Sugars and Beyond. The Role of Sugars and the Other Nutrients and Their Potential Impact on Caries

Abstract

The traditional concept of caries as a multifactorial transmittable and infectious disease has been challenged. Novel conceptual ideas have come to add to the complexity of this highly prevalent disease worldwide. Current etiological understanding of the disease has emphasized the pivotal role of sugar in caries. In fact, current definition points towards an ecological disease caused by the commensal microbiota that under ecological imbalances, mainly due to high and or frequent sugar consumption, creates a state of dysbiosis in the oral biofilm. This modern conceptual idea, however, tends to underrate a key issue. Since humans are omnivore and consume a mix diet composed by a multitude of substances, the role of the diet in caries must not be restricted only to the presence of simple sugars. This review explores the contribution of other food components, ubiquitous to the diet, mostly as potentially protective factors. Anticaries nutrients might determine an environmental change, affecting the ecology of the oral microbiome and partially mitigating the effect of sugar. Understanding the function of the food usually consumed by the people will contribute new knowledge on the mechanisms associated with the onset of caries, on new caries risk variables and on potential novel strategies for the prevention and treatment of the disease.

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