Abstract
Background. The most important etiological factor in the development of caries is a violation of the structure and quality of nutrition, leading to an imbalance of essential nutrients.
Aim. Studying the influence of sucrose-lactose imbalance in nutrition on the biochemical parameters of saliva and the risk of developing caries in teenage girls. Materials and methods. Teenage girls (n=138, age 11–14 years) living in urban areas, health groups 1–2, without lactase deficiency and dental anomalies, were examined. In two groups differing in the level of sucrose-lactose imbalance (control group — low sucrose-lactose imbalance, n=30; experimental group — high sucrose-lactose imbalance, n=74), comparable in age (p=0.1921) and ethnic composition (p=0.3451), determined the prevalence of caries and its intensity according to the СFEt index (C — number of carious, F — filled, E — extracted teeth), as well as nutritional factors correlating with disaccharide imbalance and caries. In the subgroups formed from them, differing in the absence/presence of caries (low sucrose-lactose imbalance without caries and high sucrose-lactose imbalance with caries), the biophysical and biochemical parameters of mixed saliva were determined. The significance of differences between groups/subgroups was assessed using the nonparametric Mann–Whitney test, and in the case of normal distribution, using a two-sided Student t-test. To identify factors associated with caries, the binary logistic regression method was used; the closeness and direction of the relationship between individual parameters was assessed using the Spearman correlation coefficient and the ¬Chaddock scale.
Results. 74 girls were characterized by a “sweet” and “low-milk” type of diet with a high level of sucrose consumption and a low level of lactose consumption, leading to a high sucrose-lactose imbalance. In the group of high sucrose-lactose imbalance compared to low, the prevalence of caries and its intensity were 8.32 times (p=0.0047) and 4.53 times (p=0.0118) higher, respectively. In the subgroup of high sucrose-lactose imbalance with caries, in comparison with the subgroup of low imbalance without caries, the rate of salivation was significantly reduced by 1.86 times (p=0.0136), the surface tension of saliva was reduced by 1.25 times (p=0.0498), mineralizing potential of saliva by 1.68 times (p=0.0250), pH value by 1.13 times (p=0.0403), acid buffer capacity of saliva by 1.27 times (p=0.0192); saliva viscosity and lactate content were increased by 1.81 times (p=0.0455) and 1.79 times (p=0.0122), respectively; the optimal ratio of free and bound calcium was impaired. A pronounced cariogenic effect was identified for nutritional factors contributing to high sucrose-lactose imbalance in the diet: sucrose consumption ≥50 g/day (odds ratio 6.86), especially in terms of caloric intake ≥10% of energy value (odds ratio 8.53) , lactose intake ≤7.0 g/day (odds ratio 6.72) and milk calcium ≤150 mg/day (odds ratio 5.92).
Conclusion. A high sucrose-lactose imbalance in the diet of teenage girls leads to negative dynamics of the biochemical parameters of saliva, increases the prevalence of caries and its intensity.