Processed starch snack products (PSSPs) and dental caries: a narrative review

Abstract

Aim: The consumption of processed starch snack products (PSSPs) has become widespread, raising concerns about their overconsumption and potential impact on overweight-related diseases including dental caries. This narrative review aims to evaluate the evidence linking PSSPs and caries focusing on Japanese PSSPs.

Materials and Methods: We conducted a search in our personal libraries and updated our collection with articles published within the last 20 years that met the predetermined inclusion criteria for a systematic search. In total, we summarised 75 articles.

Results: This review outlined the structure, types, dietary sources and metabolism of starch and discussed the cariogenicity of PSSPs, along with methods for evaluating it and behavioural factors influencing dental caries, such as the frequency and timing of consumption. The cariogenicity of PSSPs was categorised into three aspects: bioavailability, retentive properties and consumption frequency. Studies have demonstrated that combinations of starch and sugar, often found in many PSSPs, exhibited a higher cariogenic potential compared with sugar alone. As dental caries is a complex condition influenced by multiple factors, all of which depend on the individual, the dietary factor itself is also multifactorial and it was divided into two main factors: product and individual related. The latter factor (i.e. how you eat) is more important. For this reason, recent changes in Japanese eating habits, with an increasing preference for PSSPs and a prevalence of unhealthy eating behaviours, may have a negative impact on oral health. In addition, marketing portrays PSSPs as convenient, tasty and quick sources of energy, occasionally adding seemingly healthy ingredients but promoting demineralisation and erosion.

Conclusion: PSSPs are associated with dental caries due to their high bioavailability, long retention on teeth and high palatability. Japanese dental hygienists need to control the caries risk comprehensively and provide patient education on how PSSPs affect overweight-related diseases including dental caries.