The role of sucrose incorporated into milk on biofilm formation, pH change, and enamel demineralization

Backgroud: While breastfeeding is endorsed for the overall health of infants and reduces the hazard of developing various illnesses, spontaneous breastfeeding should be considered a contributing element in the growth of early childhood caries (ECC). This investigation evaluated the effects of sucrose combined with milk on biofilm formation, pH change, and enamel demineralization. Methods: Biofilm formation and pH change of in vitro medium with human milk (HM), bovine milk (BM), and infant formula (IF) were measured with/without the presence of 10% sucrose and/or Streptococcus mutans (S. mutans). Enamel areas were made on extracted permanent molars and incubated using milk specimens. Demineralization of enamel and progression of caries were evaluated histologically after two weeks. Results: HM had less biofilm formation than BM and IF. However, adding 10% sucrose and S. mutans augmented biofilm formation in all three milk types. Sweetened HM exhibited the most significant change in pH and the most severe progression of carious lesions into the enamel. Enamel lesion depths were increased and pH was more acidic under a high load of sucrose and S. mutans. Conclusions: In conclusion, HM is recommended for health and reducing the threat of disease, but spontaneous breastfeeding after introducing additional nutritional carbohydrates is a risk factor for EEC.

Milk; Sucrose; Streptococcus mutans; Biofilm; Enamel demineralization

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