Preventive Sheet #4 By Noor Haddadin

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Preventive Sheet #4 By Noor Haddadin

Post by Sura on 10/3/2012, 3:23 am

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Re: Preventive Sheet #4 By Noor Haddadin

Post by Shadi Jarrar on 13/3/2012, 5:28 am

Preventive sheet # 4
Date: 28-2-2012
Done by:Noor Haddadin


*Today we will talk about sugar substitutes and Diet control

We will talk about: -classification of mal sugar sweeteners’ and non sugar
ones
-The role of chewing gums and how they are related to
Dental caries
-how we prevent caries by diet control


NON SUGAR SWEETENERS:

♣How and why did they develop non sugar sweeteners?
Because all of us like the taste of sugar,but we have problems with sugar like caries, so by this development we can have the taste without the disadvantages of dental caries.

♣Basically non sugar non sugar sweeteners are classified into:
1.Bulk sweeteners
2. intense sweeteners

♣Bulk sweeteners:

-the same sweetness sugar gram for gram (a gram of sugar will give u the same sweetness of a gram of bulk sweeteners.
-when u add it to food it gives bulk of sweetness(its bulk to food)that’s why its called bulk!
-It has calories
-Non cariogenic :its metabolized by the bacteria and fermented slowly so the acid product is also produced slowly so less acid
-The problem with the bulk sugar is that its not easily absorbed by the small intestine part of it is not absorbed which pass to the colon and can actually produce osmotic diarrhea. So taking it in large amount is not good and its not recommended for children less than 3 years old.



♣ intense sweeteners:

-from the name they are intense and contain many types of sweeteners ,gram of them is not the same as a gram of normal sugar they are much sweeter.
-No calories absolutely zero.
-Non cariogenic can’t actually be metabolized by the bacteria so no acid produced .


☺ so these are the main types of sweetners that u can see on food labels and that are recommended and proofed from the UK .





Bulk sweeteners


Intense sweeteners
Sorbitol

Mannitol

Xilitol

Lacitol
Saccharin

Aspartame
















*Bulk sweeteners:

♣Sorbitol

- is a sugar alcohol and a sugar substitute
-is found in some oral medications to make them taste better and in toothpastes and mouthwashes. Also its found in chewing gums.

♣Mannitol

-used in chewing gums
-esed as a sweetener for people with diabetes
-has the same properties as sorbitol but its more expensive.


♣ Xilitol:

-it’s a naturally non sugar sweetener found in fruits and vegetables ,corn
and strawberries.
-the commercially available xilitol is taken from corn
- an important study to look at the effect of xilitol and how its related to caries is the Turku study in this study they found that when ppl have xilitol in their diet ,there will be 85% reduction in dental caries ,so it doesn’t just cause caries it also reduces it that’s because its not just non cariogenic it has property of being anti-cariogenic .
-how does xilitol reduce caries?
Basically it affects how the bacteria produce acid from the metabolism of sugar so the bacteria is less able to produce the acid and it actually actively reduces the number of cocci .


*Intense sweetners:

♣ saccharin:

-it was discovered in 1879, it was discovered by accident by working in the lab , they didn’t have the hygiene we have now where u wash ur hand then eat , they noticed wlile they were eating lunch a sweet taste on their hands and when they went back to what they were doing in the lab they found that they were using this material ortho benzo sulfimide .
-if u had ever anything with saccharin u will notice that there is a bitter taste
-usually its added in carbonate beverages and soft drinks ,its on the table top sweeteners also its added to toothpastes sometimes and yogurts.
-its 130 time sweeter than sucrose .

♣ Aspartame:

Its an artificial ,non-saccharide sweetener used as a sugar substitute in some food and beverages and soft drinks .
It’s a dipeptide of aspartic acid and phenylalanine. So it’s a protein.
They call it canderel sweet so any kind of canderel sweet its made from aspartame .







-its digested the same way of protein and metabolized the as aspartic acid and phenylalanine.
-some group of patients cant metabolize phenylalanine so its not allowed to be given for phenylketo urea patients.




*now we will talk about chewing gums and how it affects caries and saliva
The sugared gums ,sugarless gums and xilitol gums ,sorbitol gums.

-The more saliva ----- the lees caries

♣ SUGARED GUMS AND CARIES:
-They did several studies on two groups one group was chewing sugared gums and the other group chewing no gum at all. They found that those chewing sugared gums developed more caries than those who didn’t chew at all ,so that basically means the introduction of sugar overpowered the saliva flow increase ,there is no benefit anymore from the saliva being increased ,the sugar have the detrimental effect.

☺☺☺ so we don’t advise chewing sugared gums

♣SUGARLESS GUMS AND CARIES:

-So again two groups one chewing sugarless gum verses sugared gum, and they found that with the sugarless gum there is a substantial decrease in caries

-now comparing groups chewing sugarless gums with those not chewing gums at all and what they found that there is less caries developing in the group chewing sugarless gums .

☺☺☺ we do advise of chewing sugarless gums in terms of preventing caries.


-if u look at sugarless gums there are different types of sweeteners added to different gums so we need to say which one is better :
•xilitol which is anti –cariogenic is good to be added to sugarless gums

*a study was done in 2003 came out with the following :
•,xilitol gums are better than gums containing sorbitol in reducing caries
•Chewing 5 times a day is better than 3 times
•Mixing sorbitol and xilitol is less effective than sugarless gums containing xilitol alone .
•recent studies reported gum chewers have less cavities than non gum chewers
• The greatest reduction of caries occurs when gum chewing is occurring at least one year prior to the eruption of permanent teeth
•children chewing xilitol gums have a greater reduction in streptococcus mutans than children who were not .


:

♣TOOTH FRIENDLY SWEETS:

-These sweets are developed in Switzerland ,they are a group of sweets that are non cariogenic ,they contain polyols (bulk sweeteners)
-examples for tooth friendly sweets :chupa chups , s-mints
Their problems are:
1.The diarrhea they cause so there is a warning on those sugars that excessive use will result in diarrhea especially in children less than 3 years.
2.these sweets are of no nutritional value ,so no benefit for the child to take these sweets in excess. And they encourage the sweet taste so children will have a habit to have sth sweet always





-Again bulk sweeteners are non cariogenic or virtually non cariogenic , xilitol and the intense sweeteners are non cariogenic
-Chewing gums sweetened by xilitol protect against dental caries


♣NON SUGAR SWEETENRES AND CANCER:
-There is a warning that used to be placed on non sugar sweeteners that says any food that cause cancer in animals is supposed to be bad for ur consumption and one of them was saccharin so the question is why saccharin is still being used ??
I searched and this is what I found from Wikipedia:

In 1958, the United States Congress amended the Food, Drugs, and Cosmetic Act of 1938 with the Delaney clause to mandate that the Food and Drug Administration not approve substances that "induce cancer in man, or, after tests, [are] found to induce cancer in animals." Studies in laboratory rats during the early 1970s linked saccharin with the development of bladder cancer in rodents. As a consequence, all food containing saccharin was labeled with a warning.[23]
However, in 2000, the warning labels were removed because scientists learned that rodents, unlike humans, have a unique combination of high pH, high calcium phosphate, and high protein levels in their urine.[24][25] One or more of the proteins that are more prevalent in male rats combine with calcium phosphate and saccharin to produce microcrystals that damage the lining of the bladder. Over time, the rat's bladder responds to this damage by over-producing cells to repair the damage, which leads to tumor formation. As this does not occur in humans, there is no elevated bladder cancer risk.
The delisting of saccharin led to legislation, which was signed into law on December 21, 2000, repealing the warning label requirement for products containing saccharin. In 2001, the U.S. Food and Drug Administration and the state of California reversed their positions on saccharin, declaring it safe for consumption.[26] The FDA’s decision followed a 2000 determination by the U.S. Department of Health and Human Services' National Toxicology Program to remove saccharin from its list of carcinogens.

♣ DIET CONTROL:
How can we prevent caries when u talk about diet?
Controling diet is difficult and it requires what’s called behaviour modification ,person’s diet is part of their character and its difficult to change the earlier you begin the better
*General guidelines for a healthy diet:
-eat a variety of different food , eat the right amount
-eat plenty of food rich in starch and fibers ,fruits and vegetables .ideally we should eat vegetables 5 times a day they help in preventing cancer as they are rich in anti-oxidants
-Don’t eat too many fruits that are rich in fats
-Non milk extrinsic sugars are the ones that are highly cariogenic
-The influence of diet is more important after teeth have erupted
-The frequency of eating and drinking of non milk extrinsic sugars is most important regarding caries .
-Intrinsic sugars (fresh fruits ,vegetables ,starch ,rice ,potato ) are of low cariogenity
-Milk extrinsic sugars are virtually non cariogenic
-Alternatives (non sugar sweeteners ) are non cariogenic
-Frequent consumption of acidic drinks is liked to erosion

**RECOMMENDATIONS:
-The frequency and amount of non milk extrinsic sugars should be reduced
-limit the consumption of non milk extrinsic sugars to maximum 4 times a day
-NMES shouldn’t provide more that 10% of the total energy of the diet and it shouldn’t exceed 60 gm /day/person ,for example coca cola has 35 gm of sugars .

***sorry for any mistakes but this sheet was written without the handout!
The lecture was only 30 minutes .

Good luck all=)
Noor Haddadin






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Shadi Jarrar
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