More Chocolate! The FUN Biochemistry of Cavity Prevention

Transcription

1 More Chocolate! The FUN Biochemistry of Cavity Prevention Dr. Roger Lucas, DDS Board Diplomate of American Board of Pediatric Dentistry Biochemist Website: TheDentistDad.com Facebook: Facebook.com/TheDentistDad

2 Milk consumption and acne in teenage boys. J Am Acad Dermatology May Cariogenicity of Different Commercially Available Bovine Milk Types in a Biofilm Caries Model Pediatric Dentistry January 2014 Kashket, S., J. Van Houte, L.R. Lopez, and S. Stocks. Lack of Correlation Between Food Retention on the Human Dentition and Consumer Perception of Food Stickiness. Journal of Dental Research 70, no. 10 (1991): Hara, Anderson T., and Domenick T. Zero. The Caries Environment: Saliva, Pellicle, Diet, and Hard Tissue Ultrastructure. Dental Clinics of North America 54, no. 3 (2010): Verakaki E1, Duggal MS. A comparison of different kinds of European chocolates on human plaque ph. Eur J Paediatr Dent Dec;4(4): Plaque ph and Dental Retention after Consumption of Different Types of Chocolates Int J Clin Prev Dent 2016;12(2): Published online June 30, 2016 Int J Clin Pediatr Dent May;2(2):20-4. doi: /jp-journals Epub 2009 Aug 26. The acidogenicity of various chocolates available in Indian market: a comparative study. M Hegde A1, Shetty R2, Sequeira AR3. Van der Hoeven, J.S., De Jong, M.H., Camp, P.J.M. Van den Kieboom, C.W.A., 1985 Competition between oral Streptococcus species in the chemostat under alternating conditions of glucose limitation and excess. FEMS Microbiol. Ecol. 31, Colby, S.M., Russell, R.R.B., Sugar metabolism by mutans streptococci. J. Appl. Microbiol. Symp. Suppl. 83, 80S-88S Best article ever!: Olga Ilie n, Mark C.M. van Loosdrecht, Cristian Picioreanu. Mathematical modelling of tooth demineralisation and ph profiles in dental plaque. Journal of Theoretical Biology, 309 (2012)

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14 Dr. Lucas Cracker Hypothesis: A large majority of previously unexplained cavities in children ages 5 and under were caused by frequent cracker or dry cereal consumption. (Usually 3 or more times a day.) I used to call these children high risk for caries Because the biochemistry tells us that time that carbohydrates touch teeth is all that really matters

15 Dark Chocolate is Better than a Cracker

16 Throwing Out Crackers is More Effective Than Flossing

17 Equation of Solubility of Hydroxyapatite Ca 10 (PO 4 ) 6 (OH) 2 (s) 10 Ca 2+ (aq) + 6 PO 4 3- (aq) + 2 OH - (aq) K sp =6.8 x 10-37

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19 Time ph <5.5

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23 Lactate Dehydrogenase

24 Pyruvate s Choice!

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26 20 Minutes Ilie, Journal of Theoretical Biology, 309 (2012)

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30 Concentration Matters!

31 Cariogenicity of Different Commercially Available Bovine Milk Types in a Biofilm Caries Model Pediatric Dentistry January 2014

32 Bovine Milk Study Results Only whole and whole lactose-free milk kept ph above the demineralization threshold. Skim and semi-skim milk induced similar demineralization to the sucrose control, albeit slightly lower for semi-skim milk (P<.05)

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34 Diffusibility Matters!

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36 Flour Matters!

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38 Complex carb: /\/\/\/\/\/\/\/\/\/\/\ Simple carb: / / / / / / / / / / / / Processed carb: / /\ /\/ / /\ /\ \/ / \

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46 Crackers (cheddar) 6 g Fat 19g Carb 0g Fiber 1g Sugar 3g Protein 70% Dark Chocolate 17g Fat 21g Carb 5g Fiber 12g Sugar 3g Protein Ratio of Starch 19g Starch 9g Fat/Protein 19/9 = Ratio of Starch 16g Starch 25g Fat/Fiber/Protein 16/25 = 11g sugar 16g fat/protein 11/16= 11 g sugar 8g fat/protein 11/8=

47 Sucrose Sorbitol Plain European Chocolate Diet Chocolate Plain English Chocolate Milk English Chocolate Milk European Chocolate White Chocolate Milk Chocolate with Hazelnuts Verakaki E1, Duggal MS. A comparison of different kinds of European chocolates on human plaque ph. Eur J Paediatr Dent Dec;4(4):

48 Verakaki E1, Duggal MS. A comparison of different kinds of European chocolates on human plaque ph. Eur J Paediatr Dent Dec;4(4):

49 API = Acidogenic Potential Index

50 Plaque ph and Dental Retention after Consumption of Different Types of Chocolates Int J Clin Prev Dent 2016;12(2): Published online June 30, 2016

51 Int J Clin Pediatr Dent May;2(2):20-4. doi: /jp-journals Epub 2009 Aug 26. The acidogenicity of various chocolates available in Indian market: a comparative study. M Hegde A1, Shetty R2, Sequeira AR3.

52 Dark Chocolate is Better than a Cracker

53 Throwing Out Crackers is More Effective Than Flossing

54 Easy (non-crazy) Crackers Analogy Dried Fruit : Fresh Fruit Crackers : Bread Crackers aren t bad for you, they just get stuck to your teeth like dried fruit does, and are nine times stickier than bread. We recommend eating crackers no more than once a day.

55 TheDentistDad.com/SnackGuide

56 Dr. Lucas Three Principles Review 1) Brush well every night. Only water afterwards. 2) Eat 5-6 mini-meals a day, and only water in between 3) Eat snacks from the better for teeth categories Snack Foods are the secret

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58 Vitamin D Vitamin D Recent study at Seattle Children s showed children who had higher vitamin D blood levels had less caries rate Vitamin D is correlated with increased calcium and phosphorous in saliva Vitamin D has been shown to activate defense's - peptides that facilitate phagocytosis Imagine if you have a child who is vitamin D deficient: Probably very little calcium in saliva and worse immune response. This could explain that other subset that isn t diet, isn t reflux no calcium in saliva from lack of sun/ animal fat (only sources of vitamin D) Kids with Celiac Disease have enamel that falls apart. Perhaps this is from their gut not being able to absorb vitamin D? I give my kids a drop of infant Vitamin D3 every night in their water. (D3 is better absorbed than D2.) Flinstones have Vitamin K as well, which is needed for Vitamin D to work.

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71 TheDentistDad.com/ Dentists Free 30 minute Training Video for assistants / dentists on How to Use a Snack Guide and Have Parents Love You With 12 Extra Tips