PRESENTED BY: SOR2

SESSION OVERVIEWSTUDY TITLEINTRODUCTIONOVERVIEW OF INDIAN BISCUIT INDUSTRYAIMS & OBIECTIVES OF STUDYPURPOSE OF STUDYMATERIAL AND METHODSRESULTSCONCLUSION

STUDY TITLE

COMPARATIVE EVALUATION OF THE EFFECT OF DIFFERENT COMMERCIALLY AVAILABLE BISCUITS ON PLAQUE pH: A

CLINICAL TRIAL

The concept of health has prevailed for

centuries and dietary habits are apparently

changing with modernization . With improved socioeconomic status and busy modern life of families, there has been an increased intake of readymade food with fermentable carbohydrates among the masses.

Among all commercially available refined carbohydrates biscuits have become one of the most loved fast food products for every age group specially children as

it is easy to carry, tasty to eat, and reasonable at cost.

OVERVIEW OF INDIAN BISCUIT INDUSTRY

India Biscuits Industry came into limelight and started gaining a sound status in the later part of 20th century when the urbanized society called for ready made food products at a tenable cost.

05/01/2023 8

Industry Research

• Of the people who consume biscuits 25% people prefer cream biscuits,

• 12% prefer wafer biscuits,• 34% prefer sweet plain

biscuits and• 29% of people prefer

namkeen or salty biscuits.

Source:- Indian Biscuit Manufacturers’ Association (IBMA),2011

05/01/2023 9

Industry Research• The number of people

who eat biscuits include 37% of people who eat them everyday,

• 29% eat twice a week, • 14% eat four times a week, • 8% eat once in 15 days, • 6% eat once in 10 days and

once in a month.

Source:- Indian Biscuit Manufacturers’ Association (IBMA,2011)

It is widely accepted that all foods containing “fermentable

carbohydrates” have the potential to contribute to caries formation.There are different methods for

evaluating cariogenic potential of foods and drinks . One of them is

Acidogenicity assessment of consumed food.

CHOICE OF STUDY METHOD

Measuring the decrease in

dental plaque pH after

exposure to fermentable

carbohydrates is the basis of

plaque pH studies.

Acidogenicity tests measure

plaque responses and are the only

indirect tests of

cariogenicity.

In general, plaque pH

studies have excellent

reproducibility, but they are expensive and

complex.

‘Strip method’ is inexpensive

and easy to handle, may be applicable

for assessment of

plaque acidogenicity in the clinic

The majority of plaque pH studies have compared one

type of biscuit or cookies with the other commonly consumed

products with refined carbohydrates and assumptions were made about their relative

cariogenicity.There are no available studies

evaluating and comparing cariogenic potential among

biscuits having different composition.

AIM OF THE STUDY

ASSESS THE EFFECT OF FIVE VARIETIES OF COMMERCIALLY

AVAILABLE BISCUITS WITH DIFFERENT CONTENT ON

PLAQUE pH AT DIFFERENT TIME INTERVAL AMONG 6- 11

YEARS OF CHILDREN.

OBJECTIVES• To estimate the endogenous pH of five

different commonly consumed biscuits.

• To assess the effect of these test biscuits on plaque pH at various time intervals

• To compare between the biscuits for their effect on plaque pH.

LIST OF ARMAMENTARIUM• Mouth mirror, Explorer, Spoon excavator• Gloves ,Face mask• Test tube , Test tube racks• Distilled water• Pipette , Stirrer• Merck universal pH indicator paper

Five types of sample biscuits

ARMAMENTARIUM

Cream biscuit Plain sweet biscuit

Chocolate biscuit Salty biscuit Oat biscuit

STUDY AREA

STUDY SAMPLE

STUDY DESIGNHealthy children with an age range 6 to 11

years ,caries free , with presence of permanent molars and incisors. The consent of the principal,

parents of the study sample and institutional ethical clearance was obtained.

Subjects with caries , restored tooth ,missing molars and incisors were excluded. The volunteers

were asked to refrain from oral hygienic procedures for 48 hours and from having food or

drinks for at least 2 hours prior to the procedure.

On the examination day, the groups were allocated randomly for 5 different test biscuits.Each group contain 10 subjects except the last group having 11 subjects and the intrinsic pH of the test biscuits was measured by the MERCK pH INDICATOR PAPER

Plaque was collected at the baseline with a spoon excavator

from all accessible surfaces of the upper central incisors, the buccal surfaces of the upper first molars, the lingual surfaces of the lower

molars and the incisors. The collection was done within a period

of 30 – 60 seconds.

Subjects were asked to consume the test biscuit in

two minutes and to chew the biscuit carefully around the

teeth before swallowing in order to maintain a uniform method in

eating

Post consumption, the plaque samples were collected at baseline and at 5, 10, 15,20 and

30 minutes and the pH was estimated.

The sample was pooled in 5ml of distilled water and was kept in a test tube and the

pH was determined immediately after collection using a pH strip immersed into the

tube.

Post consumption plaque sample collection

Plaque pH measurement

Plaque pH at different time interval

After the collection of the last sample, the subjects were allowed to brush and a 3 day wash out period was given, after which a similar experiment as detailed above, was

done for the next test biscuit.

RESULT OF THE STUDY

This was a observational study. Total number of subjects in this study was 51 with power 81%. Subjects were randomly chosen from a school of Kolkata during the period MAY 2013 to JUNE 2013

STATISTICAL ANALYSIS

Statistical Analysis was performed with help of Epi Info (TM) 3.5.3. EPI INFO is a

trademark of the Centers for Disease Control and Prevention (CDC). Using this software

basic cross-tabulation was performed. Descriptive statistical analysis was

performed to prepare different frequency tables and to calculate the means with

corresponding standard deviations. t-test was used to compare the means. p≤0.05 was taken to be statistically significant.

Mean ± S.D. pH of plaque after intake of commercially available biscuits at different time interval among 6-11 years of children

Type of biscuit

Baseline After eating

Before eating Immediate 5 minutes 10 minutes

15 minutes

20 minutes

30 minutes

Salty biscuit 6.33±0.21 6.11±0.34 5.23±0.19 5.28±0.47 5.82±0.16 6.24±0.26 6.16±0.28

Chocolate biscuit 6.50±0.54 6.31±0.89 5.83±0.98 5.66±0.81 6.91±0.82 6.33±0.81 6.20±0.54

Oat biscuit 6.11±0.27 6.00±0.64 5.01±0.44 5.23±0.63 5.72±0.16 6.17±0.43 6.02±0.03

Cream biscuit 6.60±0.54 6.27±0.70 5.40±0.54 5.42±0.55 6.60±0.89 6.31±0.71 6.50±1.09

Marie biscuit 6.46±0.42 6.20±0.25 5.04±0.31 5.27±0.82 5.66±0.42 6.22±0.73 6.08±0.11

t-test showed that mean pH was significantly higher for cream biscuit after eating than that of others (p<0.01). But there was no significant difference between the mean pH of cream and chocolate biscuits after eating (p>0.05). For oat biscuit the mean pH was significantly lower than that of others (p<0.01). Significant decrease was observed at 5 minute after eating for oat biscuits. Also no significant difference was observed between oat and marie biscuit at 5 minute after eating (p>0.05).

Maximum pH was observed for chocolate and cream biscuits at 30 minutes after eating which was statistically significant (p<0.05).

Mean pH of plaque after intake of commercially available biscuits at different time interval among 6-11 years of children

4.00

4.50

5.00

5.50

6.00

6.50

7.00

7.50

Beforeeating

Immediate 5 minutes 10 minutes 15 minutes 20 minutes 30 minutes

Time Interval

pH

Salty biscuit Cream biscuit Oat biscuit Chocolate biscuit Marie biscuit

0

1

2

3

4

5

6

7

pH

Time Interval

Mean pH of plaque after intake of Cream Biscuit at different time interval among 6-11 years of children

0

1

2

3

4

5

6

7

pH

Time Interval

Mean pH of plaque after intake of Chocolate Biscuit at different time interval among 6-11 years of children

0

1

2

3

4

5

6

7

pH

Time Interval

Mean pH of plaque after intake of Oat Biscuit at different time interval among 6-11 years of children

0

1

2

3

4

5

6

7

pH

Time Interval

Mean pH of plaque after intake of Salty Biscuit at different time interval among 6-11 years of children

0

1

2

3

4

5

6

7

pH

Time Interval

Mean pH of plaque after intake of Maire Biscuit at different time interval among 6-11 years of children

DISCUSSION

• It is now clear that sucrose is not the only dietary contributor to dental decay

• Many other sugars, whether refined in the form of sweets and confection or occurring

naturally in fruits and juices are equally cariogenic

• The substrate that causes a prolonged acidic pH is more detrimental to teeth than its sugar

content alone.

• Oat biscuit was found to have a least drop in plaque pH and found to be least cariogenic

• Cream biscuit was found to have a maximum pH drop , making it most cariogenic.

CONCLUSIONDiet has an important role in prevention of dental caries. Our target should be customized dietary

modifications rather than dietary restrictions and result of present study will help in the process.

It is mandatory for us as preventive dentists, to provide appropriate diet counseling which is

tailored for a particular individual to maximize the compliance.

“To eat is a necessity, but to eat intelligently is an art."

- La Rochefoucauld

05/01/2023 41

REFERENCES www.google.com www.mofi.nic.in www.fbmi.in www.economictimes.com www.yahoo.com www.britannia.com www.parle-producuts.in

QUESTION ??????????

?