European Journal of Paediatric Dentistry. 2000;1:55-62
Modern dietary counselling places an emphasis on the reduction of fat intake and promotes the consumption of starch-rich foods and fruits and vegetables. If followed, this advice will increase the intake of carbohydrates including the free and intrinsic sugars of fruits and vegetables and the intake of free acids, especially from fruits. The intake of free acids increases the risk of erosion while the intake of carbohydrates implies a caries risk. On the other hand, epidemiologists have shown that, at least for certain populations, sugar consumption and caries prevalence have become independent. The secular trend of decreasing caries has occurred while the consumption of sugars remained consistently high.
This paper reviews literature to (re-) examine whether carbohydrate-containing foods can be classified according to acidogenicity and cariogenicity. The acidogenic potential of various dietary carbohydrates is not different in principle, although polysaccharides have first to be hydrolysed. The proposed differentiation between “intrinsic” and “non-milk extrinsic” sugars is not relevant with respect to the caries risk of individuals and populations. The cariogenicity of food, for an individual, is strongly dependent on consumer habits and local oral factors.
The most important behavioural factors determining cariogenicity of food are lack of oral hygiene and failure to apply fluoride regularly. If good hygiene is maintained and fluoride is supplied frequently, teeth will remain intact even if carbohydrate-containing food is frequently eaten. Local oral factors such as retention around the teeth and salivary functions may be factors strongly modifying caries activity.
To access this article, click here
To download the German translation, click here.
(Note: The English version is no longer available online).