PubMed · 1076830
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S Edwardsson, D Birkhed, G Frostell. 1976-10-01. [Sugar substitutes -- cariogenic?].. https://pubmed.ncbi.nlm.nih.gov/1076830/
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The aim of the study was to compare sucrose solution and bananas on demineralizing potential in situ, and to address the question if fluoride toothpaste is equally effective in preventing dentin demineralization at open, smooth surfaces and at plaque stagnation sites (grooves). Four volunteers wore an appliance containing bovine dentin specimens with narrow grooves and a smooth surface for two 1-week in situ periods, with 8 1-minute exposures daily: either by a rinse with 10% sucrose, or by consumption of a piece of banana. Twice daily, the appliance was dipped in toothpaste slurry of a fluoride-free toothpaste at one side and a fluoride toothpaste at the contralateral side. Demineralization was assessed by tranversal microradiography. No difference in dentin demineralization was found after frequent exposure to either sucrose solution or bananas. Fluoride toothpaste effectively protected dentin only at the smooth surfaces. In the grooves, fluoride affected the demineralization pattern; it drove lesions towards the bottom of the groove.
PURPOSE: The purpose of the present paper is: 1) to review recent concepts of the causes of caries; 2) to illustrate parameters of causes of cases and of incidence; and 3) to outline the consequences for caries prevention and oral health promotion. The paper is divided in three sections. Section 1 reviews recent theories of the causes of caries and summarizes that it is necessary to make a clear distinction between the causes of a case of caries and causes of occurrence of caries in populations. Cases relate to the reasons why individuals get sick, while incidence relates to why so many (or so few) within a population get sick. In section 2 the difference between the causes of a case and of the occurrence in a population is illustrated. A new social epidemiology moves beyond the focus on individual level risk factors to a multi-level perspective. Applied to oral diseases the paradigm of social epidemiology bridges our understanding of the biological determinants of caries with an understanding of the societal determinants of caries. Social epidemiology is the branch of epidemiology that studies the social distribution and social determinants of states of health. Individuals are embedded in societies and populations. In section 3 the insight acquired above is applied to the choice of disease-preventive and oral health-promotive strategies. Prevention of caries and promotion of oral health must be rooted in the understanding of caries as it occurs in populations.
As in most other established market economies throughout the world the prevalence of dental caries has declined in most Member States of the European Union (EU). There is evidence that the increased use of fluoride toothpaste has been a major factor in this improvement. Recently there has been increasing debate on the alleged link between increased use of fluoride toothpaste, particularly by infants and young children, and increased levels of enamel fluorosis. Central to these discussions are two issues, namely measurement of the amount of fluoride ingested by infants and young children and measurement of enamel opacities including fluorosis. The aims of the project described in this special issue addressed these two measurement issues. Seven EU Partners participated. Standardized methods for recording the amount of fluoride ingested when using fluoride toothpaste were developed and used in the seven sites. Similarly a standardized photographic method for recording enamel opacities, including fluorosis, was developed.