Frequency of sucrose exposure on the cariogenicity of a biofilm-caries model

ABSTRACT

Objective: Although sucrose is considered the most cariogenic carbohydrate in the human diet, the question of how many exposures are needed to induce damage on the hard dental tissues remains unclear. To approach this question, different frequencies of daily sucrose exposure were tested on a relevant biological caries model. Materials and Methods: Biofilms of the Streptococcus mutans were formed on enamel slabs and exposed to cariogenic challenges with 10% sucrose for 5 min at 0, 1, 3, 5, 8, or 10 times per day. After 5 days, biofilms were retrieved to analyze biomass, protein content, viable bacteria, and polysaccharide formation. Enamel demineralization was evaluated by percentage of microhardness loss (percentage surface hardness loss [%SHL]). Results: Biomass, protein content, polysaccharide production, acidogenicity of the biofilm, and %SHL proportionally increased with the number of daily exposures to sucrose (P < 0.05). One daily sucrose exposure was enough to induce 20% more demineralization than the negative unexposed control. Higher frequencies induced greater demineralization and more virulent biofilms, but eight and ten exposures were not different between them in most of the analyzed variables (P > 0.05). Conclusions: Higher sucrose exposure seems to increase cariogenicity, in a frequency-dependent manner, by the modification of bacterial virulent properties.

Key words:

Caries - diet - nutrition - Streptococcus mutans - sucrose - sugar

• REFERENCES

• 1 Fejerskov O. Changing paradigms in concepts on dental caries: Consequences for oral health care. Caries Res 2004; 38: 182-91
• 2 Zero DT. Sugars – The arch criminal?. Caries Res 2004; 38: 277-85
• 3 Bowen WH, Lawrence RA. Comparison of the cariogenicity of cola, honey, cow milk, human milk, and sucrose. Pediatrics 2005; 116: 921-6
• 4 Paes LemeAF, Koo H, Bellato CM, Bedi G, Cury JA. The role of sucrose in cariogenic dental biofilm formation – New insight. J Dent Res 2006; 85: 878-87
• 5 Gupta P, Gupta N, Pawar AP, Birajdar SS, Natt AS, Singh HP. Role of sugar and sugar substitutes in dental caries: A review. ISRN Dent 2013; 2013: 519421
• 6 Anderson CA, Curzon ME, Van Loveren C, Tatsi C, Duggal MS. Sucrose and dental caries: A review of the evidence. Obes Rev 2009; 10 (Suppl. 01) 41-54
• 7 Marsh PD. Dental plaque as a biofilm and a microbial community – Implications for health and disease. BMC Oral Health 2006; 6 (Suppl. 01) S14
• 8 Takahashi N, Nyvad B. The role of bacteria in the caries process: Ecological perspectives. J Dent Res 2011; 90: 294-303
• 9 Sheiham A, James WP. Diet and dental caries: The pivotal role of free sugars reemphasized. J Dent Res 2015; 94: 1341-7
• 10 Touger-Decker R, van Loveren C. Sugars and dental caries. Am J Clin Nutr 2003; 78: 881S-92S
• 11 Saeed S, Bshara N, Trak J, Mahmoud G. Effect of dietary combinations on plaque pH recovery after the intake of pediatric liquid analgesics. Eur J Dent 2015; 9: 340-5
• 12 Sheiham A, James WP. A reappraisal of the quantitative relationship between sugar intake and dental caries: The need for new criteria for developing goals for sugar intake. BMC Public Health 2014; 14: 863
• 13 Moynihan PJ. Response to letter to the editor, “Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines”. J Dent Res 2014; 93: 531
• 14 Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutr 2004; 7: 201-26
• 15 Bradshaw DJ, Lynch RJ. Diet and the microbial aetiology of dental caries: New paradigms. Int Dent J 2013; 63 (Suppl. 02) 64-72
• 16 Koo H, Hayacibara MF, Schobel BD, Cury JA, Rosalen PL, Park YK. et al. Inhibition of Streptococcus mutans biofilm accumulation and polysaccharide production by apigenin and tt-farnesol. J Antimicrob Chemother 2003; 52: 782-9
• 17 Ccahuana-Vásquez RA, Cury JA. S. mutans biofilm model to evaluate antimicrobial substances and enamel demineralization. Braz Oral Res 2010; 24: 135-41
• 18 Aires CP, Del Bel Cury AA, Tenuta LM, Klein MI, Koo H, Duarte S. et al. Effect of starch and sucrose on dental biofilm formation and on root dentine demineralization. Caries Res 2008; 42: 380-6
• 19 Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 1976; 72: 248-54
• 20 Burt BA, Pai S. Sugar consumption and caries risk: A systematic review. J Dent Educ 2001; 65: 1017-23
• 21 Ismail AI, Burt BA, Eklund SA. The cariogenicity of soft drinks in the United States. J Am Dent Assoc 1984; 109: 241-5
• 22 Bernabé E, Vehkalahti MM, Sheiham A, Aromaa A, Suominen AL. Sugar-sweetened beverages and dental caries in adults: A 4-year prospective study. J Dent 2014; 42: 952-8
• 23 Ervin RB, Ogden CL. Consumption of added sugars amongU.S. adults, 2005-2010. NCHS Data Brief 2013; 122: 1-8
• 24 Heller KE, Burt BA, Eklund SA. Sugared soda consumption and dental caries in the United States. J Dent Res 2001; 80: 1949-53
• 25 Dawes C. What is the critical pH and why does a tooth dissolve in acid?. J Can Dent Assoc 2003; 69: 722-4
• 26 Hojo K, Nagaoka S, Ohshima T, Maeda N. Bacterial interactions in dental biofilm development. J Dent Res 2009; 88: 982-90
• 27 Koo H, Falsetta ML, Klein MI. The exopolysaccharide matrix: A virulence determinant of cariogenic biofilm. J Dent Res 2013; 92: 1065-73
• 28 Bowen WH, Koo H. Biology of Streptococcus mutans-derived glucosyltransferases: Role in extracellular matrix formation of cariogenic biofilms. Caries Res 2011; 45: 69-86
• 29 Shemesh M, Tam A, Steinberg D. Expression of biofilm-associated genes of Streptococcus mutans in response to glucose and sucrose. J Med Microbiol 2007; 56 (Pt 11) 1528-35
• 30 Li Y, Burne RA. Regulation of the gtfBC and ftf genes of Streptococcus mutans in biofilms in response to pH and carbohydrate. Microbiology 2001; 147 (Pt 10) 2841-8
• 31 Aires CP, Tabchoury CP, Del Bel Cury AA, Koo H, Cury JA. Effect of sucrose concentration on dental biofilm formed in situ and on enamel demineralization. Caries Res 2006; 40: 28-32
• 32 Ribeiro CC, Tabchoury CP, Del Bel Cury AA, Tenuta LM, Rosalen PL, Cury JA. Effect of starch on the cariogenic potential of sucrose. Br J Nutr 2005; 94: 44-50
• 33 Zhao W, Li W, Lin J, Chen Z, Yu D. Effect of sucrose concentration on sucrose-dependent adhesion and glucosyltransferase expression of S. mutans in children with severe early-childhood caries (S-ECC). Nutrients 2014; 6: 3572-86
• 34 Mattos-Graner RO, Smith DJ, King WF, Mayer MP. Water-insoluble glucan synthesis by mutans streptococcal strains correlates with caries incidence in 12- to 30-month-old children. J Dent Res 2000; 79: 1371-7
• 35 Busuioc M, Mackiewicz K, Buttaro BA, Piggot PJ. Role of intracellular polysaccharide in persistence of Streptococcus mutans. J Bacteriol 2009; 191: 7315-22
• 36 Guo L, He X, Shi W. Intercellular communications in multispecies oral microbial communities. Front Microbiol 2014; 5: 328
• 37 Ccahuana-Vásquez RA, Tabchoury CP, Tenuta LM, Del Bel Cury AA, Vale GC, Cury JA. Effect of frequency of sucrose exposure on dental biofilm composition and enamel demineralization in the presence of fluoride. Caries Res 2007; 41: 9-15
• 38 Duggal MS, Toumba KJ, Amaechi BT, Kowash MB, Higham SM. Enamel demineralization in situ with various frequencies of carbohydrate consumption with and without fluoride toothpaste. J Dent Res 2001; 80: 1721-4
• 39 Duarte S, Klein MI, Aires CP, Cury JA, Bowen WH, Koo H. Influences of starch and sucrose on Streptococcus mutans biofilms. Oral Microbiol Immunol 2008; 23: 206-12
• 40 Stookey GK. The effect of saliva on dental caries. J Am Dent Assoc 2008; 139 Suppl 11S-7S