TO EVALUATE THE CARIOGENIC POTENTIAL OF NATURAL AND ARTIFICIAL MILK BEVERAGES BY STREPTOCOCCUS MUTANS BIOFILM MODEL IN PRIMARY TEETH : AN IN-VITRO STUDY
DOI:
https://doi.org/10.48165/ajm.2025.8.02.6Keywords:
Dental caries, Milk beverages, Primary teeth, Streptococcus mutans, Enamel microhardness, Cariogenic potentialAbstract
Background: Dental caries remains a prevalent chronic disease in children, influenced by diet, microbial activity, and oral hygiene. Milk is a widely consumed beverage with both protective and cariogenic potential, depending on its composition and sugar content. This study evaluated the cariogenic effects of natural and flavoured milk beverages on primary teeth using an in vitro Streptococcus mutans biofilm model. Materials and Methods: Sixty caries-free primary teeth were sectioned into enamel slabs and randomly allocated into six groups: cow, buffalo, goat, strawberry-flavoured, vanilla flavoured milk, and saline control (n=10 each). Enamel slabs were inoculated with S. mutans and exposed to the respective beverages three times daily for three days. Baseline and post exposure surface microhardness were measured using the Brinell hardness test. Percentage surface hardness loss was calculated, and data were analyzed using one-way ANOVA with Tukey’s post hoc test and paired t-tests (p<0.05). Results: Baseline microhardness was comparable across all groups (p>0.05). Natural milk types (cow, buffalo, goat) caused moderate enamel demineralization, whereas flavoured milk beverages led to significantly higher microhardness loss (p<0.05). Tukey’s post hoc analysis confirmed that sweetened milk groups exhibited greater cariogenic potential compared to natural milk and the control. Conclusion: Natural milk poses a lower risk for enamel demineralization due to its buffering capacity and absence of added sugars. Sweetened milk beverages significantly increase cariogenic risk, particularly with frequent consumption. Limiting sugary milk drinks and promoting proper oral hygiene are essential strategies to reduce caries risk in children.Downloads
References
World Health Organization. (2025, August 14). Sugars and dental caries. Geneva: World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/sugars-and-dental-caries
World Health Organization. (2022, November 18). Global oral health status report: Towards universal health coverage for oral health by 2030. Geneva: World Health Organization. Available from: https://www.who.int/publications/i/item/9789240061484
Nicklisch, N., Oelze, V. M., Schierz, O., Meller, H., & Alt, K. W. (2022, April 27). A healthier smile in the past? Dental caries and diet in early Neolithic farming communities from Central Germany. Nutrients, 14(9), 1831. https://doi.org/10.3390/nu14091831
Abbass, M. M. S., Mahmoud, S. A., El Moshy, S., Rady, D., AbuBakr, N., Radwan, I. A., Ahmed, A., Abdou, A., & Al Jawaldeh, A. (2019, January 3). The prevalence of dental caries among Egyptian children and adolescents and its association with age, socioeconomic status, dietary habits and other risk factors: A cross-sectional study. F1000Research, 8, 8. https://doi.org/10.12688/f1000research.17047.1
Chen, X., Daliri, E. B., Kim, N., Kim, J. R., Yoo, D., & Oh, D. H. (2020, July 14). Microbial etiology and prevention of dental caries: Exploiting natural products to inhibit cariogenic biofilms. Pathogens, 9(7), 569. https://doi.org/10.3390/pathogens9070569
Carvalho Silva, C., Gavinha, S., Vilela, S., Rodrigues, R., Manso, M. C., Severo, M., Lopes, C., & Melo, P. (2021, June 24). Dietary patterns and oral health behaviours associated with caries development from 4 to 7 years of age. Life (Basel), 11(7), 609. https://doi.org/10.3390/life11070609
Zero, D. T. (1995, November). In situ caries models. Advances in Dental Research, 9(3), 214–230; discussion 231–234. https://doi.org/10.1177/08959374950090030501
Featherstone, J. D. (2009). Remineralization, the natural caries repair process—the need for new approaches. Advances in Dental Research, 21(1), 4–7. https://doi.org/10.1177/0895937409335590
Craig, R. G., & Peyton, F. A. (1958, August). The micro-hardness of enamel and dentin. Journal of Dental Research, 37(4), 661–668. https://doi.org/10.1177/00220345580370041301
Durso, S. C., Vieira, L. M., Cruz, J. N., Azevedo, C. S., Rodrigues, P. H., & Simionato, M. R. (2014). Sucrose substitutes affect the cariogenic potential of Streptococcus mutans biofilms. Caries Research, 48(3), 214–222. https://doi.org/10.1159/000354410
Amaechi, B. T., & van Loveren, C. (2013). Fluorides and non-fluoride remineralization systems. Monographs in Oral Science, 23, 15–26. https://doi.org/10.1159/000350458
Pradhan, S., Yadav, G., Saha, S., Dhinsa, K., Sharma, A., & Rai, A. (2024, October 1). Comparison of Streptococcus mutans biofilm formation, acidogenicity, and buffering capacity among human breast milk, plain packaged bovine milk, sweetened bovine milk, and infant formula: An in vitro study. Journal of Indian Society of Pedodontics and Preventive Dentistry, 42(4), 328–335. https://doi.org/10.4103/jisppd.jisppd_373_24
Haenlein, G. F. W. (2004). Goat milk in human nutrition. Small Ruminant Research, 51(2), 155–163. https://doi.org/10.1016/j.smallrumres.2003.08.010
Reddy, B. V. T., Chowdary, B. U. K., Kumar, J. R., Kumar, R. H., Gunde, V., & Nagilla, S. R. (2023, October 1). Comparative evaluation of human breast milk, bovine milk, and infant milk formula on cariogenicity in children: An in vivo study. Journal of Indian Society of Pedodontics and Preventive Dentistry, 41(4), 274–281. https://doi.org/10.4103/jisppd.jisppd_450_23
Huang, Y., et al. (2019). Cariogenic potential of plant-based milk alternatives in comparison with bovine milk: An in vitro study. Caries Research, 53(5), 482–490. https://doi.org/10.1159/000495852
Wimolsantirungreung, W., et al. (2023). In vitro assessment of cariogenic potential of alternative milk beverages on primary teeth enamel. Journal of Dental Sciences, 18(2), 95–103.
Signori, C., et al. (2018). The role of human milk and sucrose on cariogenicity of microcosm biofilms. Brazilian Oral Research, 32, e109.
Giacaman, R. A., & Muñoz-Sandoval, C. (2014, January–February). Cariogenicity of different commercially available bovine milk types in a biofilm caries model. Pediatric Dentistry, 36(1), 1E–6E. PMID: 24717697
Srivoha, N., Asvanund, Y., Mitrakul, K., & Srisatjaluk, R. (2025). Effects of alternative milk on Streptococcus mutans biofilm formation and enamel demineralization in human primary teeth. European Journal of General Dentistry, 14, 203–211. https://doi.org/10.1055/s-0044-1792165
Meltharyna, M., Putri, D. A., Rahman, I. A., et al. (2017). Effect of different types of milk formula against Streptococcus mutans biofilm formation in vitro. Asian Journal of Pharmaceutical and Clinical Research, 10(Suppl 5), 230–238. https://doi.org/10.22159/ajpcr.2017.v10s5.23088
