Smutkeeree Apiwan, Rattanapakdeekul Navaphan, Lapirattanakul Jinthana, Tosrisawatkasem Orada, Surarit Rudee
Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
J Int Soc Prev Community Dent. 2025 Jun 30;15(3):265-274. doi: 10.4103/jispcd.jispcd_3_25. eCollection 2025 May-Jun.
Lactose-free infant formulas (LFs) are commonly used for children with lactose intolerance, but their potential contribution to early childhood caries (ECC) remains poorly understood, particularly with varying sugar compositions. The present study aimed to assess the biofilm-forming ability, acidogenicity, and structural biofilm characteristics of LFs with and without sucrose using a model.
Two LFs (with and without 24% sucrose) were tested alongside brain heart infusion (BHI) (negative control) and BHI + 10% sucrose (positive control). biofilm formation was quantified using crystal violet staining (A). Biofilm pH was measured after 24 h of incubation. Structural characteristics were assessed via confocal laser scanning microscopy (CLSM). Statistical analysis included Kruskal-Wallis tests, Bonferroni tests, and linear regression modeling ( < 0.05).
Both LF samples showed significantly greater biofilm formation than the negative control (A: 3.57 ± 0.06 vs. 0.08 ± 0.02; < 0.05). Biofilm pH was significantly lower in both LFs (4.23 and 4.28) than in BHI alone (5.26; < 0.05). However, there were no significant differences between the LFs with and without sucrose. CLSM revealed denser aggregation in sucrose-supplemented LF, but without distinct biofilm boundaries.
LFs, even those without supplemental sucrose, promote biofilm formation and acidogenicity, suggesting a potential cariogenic risk. These findings underscore the need for careful dietary recommendations and oral hygiene strategies for infants consuming LF formulas. Further studies involving and clinical trials are warranted to validate the results and assess the long-term implications for ECC development.
无乳糖婴儿配方奶粉（LFs）常用于乳糖不耐受的儿童，但它们对幼儿龋齿（ECC）的潜在影响仍知之甚少，尤其是在糖成分不同的情况下。本研究旨在使用一种模型评估含蔗糖和不含蔗糖的LFs的生物膜形成能力、产酸性和生物膜结构特征。
测试了两种LFs（一种含24%蔗糖，一种不含蔗糖），同时设置脑心浸液（BHI）（阴性对照）和BHI + 10%蔗糖（阳性对照）。使用结晶紫染色法（A）对生物膜形成进行定量。孵育24小时后测量生物膜pH值。通过共聚焦激光扫描显微镜（CLSM）评估结构特征。统计分析包括Kruskal-Wallis检验、Bonferroni检验和线性回归建模（P < 0.05）。
两种LFs样品的生物膜形成均显著高于阴性对照（A：3.57 ± 0.06对0.08 ± 0.02；P < 0.05）。两种LFs的生物膜pH值（4.23和4.28）均显著低于单独的BHI（5.26；P < 0.05）。然而，含蔗糖和不含蔗糖的LFs之间没有显著差异。CLSM显示，添加蔗糖的LFs中细菌聚集更密集，但没有明显的生物膜边界。
LFs，即使是那些没有添加蔗糖的，也会促进细菌生物膜形成和产酸性，提示存在潜在的致龋风险。这些发现强调了为食用LF配方奶粉的婴儿制定谨慎的饮食建议和口腔卫生策略的必要性。有必要进行进一步的体外研究和临床试验，以验证结果并评估对ECC发展的长期影响。
