The cariostatic potential of cheese: cooked cheese-containing meals increase plaque calcium concentration P. J. Moynihan, S. Ferrier, and G. N. Jenkins Br Dent J 1999; 187: 664–667


The concept of protective foods is particularly resonant at this moment, with evidence of the beneficial effects of anti-oxidants against cancers and heart disease giving rise to (sometimes exaggerated) claims for the benefits of red wine, olive oil and greens to name the most popular examples. In oral health, particularly caries, protective effects have been attributed without justification to foods which were believed to remove plaque — apples, celery etc. However, the largest body of evidence relates to the protective actions of milk products. These include protection of the enamel by casein phospho-peptides, stimulation of salivation by flavoured cheeses, reduction of plaque formation by milk lipids, and enhancement of plaque calcium levels — which by opposing enamel dissolution acts to reduce demineralisation and enhance remineralisation. These beneficial actions have been demonstrated in in situ cariogenicity tests, and clinical surveys have shown an association between low caries prevalence and consumption of milk products, including cheese.

This paper provides further evidence for the incorporation of calcium from cheese into plaque. Such an effect had been shown previously when cheese was eaten after a snack intake (when it would be considered to be most protective), but here the effect is also shown when the cheese was present in cooked form as part of a meal (pasta with cheese sauce, or chicken filled with cheese and ham). The uptake of calcium was not however statistically related to the calcium content or concentration in the food — the chicken dish had less calcium in it than a pasta dish with mushroom sauce which did not elevate plaque calcium — suggesting that there is some feature of the calcium in cheese which specifically promotes its uptake into plaque.

It is suggested that in oral health promotion, offering positive advice about protective foods is likely to be better received by those who are most at risk for caries than negative advice to reduce sugar consumption, and this study provides a basis for such positive recommendations. Further clinical studies are required to confirm the data.