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Human Intervention Studies

These are the classic type of studies used in the pharmaceutical industry in which a group(s) of people are observed closely over a period of time under controlled circumstances to determine the development or absence of disease, and whether a drug is effective or not. While they are carried out every day in medicine, for many years they have not been allowed in dental research on foods and diets. One cannot deliberately instigate dental caries, purely for experimental purposes. For this reason, there has been only one proper study. Known as the Vipeholm Study (6), it remains the only intervention study involving chocolate in a human population. It plays a major role in any consideration of diet and dental caries.

The Vipeholm project involved over 436 inmates of an institution for the mentally retarded. Over a study period of several years, groups of adult subjects were given dietary supplements, either as between-meals snacks or added to meals. The caries incidence was monitored and relationships between caries increment and dietary supplement assessed. All three of the candy-eating (confectionery) groups developed more cavities than the no-candy groups. The greatest incidence was found in the group that used toffees most frequently. The group of subjects receiving additional chocolates between meals had a lower incidence (Fig. 13.1). The chocolate group had a lower caries increment than the group of inmates using caramels between meals. The highest caries increment occurred in those subjects using 24 caramels between meals. The chocolate group therefore ranked midway between the highest and lowest caries groups.

There have been no other intervention studies in which chocolate was specifically used in a test group of individuals. In the Turku xylitol study (7), some 200

Vipeholm Study

Relationship of dental caries increment and clearance time of snack foods used by various groups of subjects in the Vipeholm Study (6).

Relationship of dental caries increment and clearance time of snack foods used by various groups of subjects in the Vipeholm Study (6).

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