Indian Journal of Oral Health and Research

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 3  |  Issue : 1  |  Page : 19--22

The acidogenicity of crispy snacks available in Indian Market: A comparative study


Ashveeta J Shetty, Farhin Katge, Debapriya Pradhan, Mayur Wakpanjar 
 Department of Paedodontics and Preventive Dentistry, TPCT's Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India

Correspondence Address:
Ashveeta J Shetty
Department of Paedodontics and Preventive Dentistry, TPCT's Terna Dental College and Hospital, Nerul, Navi Mumbai - 400 706, Maharashtra
India

Abstract

Background: Sucrose and starches are the predominant dietary carbohydrates in modern societies. This study has been conducted to determine whether a relationship exists between dental caries and commonly consumed crispy snacks which are processed starches. One approach to estimate the cariogenic potential of a food involves evaluation of the magnitude of the pH response obtained following ingestion. Aim: The aim of the study is to compare the dental plaque pH changes after consumption of four commercially available crispy snacks in the Indian market. The pH was measured using the plaque sampling method in 40 subjects. Statistical analysis was done using the SPSS version 17 software (SPSS Inc., Chicago, IL, USA). One-way ANOVA test with Bonferroni post hoc test was used for statistical evaluation. P value was set to 0.05. Results: Intragroup comparison showed a drop in pH which was statistically significant in each group immediately after the consumption of the crispy snacks and the pH returned to baseline values by 30 min. The pH response comparison between the different groups of crispy snacks was not statistically significant from baseline to immediately after consumption of the crispy snacks (P = 0.241) and at 30 min interval (P = 0.580). Conclusion: Frequent consumption of crispy snacks may have a cariogenic potential due to high fermentability in dental plaque of these processed starch products.



How to cite this article:
Shetty AJ, Katge F, Pradhan D, Wakpanjar M. The acidogenicity of crispy snacks available in Indian Market: A comparative study.Indian J Oral Health Res 2017;3:19-22


How to cite this URL:
Shetty AJ, Katge F, Pradhan D, Wakpanjar M. The acidogenicity of crispy snacks available in Indian Market: A comparative study. Indian J Oral Health Res [serial online] 2017 [cited 2020 Aug 3 ];3:19-22
Available from: http://www.ijohr.org/text.asp?2017/3/1/19/210926


Full Text

 Introduction



Increasing prevalence of childhood obesity is seen globally. In India, 22.0% children are suffering from childhood obesity.[1] One of the major causes for this high prevalence is the change in lifestyle and dietary patterns.[2] Some dietary patterns appear quite common among children and adolescents such as snacking, usually on energy-dense foods; meal skipping, particularly breakfast or irregular meals; wide use of fast food; and low consumption of fruits and vegetables.[3],[4] Various studies on diet and nutrition intake of adolescents and young adults in the developed world have shown that their diets are often high in fats and refined carbohydrate.[5] A study by Punjab Agricultural University, Ludhiana, on consumption pattern of fast foods among teenagers found that fast foods are most commonly consumed between regular meals.[6] Consumption of diet which is rich in sugar, saturated fat, salt and calorie content in children can lead to early development of obesity, hypertension, dyslipidemia, and impaired glucose tolerance.[7]

Starchy foods such as crispy snacks, due to their high fermentability and their tendency to be retained in the mouth for a long period probably have a moderate to high cariogenic potential if consumed frequently.[8] One approach to estimate the cariogenic potential of food involves evaluation of magnitude of pH response of the dental plaque obtained following ingestion.[8]

Dental plaque is an adherent deposit of bacteria and their products, which forms on all tooth surfaces and is the cause of caries.[9] Fermentable carbohydrates provide plaque bacteria with substrate for acid production and the synthesis of extracellular polysaccharides. The plaque remains acidic for some time, taking 30–60 min to return to its normal pH.[9] The gradual return of pH to baseline values is a result of acids diffusing out of the plaque and buffers in the plaque and salivary film overlying it, exerting a neutralizing effect. Repeated and frequent consumption of such fermentable carbohydrates will keep plaque pH depressed and cause demineralization of the teeth.[9]

The aim of the present study is

To check the pH response of human dental plaque immediately after consumption of crispy snacks and at 30 min intervalsTo compare the pH response between four different types of commonly consumed crispy snacks available in the Indian market.

 Materials and Methods



Ethical clearance was obtained from the Institutional Review Board.

Subject selection: Subjects were screened and forty subjects in the age group of 7 to14 years with plaque score >2 according to plaque index by Silness and Loe (1967) were included in the study so that sufficient amount of plaque was available for sample collection.[10] Parent consent and patient assent were obtained. Medically compromised subjects were excluded from the study. The subjects were refrained from eating or drinking anything except water 2.5 h before collection of the baseline plaque samples.[11]

Test groups: Subjects were randomly assigned to the four groups of crispy snacks to be tested in the study: Group A (Lays Classic Salted, Pepsico India), Group B (Cheetos Cheeez Puffs, Pepsico India), Group C (Kurkure Masala Munch, Pepsico India), and Group D (Peppy, SM Foods India).

Plaque sampling technique and pH measurements

A pocket type digital pH meter (HMDPHM80 Digital pH/Temperature Meter, HM Digital, India) was used to measure the plaque pH. The electrode was calibrated against standard pH buffers before each test session [Figure 1]. Plaque sample was collected from the buccal surfaces of posterior teeth using a sterile blunt explorer.[11] Each plaque sample was thoroughly mixed with 15 ml of distilled water, measured by a pipette into a beaker.[12] The recording of pH reading was done chairside. The electrode of the digital pH meter was dipped into the diluted sample. The reading on the pH meter was recorded, and thereafter, the electrode was cleaned with a stream of distilled water and dried.{Figure 1}

A plaque sample taken before the test product was consumed and a baseline plaque pH was recorded. The subjects were then given 30 g of the crispy snacks to eat. Plaque samples were again taken immediately after consumption of the crispy snack and at 30 min interval from the time of consumption of the snack. The pH of these samples was measured and recorded using the digital pH meter.

Statistical analysis was done using the SPSS version 17 software (SPSS Inc., Chicago, IL, USA). One-way ANOVA test with Bonferroni post hoc test was used for statistical evaluation. P value was set to 0.05.

 Results



Maximum subjects (52.5%) were in the 9 years age group [Figure 2]. 62% were male and 38% were female [Figure 3]. [Figure 4]a,[Figure 4]b,[Figure 4]c,[Figure 4]d show the pH changes within the four groups of crispy snacks from baseline to immediately after consumption of the crispy snacks and at 30 min interval. A drop in the pH was observed from the baseline to immediately after consumption of the crispy snack in Group A, B, C, and D. This drop in pH was statistically significant for all four groups from baseline to immediately after consumption of the snack (Group A, P < 0.05; Group B, P < 0.05; Group C, P < 0.05; Group D, P < 0.05). The difference in pH was also statistically significant after snack consumption to the 30 min interval. A recovery in the pH values was obtained at the 30 min interval in all four groups (Group A, P < 0.05; Group B, P < 0.05; Group C, P < 0.05; Group D, P < 0.05). Intergroup comparison showed that pH changes from baseline to immediately after consumption of the snacks were not statistically significant (P > 0.05). A rise in pH values was observed at 30 min following consumption of the snacks. pH difference between the four groups at 30 min interval was not statistically significant (P > 0.05). [Figure 5] shows intergroup comparison of the pH changes.{Figure 2}{Figure 3}{Figure 4}{Figure 5}

 Discussion



Changes in human dental plaque pH can be used to estimate of the acidogenic potential of ingested foods.[8] Modern diets of urban populations contain a wide range processed foods, refined flours, foods consisting of mixtures of starch and sugars and foods with a soft consistency. The cariogenic potential of starch and starch containing food products seems to be influenced by a large number of factors such as the processes used for manufacturing these products, the frequency of consumption, different tendencies for retention on the dentition, presence of caries-promoting or inhibitory ingredients, and the interactions with salivary amylase in vivo.[13] Studies suggest that the pH response to a single substrate varies with factors endogenous to individual subjects but that in response to differing foods, acid production becomes the dominant factor in determining the plaque pH.[14] In the present study, the plaque sampling method was used to determine the plaque pH. A pocket type digital pH meter was used to measure the plaque pH. The advantages of using this method are that it does not require sophisticated equipment, can be efficiently used on a large number of subjects, can be used chairside.[8]

Age and gender have been mentioned to show demographic distribution of subjects, random allocation of subjects, and similar eating habits in common age group children.

The present study shows that intragroup comparison showed a significant drop in pH in each group immediately after consumption of the crispy snacks and the pH returned to normal by 30 min. Intergroup comparison was not statistically significant between the different groups of crispy snacks.

The fact that a processed starch product, such as potato chips, causes low pH values in dental plaque is in agreement with earlier reports (Lingstrom, 1993).[8] Starch modified by different processes shows an increasing susceptibility to hydrolysis by alpha-amylase and correspondingly produces an increased pH drop in dental plaque compared with raw starch.[8]

The products used in the present study contain starches modified by various processes. Processed pure wheat, corn, rice, rye, and potato starch can all cause a significant plaque pH drop (Lingstrom et al., 1989, 1993).[8] In addition to these, there is added sugar present in each of the products tested in the present study. Sugars, even in low concentration, can significantly affect plaque pH.[15] Another important finding is that though certain crispy snacks contain cheese, the quantity of cheese powder is very less and has no protective effect against caries.

The aim of this study was to evaluate the drop in pH of the samples as a whole and not of individual components. Influence of pH of individual components was beyond the scope of this study. Further research can be undertaken to analyze the effect of individual components of such crispy snacks.

Junk foods are preferred by children as well as parents due to their easy availability and attractive packaging. These products are usually inexpensive and hence, a preferred snack especially by school children during breaks. It is important for dental professionals to guide parents regarding the effects of these foodstuffs on the oral health of their children. Guidelines regarding caries risk for sugary foods should be further supplemented by similar guidelines for crispy snacks consisting of starch-sugar mixtures.

 Conclusion



It is believed that most processed starch products have a cariogenic potential due to high fermentability in dental plaque of the crispy snacks included in the present study and the probability of frequent consumption in conjunction with other cariogenic foodstuffs. Counseling should be done to guide parents regarding the right choices of foodstuffs that affect the teeth as well as overall well-being of their children.

Acknowledgement

We thank the Department of Public Health Dentistry, Terna Dental College, for their support in statistical analysis of data.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: Epidemiology, determinants, and prevention. Endocr Rev 2012;33:48-70.
2Tong HJ, Rudolf MC, Muyombwe T, Duggal MS, Balmer R. An investigation into the dental health of children with obesity: An analysis of dental erosion and caries status. Eur Arch Paediatr Dent 2014;15:203-10.
3Cavadini C, Decarli B, Dirren H, Cauderay M, Narring F, Michaud P. Assessment of adolescent food habits in Switzerland. Appetite 1999;32:97-106.
4Dausch JG, Story M, Dresser C, Gilbert GG, Portnoy B, Kahle LL. Correlates of high-fat/low-nutrient-dense snack consumption among adolescents: Results from two national health surveys. Am J Health Promot 1995;10:85-8.
5Bull NL. Studies of the dietary habits, food consumption and nutrient intakes of adolescents and young adults. World Rev Nutr Diet 1988;57:24-74.
6Sadana B, Khanna M, Mann SK. Consumption pattern of fast foods among teenagers. Appl Nutr 1997;22:41-5.
7Seethalakshmi SS. Indian Food Worse Than Western Junk. Times of India; 13 March, 2007. Available from:http://timesofindia.indiatimes.com/india/Indian-food-worse-than-Western-junk/articleshow/1755418.cms. [Last accessed on 2017 May 15].
8Lingström P, Imfeld T, Birkhed D. Comparison of three different methods for measurement of plaque-pH in humans after consumption of soft bread and potato chips. J Dent Res 1993;72:865-70.
9Kidd EA, editor. Dental plaque. In: Essentials of Dental Caries. 3rd ed. New York: Oxford University Press; 2005. p. 2-19.
10Peter S, editor. Indices in dental epidemiology. In: Essentials of Preventive and Community Dentistry. 4th ed. New Delhi: Arya Publishing House; 2006. p. 312-59.
11Verakaki E, Duggal MS. A comparison of different kinds of European chocolates on human plaque pH. Eur J Paediatr Dent 2003;4:203-10.
12Hegde AM, Shetty R, Sequeira AR. The acidogenicity of various chocolates available in Indian market: A comparative study. Int J Clin Pediatr Dent 2009;2:20-4.
13Lingström P, Holm J, Birkhed D, Björck I. Effects of variously processed starch on pH of human dental plaque. Scand J Dent Res 1989;97:392-400.
14Dodds MW, Edgar WM. The relationship between plaque pH, plaque acid anion profiles, and oral carbohydrate retention after ingestion of several 'reference foods' by human subjects. J Dent Res 1988;67:861-5.
15Kleinberg I. Studies on dental plaque. The effect of different concentrations of glucose on the pH of dental plaque in vivo. J Dent Res 1961;40:1087-111.