Zusammenfassung
Die drei häufigsten Erkrankungen der Mundhöhle, nämlich Periodontalerkrankungen, Zahnerosionen und Zahnkaries unterscheiden sich erheblich in ihrer Ätiologie, gerade auch hinsichtlich der Mitbeteiligung der Ernährung. Was die Periodontalerkrankungen betrifft, so gibt es keine wissenschaftlich fundierten Belege für eine Beteiligung der Ernährung an diesem Krankheitsbild. Das Auftreten von Zahnerosionen und von Zahnkaries steht in deutlicher Beziehung zur Ernährungsweise. Erosionen können durch frei in der Kost vorliegende Säuren verursacht werden. Dagegen entsteht Karies durch Säuren, die von Zahnbelagsbakterien durch Fermentation von Kohlenhydraten gebildet wurden. Dieser Artikel diskutiert die Unterschiede in den Beziehungen zwischen Ernährung und Zahnkaries zuzeiten bevor Fluorid verwendet wurde (sog. „Prä-Fluorid-Ära”) bzw. seitdem Fluorid zur Mundhygiene und Kariesprophylaxe zum Einsatz kommt (sog. „Fluorid-Ära”). Die gewissenhafte Verwendung von Fluorid bei der regelmäßigen Mundhygiene führte dazu, dass heutzutage die Ernährungsweise lediglich nur noch einen Risikofaktor für Zahnkaries darstellt. Deswegen kann man heutzutage auch solche Lebensmittel, die herkömmlicherweise als „schlecht” für die Zahngesundheit galten, konsumieren, ohne dass die Zahngesundheit zwangsläufig Schaden nehmen muss.
Abstract
The 3 prevalent oral health disorders, periodontal diseases, dental erosion and dental caries differ considerably as the extent to which diet and nutrition are involved in their aetiology. Most associations between diet and periodontal disease are anecdotic. For both dental erosion and dental caries there is an obvious relationship with the diet. Erosion can be caused by free acids in the diet, while dental caries is caused by acids produced by bacteria in the dental plaque from the fermentation of carbohydrates. This paper discusses the relationship between diet and dental caries in the pre-fluoride and the fluoride era. Diligent use of fluoride converts the diet from the cause of to a risk factor for dental caries and people should be able to enjoy foods traditionally considered „bad” for dental health without any risk to their dental health.
Schlüsselwörter
Ernährung - Zahnerosion - Karies - Beratung
Key words
Diet - dental erosion - dental caries - counselling
References
-
1
Mäkinen K K, Sheinin A.
Turku sugar studies VII; principal biochemical findings on whole saliva and plaque.
Acta Odont Scand.
1975;
33, suppl 70
129-170
-
2
Marthaler T M.
Epidemiological and clinical dental findings in relation to intake of carbohydrates.
Caries Res.
1967;
1
222-238
-
3
König K G.
Changes in the prevalence of dental caries: How much can be attributed to changes in diet?.
Caries Res.
1990;
24 (suppl 1)
16-18
-
4
Sheinin A, Mäkinen K K.
Turku sugar studies I - XXI.
Acta Odont Scand.
1975;
33, suppl 70
1-349
-
5
Gustafsson B E, Quensel C-E. et al .
The Vipeholm caries study: The effects of different levels of carbohydrate intake in 436 individuals observed in five years.
Acta Odontol Scand.
1954;
1
207-231
-
6 Micheelis W, Reich E. The Third German Oral Health Study (DMS III), Institute of German Dentists (IDZ). Köln; Deutscher Ärzte-Verlag 1999
-
7 Sugar Economy-Europe. Berlin; Albert Bartens KG 2005
-
8
Burt B A, Pai S.
Sugar consumption and caries risk: a systematic review.
J Dent Educ.
2001;
65
1017-1023
-
9
Consensus Statement on Diet of the FDI's Second World Conference on Oral Health Promotion.
Int Dent J.
2000;
50
174
-
10
Duggal M S, Toumba K J. et al .
Enamel demineralization in situ with various frequencies of carbohydrate consumption with and without fluoride toothpaste.
J Dent Res.
2001;
80
1721-1724
-
11
Newbrun E.
Sucrose the arch criminal of dental caries.
ASDC J Dent Child.
1969;
36
239-248
-
12
Loveren C Van, Duggal M S.
Experts'opinions on the role of diet in caries prevention.
Caries Res.
2004;
38 (suppl 1)
16-23
-
13
Rugg Gunn A J, Edgar W M, Jenkins G N.
The effect of eating some British snacks upon the pH of human dental plaque.
Br Dent J.
1978;
145
95-100
-
14
Mundorff S A, Featherstone J DB. et al .
Cariogenicity of foods. I. Caries in the rat model.
Caries Res.
1990;
24
344-355
-
15 Imfeld T. Identification of Low Risk Dietary Components. Basel; Karger 1983
-
16
Koulourides T, Bodden S. et al .
Cariogenicity of nine sugars tested with an intraoral device in man.
Caries Res.
1976;
10
427-441
-
17
Gardener D E, Norwood J R, Eisenson J E.
At will breastfeeding and dental caries: Four case reports.
J Dent Child.
1977;
44
186-191
-
18
Kotlow L A.
Breastfeeding: A cause of dental caries in children.
J Dent Child.
1977;
44
192-194
-
19
Brams M, Maloney J.
‘Nursing bottle caries’ in breast fed children.
J Pediatr.
1983;
103
415-416
-
20
Hackett F A, Rugg Gunn A J. et al .
Can breast feeding cause dental caries?.
Hum Nutr Appi Nutr.
1984;
38
23-25
-
21
Matee M IN, Mikx F HM. et al .
Mutans streptococci and lactobacilli in breast fed children with rampant caries.
Caries Res.
1992;
26
183-187
-
22 Rugg-Gunn A J. Nutrition and Dental Health. Oxford University Press 1993: 304-321
-
23
Fry A J, Grenby T H.
The effects of reduced sucrose intake on the formation and composition of dental plaque in a group of men in the Antarctic.
Arch Oral Biol.
1972;
17
873-882
-
24
Grenby T H, Powell J M, Gleeson M J.
Effects of sweets made with and without sucrose on the dental plaque and the correlation between the extent of plaque and human dental caries experience.
Arch Oral Biol.
1974;
19
217-224
-
25
Grenby T H, Mistry M.
Properties of maltodextrins and glucose syrups in experiments in vitro and in diets of laboratory animals relating to dental health.
Br J Nutr.
2000;
84
565-574
-
26
Al-Kathib G, Toumba K J. et al .
An in vitro evaluation of the demineralising potential of maltodextrins using an intra-oral cariogenicity testing method.
Caries Res.
1998;
31
316
-
27
Linke H AB, Moss S J. et al .
Intraoral lactic acid production during clearance of different foods containing various carbohydrates.
Z Ernährungswiss.
1997;
36
191-197
-
28
Pollard M A, Imfeld T. et al .
Acidogenicity of cereals and fruit using the indwelling electrode to measure plaque pH.
Caries Res.
1993;
27
215
-
29
Lingström P, Imfeld T, Birkhed D.
Comparison of three different methods for measurement of plaque-pH in humans after consumption of soft bread and potato chips.
J Dent Res.
1993;
72
865-870
-
30
Lingström P, Houte J van, Kaskhet S.
Food starches and dental caries.
Crit Rev Oral Biol Med.
2000;
11
366-380
-
31 COMA: Department of Health .Dietary Sugars and Human Disease. Report on Health and Social Subjects 37. London; Her Majesty's Stationery Office 1989
-
32
Stephan R M.
Effects of different types of human foods on dental health in experimental animals.
J Dent Res.
1966;
45
1551-1561
Dr. Cor van LoverenProfessor Preventive Dentistry
Academic Centre for Dentistry Amsterdam (ACTA)
Louwesweg 1
1066 EA Amsterdam · The Netherlands
Email: c.van.loveren@acta.nl
