European Archives of Paediatric Dentistry

, Volume 14, Issue 5, pp 289–300 | Cite as

Cariogenic potential of milk and infant formulas: a systematic review

  • J. AarthiEmail author
  • M. S. Muthu
  • S. Sujatha



To assess the cariogenic potential of cow’s milk, human milk and infant formulas in comparison to sucrose in animal models.


Electronic search of the following databases were undertaken: PubMed–MEDLINE, MeSH and ingentaconnect. In addition, the reference lists of all eligible studies were searched. Characteristics such as animal species were used; comparisons and outcomes measured were analysed.


The search yielded a total of 13 articles of which six studies met the inclusion criteria and seven were excluded. All the six included studies used rat models for assessing the cariogenic potential of the test groups. Cow’s milk was compared with sucrose in all of the six studies, reporting cow’s milk to be less cariogenic than sucrose. Two studies compared human milk to sucrose and reported human milk to be less cariogenic than sucrose, but more than that of cow’s milk. Although infant formulas were compared with sucrose in four studies, their cariogenic potential was a matter of some ambiguity.


The evidence suggests that cow’s milk and human milk are less cariogenic than sucrose, with cow’s milk being the least cariogenic. The cariogenic potential of infant formulas varied across the studies, with some being as cariogenic as sucrose.


Dental caries Milk Infant formulas Animal models 



This paper was presented at the 25th ISDR-IADR (INDIA CHAPTER) International conference. Sincere thanks to Dr. Divya Srinivasan and Dr. Jayakumar of Hongkong University for their relentless help to retrieve the papers. We also thank Dr. Anuradha Kuppan for her support throughout the preparation of the manuscript. This systematic review was self-funded. We certify that that we had no affiliations with any organisation or firm, involved in the subject of this review and hence free of conflict of interest.


  1. American Academy of Pediatrics Work Group on Breastfeeding. Breastfeeding and the human milk. Pediatrics. 1997;100:1035–9.CrossRefGoogle Scholar
  2. Berkowitz RJ, Turner J, Hughes C. The microbial characteristics of the human dental caries associated with prolonged bottle-feeding. Arch Oral Biol. 1984;29:949–91.PubMedCrossRefGoogle Scholar
  3. Bowen WH, Amsbaugh SM, Monell-Torrens S, et al. A method to assess cariogenic potential of foodstuffs. J Am Dent Assoc. 1980;100:677–81.PubMedGoogle Scholar
  4. Bowen WH, Pearson SK. Influence of milk, lactose-reduced milk, and lactose on caries in desalivated rats. Caries Res. 1991;25:283–6.PubMedCrossRefGoogle Scholar
  5. Bowen WH, Pearson SK. Effect of milk on cariogenesis. Caries Res. 1993;27:461–6.PubMedCrossRefGoogle Scholar
  6. Bowen WH, Pearson SK, Rosalen PL, Miguel JC, Shih AY. Assessing the cariogenic potential of some infant formulas, milk and sugar solutions. J Am Dent Assoc. 1997;128:865–71.PubMedGoogle Scholar
  7. Bowen WH, Lawrence RA. Comparison of the cariogenicity of cola, honey, cow milk, human milk and sucrose. Pediatrics. 2005;116:921–6.PubMedCrossRefGoogle Scholar
  8. Erickson PR, McClintock KL, Green N, LaFleur J. Estimation of the caries-related risk associated with infant formulas. Pediatr Dent. 1998;20:395–403.PubMedGoogle Scholar
  9. Erickson PR. Mazhari. Investigation of the role of human breast milk in caries development. Pediatr Dent. 1999;21:86–90.PubMedGoogle Scholar
  10. Green RM. A comparison in the rat of the cariogenicity of defined high sucrose diets containing either casein or skimmed milk powder as the source of dietary protein. Helv Odontol Acta. 1967;11:32–6.PubMedGoogle Scholar
  11. Grenby TH, Mistry M. Precise control of the frequency and amount of food provided for small laboratory animals by a new electronic metering technique, used to evaluate the cariogenic potential of chocolate. Caries Res. 1995;29:418–23.PubMedCrossRefGoogle Scholar
  12. Hallett KB, O’Rourke PK. Early childhood caries and infant feeding practice. Community Dent Health. 2002;19:237–42.PubMedGoogle Scholar
  13. Harper DS, Osborn JC, Clayton R, Hefferren JJ. Modification of food cariogenicity in rats by mineral-rich concentrates from milk. J Dent Res. 1987;66:42–5.PubMedCrossRefGoogle Scholar
  14. Isaksen MA. Medical corner-SDA virus-sialodacryoadenitis virus in pet rats. (1998).
  15. Keyes PH. Dental caries in the molar teeth of rats. II. A method for diagnosing and scoring several types of lesions simultaneously. J Dent Res. 1958;37:1088–99.PubMedCrossRefGoogle Scholar
  16. Kite OW, Shaw JH, Sognnaes RF. The prevention of experimental tooth decay by tube-feeding. J Nutr. 1950;42:89–105.PubMedGoogle Scholar
  17. Lange A, Hammarström L. Cell sizes and apposition of dental hard tissues in rats. Acta Odontol Scand. 1984;42:215–23.PubMedCrossRefGoogle Scholar
  18. Larson RH. Merits and modifications of scoring rat dental caries by Keyes’ method. In: Tanzer JM editors. Proceedings “symposium on animal models in cariology”. Washington, DC, Information Retrieval, Spec Suppl. Microbiology Abstracts, 1981. pp 195–203Google Scholar
  19. Lim S, Sohn W, Burt BA, et al. Cariogenicity of soft drinks, milk and fruit juice in low-income african-american children: a longitudinal study. J Am Dent Assoc. 2008;139:959–67.PubMedGoogle Scholar
  20. MacKeown JM, Faber M. Frequency of consumption of cariogenic food items by 4-month-old to 24-month-old children: comparison between two rural communities in in KwaZulu-Natal, South Africa. Int J Food Sci Nutr. 2005;56:95–103.PubMedCrossRefGoogle Scholar
  21. Peres RC, Coppi LC, Franco EM, et al. Cariogenicity of different types of milk: an experimental study using animal model. Braz Dent J. 2002;13:27–32.PubMedGoogle Scholar
  22. Peres RC, Coppi LC, Volpato MC, et al. Cariogenic potential of cows’, human and infant formula milks and effect of fluoride supplementation. Br J Nutr. 2009;101:376–82.PubMedCrossRefGoogle Scholar
  23. Reynolds EC. The prevention of sub-surface demineralization of bovine enamel and change in plaque composition by casein in an intra oral model. J Dent Res. 1987;66:1120–7.PubMedCrossRefGoogle Scholar
  24. Rollema HS. Casein association and micell formation. In: Fox PF editors Advanced dairy chemistry: proteins. London: Elsevier Applied Science; 1992. vol 1, pp 111–140Google Scholar
  25. Rugg-Gunn AJ, Roberts GJ, Wright WG. Effect of human milk on plaque pH in situ and enamel dissolution in vitro compared with bovine milk, lactose, and sucrose. Caries Res. 1985;19:327–34.PubMedCrossRefGoogle Scholar
  26. Saravanan S, Madivanan I, Subashini B, Felix JW. Prevalence pattern of dental caries in the primary dentition among school children. Indian J Dent Res. 2005;16:140–6.PubMedCrossRefGoogle Scholar
  27. Seow WK. Biological mechanisms of early childhood caries. Commun Dent Oral Epidemiol. 1998;26:8–27.CrossRefGoogle Scholar
  28. Shantinath SD, Breiger D, Williams BJ, Hasazi JE. The relationship of sleep problems and sleep-associated feeding to nursing caries. Pediatr Dent. 1996;18(5):375–8.PubMedGoogle Scholar
  29. Shaw JH. Influence of experimental diets on carious lesions in the occlusal sulci and on the smooth surfaces of the molars of caries-susceptible rats. J Dent Res. 1973;52:291–299.PubMedCrossRefGoogle Scholar
  30. Shaw JH. A summary of the relationship of dietary carbohydrates to experimental dental caries. In: Tanzer JM editor. Proceedings “Symposium on animal models in cariology”. Spec Suppl. Microbiology Abstracts; 1981. pp 287–297.Google Scholar
  31. Sheikh C, Erickson PR. Evaluation of plaque pH changes following oral rinse with eight infant formulas. Pediatr Dent. 1996;18:200–4.PubMedGoogle Scholar
  32. Stookey GK. Effect of diet consistency in assessing the cariogenic potential of presweetened cereals in rats. J Dent Res. 1978;57:730.PubMedCrossRefGoogle Scholar
  33. Tinanoff N, O’Sullivan DM. Early childhood caries: overview and recent findings. Pediatr Dent. 1997;19:12–6.PubMedGoogle Scholar
  34. Vacca-Smith AM, Bowen WH. The effect of milk and kappa casein on streptococcal glucosyltransferase. Caries Res. 1995;29:498–506.PubMedCrossRefGoogle Scholar
  35. Valaitis R, Hesch R, Passarelli C, Sheehan D, Sinton J. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health. 2000;91:411–7.PubMedGoogle Scholar
  36. Westover KM, Diloreto MK, Shearer TR. The relationship of breast feeding to oral development and dental concerns. ASDC J Dent Child. 1989;56:140–3.PubMedGoogle Scholar

Copyright information

© European Academy of Paediatric Dentistry 2013

Authors and Affiliations

  1. 1.Department of Pediatric Dentistry, Saveetha Dental CollegeSaveetha UniversityChennaiIndia
  2. 2.Department of Pediatric Dentistry, Sri Ramachandra Dental CollegeSri Ramachandra UniversityChennaiIndia
  3. 3.ChennaiIndia

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