Published online September 30, 2005
PEDIATRICS Vol. 116 No. 4 October 2005, pp. 921-926 (doi:10.1542/peds.2004-2462)
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Comparison of the Cariogenicity of Cola, Honey, Cow Milk, Human Milk, and Sucrose

William H. Bowen, BDS, PhD* and Ruth A. Lawrence, MD{ddagger}

* Center for Oral Biology
{ddagger} Department of Pediatrics, University of Rochester, Rochester, New York

Objective. The purpose of this study was to determine and compare the cariogenicity of various fluids that are frequently fed to infants and toddlers. We chose to examine sucrose, cola drink, honey, human milk, cow milk, and water because some of these have been associated with development of early childhood caries, although direct experimental evidence is lacking.

Methods. We used our desalivated rat model because the approach mimics the situation found in infants, whereby the flow of saliva is interrupted through mechanical effects of a nipple. The animals received basic nutrition by gavage, and the fluids being tested were available ad libitum. Thus, the only substances that came in contact with teeth were the test fluids. The investigation continued for 14 days.

Results. Cola, sucrose, and honey were by far the most cariogenic. In addition, cola and honey induced considerable erosion. Human milk was significantly more cariogenic than cow milk probably because of its lower mineral content and higher level of lactose.

Conclusions. Our data show that the use of honey, cola, and sucrose water in nursing bottles should be discouraged. Although human milk is more cariogenic than cow milk, it is no more cariogenic than are common infant formulas. Protracted exposure to human milk or formula through allowing an infant to sleep on the nipple should be discouraged, and the need for oral hygiene after tooth eruption should be emphasized.

Key Words: dental caries • infants • toddlers • drinking fluids

Abbreviations: ECC, early childhood caries

Accepted Jan 13, 2005.


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