Dietary studies

Vipeholm study: (Gustafsson et al -1954):

• This study was conducted in a mental
institution for 5 yrs in Vipeholm hospital.
• The institutional diet provided was
nutritious , with little sugar, and no provision
for between meal snacks.
• The dental caries rate experienced was
relatively low.

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• 7 groups:
1. Control group
2. Sucrose group(300gm sucrose)
3. Bread group (345gm bread-50gm of sugar)
4. Chocolate group(65gm – daily-for last 2yrs)
5. Caramel group((22caramel-70gm sugar)
6. 8-toffee group (60gm sugar- for 3 yrs)
7. 24- toffee group(120 gm sugar-18 months)
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 Conclusions
• Increased caries risk-
1. Increase in sugar content.
2. if sugar consumed in a form that will be retained on
tooth.
3. If sugar is consumed in between meals.
4. It varies widely in between individuals.
5. Upon withdrawl of the sugar rich foods, the increased
caries activity rapidly disappears.
6. Clearance time of the sugar correlates closely with
caries activity.
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• This study showed that the physical form of
carbohydrates is much more imporatnt in
cariogenicity than the total amount of sugar
ingested.

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Hopewood house study (Sullivan- 1958):
• The dental status of children between 3-14
yrs of age at Hopewood house was studied for
10yrs.
• All lived on a strictly institutional diet.
• The absence of meat and a rigid restriction of
refined carbohydrate were the two principal
features.

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• The meals were supplemented by vitamin
concentrates and an occasional serving of nuts
and a sweetening agent such as honey.
• DMFT /child after 10 yrs -1.6
• 53% of the children were caries free.
• Conclusion: the children’s oral hygiene was
poor, calculus uncommon but gingivitis in 75%
of children.

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• This showed that dental caries can be reduced
by diet control even in the presence of
unfavourable oral hygiene.

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Turku sugar study (Scheinin, Makinen -1975):
• This study was done to test the effects of
chronic consumption of sucrose, fructose and
xylitol on dental caries.
• 3 groups:
1. Sucrose group-35 people
2. Fructose group-38 people
3. Xylitol group-52 people
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• A dramatic reduction in the incidence of dental
caries was found after 2 yrs of xylitol
consumption.
• Fructose was cariogenic as sucrose for the first
12 months but became less so at the end of 24
months.
• It was also found that frequent between meal
chewing of a xylitol gum produced an
anticariogenic effect.
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Hereditary fructose intolerance (Froesch 1959):
• It is caused by the remarkably reduced levels of hepatic,
fructose -1-phosphate aldolase into two or three carbon
fragments to be further metabolized.
• Persons affected with this rare metabolic disorder have
learned to avoid any food that contains fructose or sucrose,
Because the ingestion of these foods causes symptoms of
nausea, vomiting, malaise, tremor , excessive sweating ,
and even coma due to fructosemia.
• Newburn 1969, found that caries prevalence was extremely
low in persons with HFI.
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