Cariogenic effects of cooked wheat starch alone or with sucrose and frequency-controlled feedings in rats

Firestone, Allen R.; Schmid, R; Mühlemann, H

doi:10.1016/0003-9969(82)90026-7

Cited by 81 publications

(73 citation statements)

References 31 publications

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“…In summary, our data provide insight into how starch and sucrose in combination are potentially more cariogenic than either compound alone in vivo (1,10,30) and also show that the composition of diet in association with specific host-pathogen interactions can modulate the development of biofilms by S. mutans with enhanced virulence. Further in vitro and in vivo studies using both parental strains of S. mutans and mutant strains of S. mutans (defective in gtfB or TCS) in the presence of microorganisms that bind amylase (e.g., Streptococcus gordonii) should elucidate in more detail the structural and molecular mechanisms in a multispecies system.…”

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confidence: 70%

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Structural and Molecular Basis of the Role of Starch and Sucrose in Streptococcus mutans Biofilm Development

Klein

Duarte

Xiao

et al. 2009

Appl Environ Microbiol

140

200

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The interaction of sucrose and starch with bacterial glucosyltransferases and human salivary amylase may enhance the pathogenic potential of Streptococcus mutans within biofilms by influencing the structural organization of the extracellular matrix and modulating the expression of genes involved in exopolysaccharide synthesis and specific sugar transport and two-component systems.Oral diseases related to biofilms, such as dental caries, affect the majority of the world's population (27,34). Dental caries results from the interaction of specific bacteria and salivary constituents with dietary carbohydrates in the oral cavity; the appearance of biofilms on the tooth surface is the first clinical evidence of the diet-bacterium interaction. Sucrose is considered the "arch criminal" from the dietary standpoint because it is fermentable and also serves as a substrate for synthesis of extracellular polysaccharides (EPS) in dental biofilm (2, 28). Starches are an important source of fermentable carbohydrate and are usually consumed simultaneously with sucrose in modern societies. The combination of starch and sucrose is highly cariogenic in vivo (1, 10, 33) and may enhance the pathogenicity of biofilms in humans (30).Streptococcus mutans is a key contributor to the formation of cariogenic biofilms; this bacterium (i) synthesizes large amounts of extracellular glucans and fructans from sucrose using several glucosyltransferases (Gtfs) and a fructosyltransferase, (ii) adheres tenaciously to glucan-coated surfaces, and (iii) is highly acidogenic and acid tolerant, which are critical virulence properties in the pathogenesis of dental caries (2, 29, 31). Glucans provide specific binding sites for bacterial colonization on the tooth surface and bulk and structural integrity to the extracellular matrix; thus, they are essential for the formation and accumulation of dental biofilms (2). In addition, starches can be digested by ␣-amylases to maltose, maltodextrins, and other oligosaccharides, some of which can be acceptors during glucan synthesis by Gtfs (11,12,35). Starch hydrolysates produced by salivary ␣-amylases bound to saliva-coated hydroxyapatite (sHA) increased, in the presence of sucrose, the synthesis of structurally distinctive glucans by surface-adsorbed GtfB (35).Moreover, maltose and maltodextrins resulting from starch hydrolysis can be catabolized in acids by S. mutans (4). In this study, we investigated whether biochemical reactions involving interactions between specific host (␣-amylase) and bacterium-derived (Gtfs) enzymes and dietary carbohydrates (starch and sucrose) influence (i) the biochemical and structural properties of the EPS matrix and (ii) trigger specific adaptive responses by S. mutans at the transcriptional level, resulting in a biofilm with enhanced virulence.Biofilms of S. mutans UA159 (ϭ ATCC 700610) were formed using our amylase-active sHA disk model (18). Biofilms were grown in buffered tryptone yeast extract broth (pH 7.0) containing (i) 1% (wt/vol) starch (soluble starch [80% amylopectin a...

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confidence: 70%

“…Starches are an important source of fermentable carbohydrate and are usually consumed simultaneously with sucrose in modern societies. The combination of starch and sucrose is highly cariogenic in vivo (1,10,33) and may enhance the pathogenicity of biofilms in humans (30).…”

mentioning

confidence: 99%

Structural and Molecular Basis of the Role of Starch and Sucrose in Streptococcus mutans Biofilm Development

Klein

Duarte

Xiao

et al. 2009

Appl Environ Microbiol

140

200

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“…Studies with processed pure starches such as wheat, corn, potato, amioca, tapioca, and arrowroot starches have shown that all exhibit major cariogenic potential that sometimes exceeds that of sucrose (Frostell and Baer, 1971a,b;Shaw and Ivimey, 1972;Firestone et at., 1982;Mundorff and Curzon, 1985). On the other hand, cooked maize and sorghum, both staple foods for black South Africans, have exhibited only a low-to-moderate cariogenic potential compared with a mixture of cooked wheat starch and sucrose (Schmid et al, 1987).…”

Section: Studies Of the Starch-caries Issue With Humansmentioning

confidence: 99%

Food Starches and Dental Caries

Lingström

Houte²,

Kashket³

2000

Critical Reviews in Oral Biology & Medicine

188

165

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Sucrose and starches are the predominant dietary carbohydrates in modern societies. While the causal relationship between sucrose and dental caries development is indisputable, the relationship between food starch and dental caries continues to be debated and is the topic of this review. The current view of dental caries etiology suggests that in-depth evaluation of the starch-caries relationship requires the consideration of several critical cariogenic determinants: (1) the intensity (i.e., the amount and frequency) of exposure of tooth surfaces to both sugars and starches, (2) the bioavailability of the starches, (3) the nature of the microbial flora of dental plaque, (4) the pH-lowering capacity of dental plaque, and (5) the flow rate of saliva. Studies of caries in animals, human plaque pH response, and enamel/dentin demineralization leave no doubt that processed food starches in modern human diets possess a significant cariogenic potential. However, the available studies with humans do not provide unequivocal data on their actual cariogenicity. In this regard, we found it helpful to distinguish between two types of situations. The first, exemplified by our forebears, people in developing countries, and special subject groups in more modern countries, is characterized by starch consumption in combination with a low sugar intake, an eating frequency which is essentially limited to two or three meals per day, and a low-to-negligible caries activity. The second, exemplified by people in the more modern societies, e.g., urban populations, is characterized by starch consumption in combination with significantly increased sugar consumption, an eating frequency of three or more times per day, and a significantly elevated caries activity. It is in the first situation that food starches do not appear to be particularly caries-inducive. However, their contribution to caries development in the second situation is uncertain and requires further clarification. Although food starches do not appear to be particularly caries inducive in the first situation, the possibility cannot be excluded that they contribute significantly to caries activity in modern human populations. The commonly used term "dietary starch content" is misleading, since it represents a large array of single manufactured and processed foods of widely varying composition and potential cariogenicity. Hence, increased focus on the cariogenicity of single starchy foods is warranted. Other aspects of starchy foods consumption, deserving greater attention, include the bioavailability of starches in processed foods, their retentive properties, also in relation to sugars present (starches as co-cariogens), their consumption frequency, the effect of hyposalivation on their cariogenicity, and their impact on root caries. The starch-caries issue is a very complex problem, and much remains uncertain. More focused studies are needed. At present, it appears premature to consider or promote food starches in modern diets as safe for teeth.

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“…Animal experiments have also shown that combinations of cooked starch and sucrose (eg biscuits and cakes) cause more caries than sucrose alone. 25 Therefore, baked and processed sugar-containing starchy foods, such as cakes, biscuits and sugared breakfast cereals, may be of particular concern. Current dietary guidelines encourage the consumption of starch-rich staple foods (such as bread, potatoes, unsweetened breakfast cereals and grains), and vegetables that naturally contain starch.…”

Section: Starchy Staple Foodsmentioning

confidence: 99%