIET + DENTAL CARIES

1. MICRONICHE: susceptible areas ie just below contact point and fissures

   • caries is fragile and vulnerable: can only proceed under certain conditions
     • CARIOUS LESIONS are driven by the plaque biofilm
       • Managing the biofilm can therefore arrest caries

2. EVIDENCE

   • 2 MAIN THEROIES about carious process
     • Historical and epidemiological studies
       • 2 main types of study
         • cross-sectional:different groups at one point in time
           • longitudinal:follows a group over along period of time

3. TRISTAN DE CUHNA

   • Isolated volcanic island in south atlantic
     • community of 300 people, volcanic eruption1961 evacuated to england
       • they were dentally examined in 1962 and after they returned to island
         • 2 earlier studies by Sampson+Sognnaes shows no caries in 6'sof 6-9yr olds
           • but by 1962 increased to 50% and to 80% 1966
             • in the 1950'sincreased communication with the outside world
               • Higher incomes altered diet with refined fermentable carbs
                 • dramatic increase in caries as the result of an altered diet

4. LONGITUDINAL/INTERVENTIONAL STUDY

   • HOPEWOOD HOUSE
     • Children were prohibited from eating sugary substances
       • caries dropped dramatically
         • study showed that the children had 16 times less decay than sydney
           • Sydney children on average had 9.5 DMF teeth

5. VIPEHOLM STUDY

   • could never be performed and shouldn't have in the first place
     • Highly unethical
       • Mental hosp segregated into blocks that didn't mix
         • 1 block given 0 toffees a day, the other 24 a day
           • discovered that sugar between meals increased caries prevelance
             • Sugar can be eaten up to x4 a day during meals with no significant drop in pH