Laine M A, Tolvanen M, Pienihäkkinen K, Söderling E, Niinikoski H, Simell O, Karjalainen S
Institute of Dentistry, University of Turku, FI-20520 Turku, Finland.
Institute of Dentistry, University of Turku, FI-20520 Turku, Finland.
Arch Oral Biol. 2014 Feb;59(2):217-25. doi: 10.1016/j.archoralbio.2013.11.013. Epub 2013 Dec 1.
The aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva, and on dental caries.
At 7 months of age 1062 infants (540 intervention; 522 controls) started in the prospective, randomized Special Turku Intervention Project (STRIP) aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis of adult age (www.clinicaltrials.gov NCT 00223600). At 3 years of age, every fifth child was invited to an oral sub-study, and 148 (78 boys) children attended. At 6, 9, 12 and 16 years of age 135, 127, 114 and 88 children were restudied, respectively. Dietary intakes of carbohydrates, protein, saturated fat, calcium, phosphate, and fibre were regularly recorded using 4-day food records. Height and weight were regularly monitored. Paraffin-stimulated saliva samples were collected at 6, 9, 12 and 16 years of age, and analyzed for flow rate, buffer capacity, calcium, phosphate and proteins. Dental health was recorded and expressed as d3mft/D3MFT, and as time of caries onset.
Dietary intakes of calcium, phosphate and fibre, and salivary flow rate increased with time in both groups (p<0.001, GLM for repeated measures). Fibre intake and salivary flow rate were higher in the intervention than in the control group (p=0.042 and p=0.0394, respectively, GLM for repeated measures). There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate. Children who did not have caries experience (d3mft/D3MFT=0) during the entire follow-up had higher salivary calcium than those who had caries already at 3 years of age. The association between salivary calcium and caries onset was significant up to 12 years of age. Toothbrushing frequency was statistically significantly associated with caries-onset at ages 6 (gamma statistic 0.457, p=0.046) and 12 years (gamma statistic 0.473, p=0.019).
The current long-term dietary intervention increased children's paraffin-stimulated salivary flow rate. The concentration of salivary calcium was directly correlated to dental health. Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group.
本研究旨在探讨饮食干预对石蜡刺激唾液特性及龋齿的影响。
1062名7个月大的婴儿（540名干预组；522名对照组）参与了前瞻性随机特库干预项目（STRIP），该项目旨在限制儿童饱和脂肪和胆固醇的摄入量，以预防成年期动脉粥样硬化（www.clinicaltrials.gov NCT 00223600）。3岁时，每五名儿童被邀请参加一项口腔子研究，148名（78名男孩）儿童参与。在6、9、12和16岁时，分别对135、127、114和88名儿童进行了再次研究。使用4天食物记录定期记录碳水化合物、蛋白质、饱和脂肪、钙、磷和纤维的饮食摄入量。定期监测身高和体重。在6、9、12和16岁时收集石蜡刺激的唾液样本，并分析其流速、缓冲能力、钙、磷和蛋白质。记录牙齿健康状况，并以d3mft/D3MFT以及龋齿发病时间表示。
两组的钙、磷和纤维饮食摄入量以及唾液流速均随时间增加（p<0.001，重复测量的广义线性模型）。干预组的纤维摄入量和唾液流速高于对照组（分别为p=0.042和p=0.0394，重复测量的广义线性模型）。饮食摄入量与唾液中钙或磷的浓度之间无相关性。在整个随访期间无龋齿经历（d3mft/D3MFT=0）的儿童唾液钙含量高于3岁时已患龋齿的儿童。唾液钙与龋齿发病之间的关联在12岁之前具有统计学意义。刷牙频率在6岁（γ统计量0.457，p=0.046）和12岁（γ统计量0.473，p=0.019）时与龋齿发病具有统计学显著相关性。
当前的长期饮食干预增加了儿童石蜡刺激的唾液流速。唾液钙浓度与牙齿健康直接相关。干预组较高的唾液流速被认为是由于干预组较高的纤维摄入量所致。
