Dental caries is still one of the most prevalent diseases worldwide. According to WHO (2018), the Global Burden of Disease Study 2016 estimated that 2.4 billion people worldwide suffer from caries of permanent teeth, and 486 million children suffer from caries of primary teeth. (WHO 2018)
Dental caries develops when dental plaque is formed on the tooth surface and oral bacteria therein convert fermentable carbohydrates and sugars from food and drink intake into acids. The accumulation of acids on the tooth surface dissolves tooth enamel and tooth hard substance over time, forming a cariogenic lesion (Figure 1). It is a multifactorial process that is also influenced by the susceptibility of the tooth, by the bacteria profile, and by the quantity and composition of saliva.
Early cariogenic lesions are reversible when enough time is allowed for natural remineralisation processes at neutral pH. And the progression into dental caries formation can be prevented with measures like tooth brushing to remove oral bacteria and dental plaque from the tooth surface, adequate fluoride exposure, and dietary means to avoid permanent availability of fermentable carbohydrates. Besides recommendations to reduce sugar intake and to limit the frequency of food and/or drink intake with sugars and fermentable carbs to four to five times per day, also the use of tooth friendly sugar alternatives can help to achieve this goal.
Figure 1: Dental caries development.
References:
Department of Health and Human Services – Food and Drug Administration (2007) 21 CFR Part 101 [Docket No 2006P-0487] Food labeling, health claims, dietary non-cariogenic carbohydrate sweeteners and dental caries. Federal Register Vol 72 No 179, September 17:p. 52783. http://www.fda.gov/OHRMS/DOCKETS/98fr/cf086.pdf
EFSA Panel on Dietetic Products, Nutrition and Allergies (2011) Scientific Opinion on the substantiation of health claims related to the sugar replacers xylitol, sorbitol, mannitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose and maintenance of tooth mineralization by decreasing tooth demineralization (…), and reduction of post-prandial glycemic responses (…) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 9(4):2076. http://www.efsa.europa.eu/de/efsajournal/doc/2076.pdf
World Health Organization (2018) Oral health Fact Sheet of 28TH September 2018. Link: https://www.who.int/news-room/fact-sheets/detail/oral-health