Diet patterns and caries

Few dietary studies have been designed to investigate the effects of intake patterns of food items upon the environment of the teeth. This brief review considers evidence about the effects of choice, combination, and sequence of ingested food and drink upon the pH of human dental plaque in vivo. A series of three studies, which were designed to investigate some of the intra-oral biological events associated with cariogenicity during various eating patterns, are discussed. The principal findings show that if a "meal" includes an item which contains carbohydrate such as sucrose, glucose, or fructose which is rapidly fermented by the acidogenic microorganisms in dental plaque, there will be rapid acid production and the plaque pH will fall. However, other items eaten immediately before, during, or after the consumption of the sugary item can influence the plaque pH. If the non-sugary item stimulates saliva, it will have a pH-raising effect. The remineralizing potential may be enhanced if, for instance, calcium or fluoride is released from the food. However, if one sugary item is followed by another, the demineralizing potential may be enhanced. The results of these experiments are discussed in the context of our current understanding of the dynamics of the carious process. Recent preliminary experiments suggest that other factors, such as the individual subject's speed of consumption, may also affect the cariogenic potential of the oral environment.