Although a high intake frequency increases the overall
length of time that the teeth are exposed to sugars, it does
not give complete information on the total time of exposure.
The total cariogenic load is also determined by the form
of the food product; that is, the physical consistency of the
sugar-containing foods affects their retention time in the
mouth. Distinctions can be made between liquids that are
cleared rapidly and adhesive (sticky) foods that vary widely
in retentiveness. Particularly high retention rates have been
found for products such as sweet biscuits, crackers, and
potato chips (crisps) [24]. Other aspects of intake pattern
are also believed to be of importance. The sequence of
eating a cariogenic food product during a meal or snack
can alter its cariogenic properties. Both cheese and peanuts
can reduce the acid production after a previous intake of
sucrose-containing foods. Conversely, starches can increase
the cariogenic properties of sugars if they are consumed
at the same time. The stickiness of starch enhances the
retention time of sugars, resulting in a prolonged pH fall,
as occurs in breakfast cereals with added sugars. Another
important issue that is difficult to account for in determining
the relationship between the dietary intake and caries is that
many food products contain hidden sugars. Examples of such
sugar-containing products may vary from one country to
another. It is not obvious to most people that sugars may be a
major constituent in products such as marmalade, breakfast
cereals, flavored crisps (chips), caviar, ketchup, and, in many
countries, bread.Thus, just focussing on confectioneriesmay have little impact on reducing caries activity if an
individual is exposed to many other sugary products per day
[8].