Hygiene Atlas

Atlas · Plate V · Biochemistry and Nutrition · 05

Diet and caries

Caries needs a susceptible tooth, cariogenic bacteria, fermentable carbohydrate and time together. After each sugar exposure, plaque pH drops below the critical level of about 5.5 for enamel within minutes and takes 20-40 minutes to recover, so frequent snacking and sipping do more harm than the total amount. Xylitol, cheese and milk help, and a 3-7 day diet diary guides counseling.

High-yield facts · 9

  1. Caries needs four things together: a susceptible tooth, cariogenic bacteria, fermentable carbohydrate and time.S37
  2. The Stephan curve: plaque pH drops below the critical level within minutes of a sugar exposure and takes about 20-40 minutes to recover.S48
  3. Critical pH for enamel is about 5.5; for root dentin and cementum it is higher, about 6.0-6.7.S37S48
  4. Frequency and retention of sugar intake matter more than the total amount.S48
  5. Sticky, slowly dissolving foods (hard candy, dried fruit) and sipping sweet drinks are high-risk patterns.S48
  6. Noncariogenic sweeteners include xylitol, sorbitol (low cariogenicity), aspartame, sucralose and saccharin.S48
  7. Xylitol is not fermented by S. mutans; effective regimens use about 5-10 g/day split into 3 or more exposures.S48
  8. Cheese and milk (casein, calcium, phosphate) help buffer acid and support remineralization.S48
  9. A diet diary for 3-7 days, including a weekend day, is the basic tool for dietary analysis.T2

Facts are written in our own words; each tag links to its source. Values marked "sources vary" differ between references, so check the one your program uses.