Acid-base Balance, Dentinogenesis and Dental Caries

High-sucrose diet and metabolic acidosis have some similar effects on bone and they both reduce the formation of dentine. This series of experiments was conducted in order to get information about the effects of acidosis and alkalosis on dentine during primary dentinogenesis and also to ascertain if high-sucrose diet affects dentine formation via acidosis. Chronic metabolic acidosis (0.25 mol/L of NH4Cl in drinking water), chronic metabolic alkalosis (0.25 mol/L of NaHCO3 in drinking water) and chronic respiratory alkalosis (atmospheric pressure equivalent to an altitude of 3000 m) were induced in the rats immediately after weaning for 6 and 7 weeks. One subgroup from each of the main groups was fed a high-sucrose (43%) diet and one a standard maintenance diet, each ad libitum. The control groups had the same diets, but normal drinking water and atmospheric pressure. All the rats were injected with tetracycline (to mark the onset of the experiment in dentine) and inoculated orally with Streptococcus sobrinus. The acid-base status was verified by blood gas analysis at the end of the experiments. After sacrifice, fissure caries was scored with Schiff reagent and the areas of dentinal lesions and tetracycline-marked new dentine were measured from sagittally sectioned mandibular molars. The mineral elements (Ca, Mg, F, Na, P and total mineral contents) of the dentine formed before and during the experiment were measured with an electron probe microanalyzer. With the high-sucrose diet, respiratory alkalosis and metabolic acidosis promoted the initiation and progression of caries while metabolic alkalosis slightly retarded it. With the standard diet, all the experimental conditions slowed the rate of dentine formation and metabolic acidosis had the most pronounced effect. The mineral analysis revealed a totally different pattern of mineralization when the rats with metabolic acidosis (increased calcium and total mineral content) were compared to the previously reported rats with a high-sucrose diet (decreased calcium and total mineral content). Besides this, metabolic alkalosis did not correct the effects of the dietary sucrose on dentine formation and blood gas analysis showed no acid-base disturbances in the sucrose diet group. Therefore, a high amount of sucrose in the diet slows the rate of dentine formation and reduces the ability of teeth to resist caries attack by mechanisms different from those of metabolic acidosis. Nevertheless, metabolic acidosis was found to be the most harmful state of disturbance in acid-base balance for the teeth of young rats, especially with a diet containing a high amount of sucrose.