The Impact of Carbohydrate Quality on Dental Plaque pH: Does the Glycemic Index of Starchy Foods Matter for Dental Health?

Abstract

Sugary carbohydrate foods have long been associated with increased risk of dental caries formation, but the dental health impact of starchy carbohydrates, particularly those with a high glycemic index (GI), has not been well examined. Aim: To investigate the effect of different starchy foods varying in their GI, on acute changes in dental plaque pH. Methods: In a series of sub-studies in healthy adults, common starchy carbohydrate foods, including white bread, instant mashed potatoes, canned chickpeas, pasta, breakfast cereals, white rice, and an oral glucose solution were consumed in fixed 25 g available carbohydrate portions. The change in dental plaque pH was assessed postprandially over 1 h and capillary plasma glucose was measured at regular intervals over 2 h. Results: Higher GI starchy foods produced greater acute plaque pH decreases and larger overall postprandial glucose responses compared to lower GI starchy foods (white bread compared with canned chickpeas: −1.5 vs. −0.7 pH units, p = 0.001, and 99 ± 8 mmol/L min vs. 47 ± 7 mmol/L min, p = 0.026). Controlling for other food factors (food form and nutritional composition), lower GI versions of matched food pairs produced smaller plaque pH excursions compared to higher GI versions of the same food. Using linear regression analysis, the GI value of starchy carbohydrate foods explained 60% of the variation in maximum plaque pH nadir and 64% of the variation in overall acute dental plaque pH excursion (p < 0.01). Conclusion: The findings imply that starchy foods, in particular those with a higher GI, may play a role in increasing the risk of dental caries.