Effects of chocolate milk on dental caries under mouth simulation conditions

Abstract

Dietary recommendations concerning chocolate milk remain controversial since the effect of chocolate milk on the dental caries process is not clear. Cocoa with antibacterial and enamel-solubility-reducing properties may inhibit the formation of dental caries. Since chocolate milk contains a significant amount of sucrose (about 5 percent) and some cocoa (1 percent), laboratory testing of the cariogenicity of chocolate milk seems valuable. The present study investigated whether or not under mouth simulation conditions chocolate milk influenced the formation of dental caries compared to white milk. A control solution, four milk solutions and a milk solution with toothbrushing were tested over a 20-week experimental period. A mouth-like environment was established by constructing a mouth simulating device. One-hundred- and-sixty-two-teeth were mounted in the mouth simulator in six groups of 27 teeth each. Two independent evaluators had certified the teeth to be caries-free and a computer program was used to ensure complete randomization of the teeth in groups. After initial sterilization by ethylene oxide, the teeth were inoculated with a mixture of a culture of Streptococcus mutans and saliva. Each group was exposed to one of the milk formulations for a 15 minute period twice daily. After each period, a sterile bacterial medium was dripped (8 to 12 mls/hr) over the teeth in the mouth-like environment. After 20 weeks the teeth were separated, coded, and re-evaluated for pit and fissure caries by the same two evaluators. A statistical analysis by Repeated t Tests indicated the presence of three levels of relative cariogenicity: the chocolate milk group had the highest caries rate, the control group and the white milk group were intermediate and the chocolate milk with brushing group showed a marked reduction in dental caries. The results of two other groups were invalidated. In summary, for pit and fissure dental caries under the conditions tested in the mouth simulating device, chocolate milk exhibited a significant cariogenic potential relative to white milk, especially in the early incipient caries stage. It may be concluded from this study that in an individual with high dental caries susceptibility, it would seem unwise to recommend frequent ingestion of chocolate milk, unless proper and immediate oral hygiene follows the ingestion.