Vipeholm experiments

Introduction

This experiment was conducted by Gustafsson et al. in 1954. It was a 5 year investigation of 436 adult inmates in a mental institution at Vipeholm Hospital near Lund, Sweden. The main purpose of the study was to investigate how the caries activity is influenced by:

• By ingestion at meals refined sugar (non-sticky form)
• By ingestion at meals of sugar (sticky form)
• By ingestion between meals of sugar (sticky form)

Study Design

The design of the study divided the inmates in 7 groups:

1. A control group.
2. A sucrose group (300gms of sucrose given in solution, but reduced to 75gms during the last 2 years).
3. A bread group (345gms of sweet bread containing 50gms of sugar daily).
4. A chocolate group (65gms of milk chocolate daily between meals during last 2 years).
5. A caramel group (22 caramels = 70gms of sugar in 4 portions between meals).
6. An 8 toffee group (8 sticky toffees = 60gms of sugar daily for 3 years).
7. A 24 toffee group (24 sticky toffees = 120gms of sugar for 18 months).

Conclusion

• An increase in carbohydrate (mainly sugar) definitely increases the caries activity.
• The risk of sugar increasing caries is greater if the sugar is consumed between meals.
• The risk of sugar increasing caries is greater if the sugar is consumed in a form that will be retained on the surfaces of the teeth.
• The increase in caries activity varies widely between individuals.
• Upon withdrawal of caries rich foods, the increased caries activity rapidly disappears.
• Caries lesions may continue to appear despite the avoidance of refined sugar and maximum restrictions of natural sugars dietary carbohydrates.
• A high concentration of sugar in solution and its prolonged retention on tooth surfaces leads to increased caries activity.
• The clearance time of sugar correlates closely with caries activity.
• The study showed that the physical form is much more important in cariogenicity than the total amount of sugar ingested.

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