The influence of sucrose-lactose imbalance in nutrition on the biochemical parameters of saliva and the risk of developing caries in teenage girls

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.