Extrinsic and Intrinsic Sugars: A Review of Recent UK Recommendations on Diet and Caries

Edgar, W.M.

doi:10.1159/000261605

Cited by 30 publications

(25 citation statements)

References 10 publications

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“…Perhaps the rat studies [Stephan, 1966;Mundorff et al, 1990] provide the answer: excessive fruit eating may induce caries. This idea is supported by Edgar [1993], who suggested that fruits 'exhibit properties which do not exonerate them in terms of cariogenic potential were they to be consumed at a frequency similar to other foods which contribute to cariogenic load'.…”

Section: Discussionmentioning

confidence: 96%

“…The role of sugars and acids in fruits in caries initiation has been the subject of some debate [Department of Health, 1989;Edgar, 1993;Sheiham, 2001]. The major sugars in fruits are glucose, fructose and sucrose and each of these can be fermented to acids by a diverse array of oral bacteria and each may cause caries in animal models [Grenby and Hutchinson, 1969].…”

mentioning

confidence: 99%

“…Epidemiological studies have provided considerable data suggesting that fruits have no or very low cariogenicity [Bibby, 1983;Rugg-Gunn et al, 1984;Edgar, 1993]. However, some data suggest that excessive intake of fruit (apples and grapes) may be associated with increased levels of caries [Grobler and Blignaut, 1989] in humans.…”

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confidence: 99%

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Intra-Oral Acid Production Associated with Eating Whole or Pulped Raw Fruits

Beighton¹,

Brailsford

Gilbert³

et al. 2004

Caries Res

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The hypotheses that raw fruits, whether whole or pulped, were cleared rapidly from the mouth and that the sugars in the whole and pulped fruits are fermented with equal efficiency to acids by the oral microflora were tested in this study. Groups of 7–9 adult subjects chewed 10 g of raw, whole or pulped fruit (apple, banana, orange, pear and pineapple) for 1 min and whole, unstimulated saliva samples were collected during the following 60-min interval. Each saliva sample was assayed for the concentrations of fruit-derived sugars (glucose, fructose and sucrose), fruit-derived acids (malic and citric) and acids which may be produced as a result of bacterial fermentation (acetic, lactic, formic and succinic). We found the fruit-derived sugars were rapidly cleared from the mouth (within 5 min). The major bacterially produced acids were lactic and succinic, which reached maximum concentrations in the 5-min sample. There was no significant difference, within a fruit, in the salivary levels of any of the sugars or acids between the raw whole or raw pulped forms. In light of these findings it seems unwise to assume that fruits may be consumed without consideration of their acidogenic potential.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

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Intra-Oral Acid Production Associated with Eating Whole or Pulped Raw Fruits

Beighton¹,

Brailsford

Gilbert³

et al. 2004

Caries Res

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“…The NMES content of unsweetened juice may amount to as much as a standard soft drink, so it is potentially cariogenic. 32,33 Dried fruit is likely to be more cariogenic than fresh fruit, 34 as the drying process degrades the cellular structure of the fruit, releasing some intrinsic sugars into NMES. Dried fruit also has a tendency to adhere to the teeth, giving it a prolonged oral retention time and compounding its cariogenicity.…”

Section: Starchy Staple Foodsmentioning

confidence: 99%

Dietary advice in dental practice

Moynihan

2002

Br Dent J

104

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“…These facts should be taken into consideration when assessing the claim made by Edgar 104 that after reviewing the same data`¼ it would appear that while fresh fruits (as consumed in a normal diet) do not contribute detectably to caries, they exhibit properties which do not exonerate them in terms of cariogenic potential were they to be consumed at a frequency similar to other foods which contribute to the cariogenic load'. Edgar's consideration that the cariogenic potential of fresh fruits, if eaten as often as sugars would be similar to other foods, is conjecture and not based upon evidence.…”

Section: The Influence On Caries Of Different Carbohydratesmentioning

confidence: 99%

Food transitions in the 20th–21st century

Bengoa¹

2001

PHN

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Dental caries is a highly prevalent chronic disease and its consequences cause a lot of pain and suffering. Sugars, particularly sucrose, are the most important dietary aetiological cause of caries. Both the frequency of consumption and total amount of sugars is important in the aetiology of caries.`The evidence establishing sugars as an aetiological factor in dental caries is overwhelming. The foundation of this lies in the multiplicity of studies rather than the power of any one.'1 . That statement by the British Nutrition Foundation's Task Force on Oral Health, Diet and Other Factors, sums up the relationship between sugars and caries in Europe. There is no evidence that sugars naturally incorporated in the cellular structure of foods (intrinsic sugars) or lactose in milk or milk products (milk sugars) have adverse effects on health. Foods rich in starch, without the addition of sugars, play a small role in coronal dental caries. The intake of extrinsic sugars beyond four times a day leads to an increase risk of dental caries. The current dose-response relationship between caries and extrinsic sugars suggests that the sugars levels above 60 g/person/day for teenagers and adults increases the rate of caries. For pre-school and young children the intakes should be proportional to those for teenagers; about 30 g/person/day for pre-school children. Fluoride, particularly in toothpastes, is a very important preventive agent against dental caries. Toothbrushing without fluorides has little effect on caries. As additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people, the main strategy to further reduce the levels of caries, is reducing the frequency of sugars intakes in the diet. Dental erosion rates are considered to be increasing. The aetiology is acids in foods and drinks and to a much lesser extent from regurgitation.

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Extrinsic and Intrinsic Sugars: A Review of Recent UK Recommendations on Diet and Caries

Cited by 30 publications

References 10 publications

Intra-Oral Acid Production Associated with Eating Whole or Pulped Raw Fruits

Intra-Oral Acid Production Associated with Eating Whole or Pulped Raw Fruits

Dietary advice in dental practice

Food transitions in the 20th–21st century

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