Nutrition & Oral Health
Everyone appreciates a great smile, after all, that’s what we show the world. It affects our self-esteem and ability to socialize. But those pearly whites are not just for show, and many of us underestimate the impact teeth have on our overall health and nutrition, and vice versa.
There are no ifs, ands, or buts about it, oral health is a huge part of our general health and a well-balanced
nutritionally adequate diet is essential for oral and general health maintenance — throughout life.
While teeth develop with a strong and protective outer coating of enamel, they are not immune to the ravages of disease and wear. Tooth decay is one of the most common diseases known to man and is responsible for untold pain, suffering, and tooth loss. Diet plays a major role in tooth development, dental caries (tooth decay), dental (acid) erosion, and even wear.
What’s more, scientific evidence overwhelmingly proves that the same sugars that cause dental decay also contribute to obesity and metabolic syndrome — the leading cause of death in the US and first world countries.
Oral Changes As We Age
The impact of diet on oral health begins in the womb and a pregnant woman’s nutrition choices impact tooth development. However, the child’s own diet immediately following eruption of the teeth is much more important. Deciduous (baby) teeth are most susceptible to decay soon after they erupt from 3-6 months of age, as are permanent (adult) teeth, which begin erupting from 6-7 years of age. However, the effect of diet on tooth decay is life long.
Older age groups are also at increased risk; mouth dryness, for example, due to lack of saliva (caused by many medications) predisposes to tooth decay. Tooth loss hampers their ability to eat, thrive, and enjoy life. As people are living longer, tooth decay rates are increasing. It is clear that more attention needs to be paid to diet and dental care in our later years.
Sugars And Decay: The Good, The Bad, And The Ugly
Sugars are the main culprit when it comes to dental decay. Bacteria in your mouth produce organic acids from dietary sugars that concentrate in dental plaque, the sticky whitish film that collects on surfaces of our teeth. When sugars are ingested, there is an increase in acidity, which causes dissolution of the enamel and dentin of the teeth leading to cavities.
Our modern diet contains a mix of sugars and oral bacteria can ferment all of them with more or less equal ability, with the exception of lactose (milk sugar) from which less acid is produced. However, it is important to remember that there are many varieties of sugars and the form and frequency in which they are ingested impacts oral and general health.
High Sugar/Low Fiber Diets: Refined or processed sugars are derived from two main sources: sugar cane or beets yield sucrose, the scientific name for what we know as sugar. The other big source is corn, which when processed yields high fructose corn syrup. Both these forms of sugar are devoid of nutrients. When added to our diets, they are referred to as “processed, added, or free sugars.” As you’ll see, they turn up in cake, candy, cereals, cola, cookies, and a lot more. Large quantities of either sucrose or fructose in the diet are highly cariogenic (decay-causing) and also contribute to obesity.
High Fiber/Low Sugar Diets: All plants produce simple sugars, known as “natural” sugars, the products of photosynthesis — sunlight acting on green leaves. Fruits and vegetables contain glucose, fructose, and sucrose, which are digested and/or absorbed slowly and more efficiently due to their fiber content. They also contain vitamins and minerals, which can only be properly absorbed in this form. Consuming more fresh fruits and vegetables instead of free sugars is likely to decrease decay and promote health.
Starches constitute a very diverse food group, which vary in botanical origin. They may be highly refined and consumed in their natural state, raw, or cooked (peas, bananas, beans). Whole grains have properties that protect teeth. They require more chewing and thereby stimulate secretion of protective saliva. Cooked or uncooked staple starchy foods such as rice, potatoes and bread have low decay producing potential. When sugars are added to already starchy foods, the potential for decay increases significantly.
Fruits do not play a significant role in dental decay unless consumed in excess. Dried fruit, on the other hand, may be more cariogenic due to a high sugars content and sticky nature. Some dried fruits contain sugars that are added during processing.
A New Bottom Line For Health
Soft drinks, sodas, fruit juices, and sport drinks represent the single largest source of sugars consumption in the US. Data from the Centers for Disease Control and Prevention (CDC) cites that half of the US population consumes a sugars-sweetened beverage on any given day and on average, sugary drinks provide 103 and 178 calories per day for females and males respectively. Data from the National Health And Nutrition Examination Survey (NHANES) in the US shows that on average children obtain between 13-17%, and adults almost 12% of their calorie intake from added sugars (excluding free sugars from fruit juices), which exceeds the current World Health Organization (WHO) guidelines.
WHO has made a strong recommendation that free sugars should not provide more than 10% of calorie intake and further suggested that limiting intake of free sugars to no more than 5% of calories (approximately 3 teaspoons for a child and 6 for an adult) would confer further health benefits.
Oral Hygiene, Sugar Substitutes, And Fluoride
The fight against dental decay starts with effective oral hygiene practices, which include brushing and flossing. Other methods of tooth cleaning such as eating fibrous foods, apples, and carrots will not cleanse the tiny pits, fissures and contact areas of adjacent teeth where decay begins, but are healthier than eating sugary snacks that stick to the teeth providing reservoirs for acid production.
Fluoride provides a vital topical protective effect. When fluoride is incorporated into tooth enamel, it makes it more resistant to acid dissolution and therefore decay. Brushing with fluoride toothpaste is the most important way of getting fluoride into the surfaces of teeth.
Even in this modern fluoridated world, individuals with a high level of free sugar intake (>10% energy intake) and a high frequency of sugar consumption (>1-2 times per day) are at increased risk of decay.
Xylitol, a natural plant “sugar alcohol,” chemically similar to sugar has proven a useful adjunct in controlling tooth decay by replacing sugars and stopping acid production in bacteria. Scientific evidence attests to the fact that chewing xylitol-sweetened gum, mints, or candy (without sugars) stimulates saliva flow which helps protect against decay.
Diet And Dental Erosion
Tooth erosion leads to a progressive irreversible loss of tooth structure that is chemically etched away from tooth surfaces by acid. It is another ever-increasing problem in industrialized countries. It results from the increased ingestion of acidic beverages — soft drinks, fruit juices, sodas, and sports drinks. Not only are they high in sugars content, but are also very acidic — even the diet drinks. Extrinsic acids contained in these beverages when consumed frequently, once or more a day, can cause erosion. Any acidic drink even if mildly acidic may initiate it.
Intrinsic acids, which are produced by the body, cause dental erosion following vomiting, regurgitation, or reflux, and can be extremely damaging to the teeth. Gastro-Esophageal Reflux Disease (GERD) is now a recognized cause of tooth erosion from hydrochloric (stomach) acid. It is responsible for the extensive erosion of teeth seen in conditions like bulimia and anorexia where reflux is common and constant.
Overzealous oral hygiene and grinding habits can also worsen dental erosion. Brushing your teeth after consuming an acidic product, before the saliva has had a chance to buffer (neutralize) the acid and re-mineralize the tooth surface, will actually cause the removal of the softened enamel.
Foods That Protect Against Decay
Cheese: Consuming cheese after a sugary snack prevents increase in acidity. Cheese stimulates saliva and is rich in calcium influencing the balance of re-calcifying teeth and protecting against loss of calcium.
Cow’s Milk: Contains lactose, which is less acid producing than other sugars and does not promote decay as readily. In addition, it also contains calcium, phosphorus, and casein, all of which help stop decay. However bottle-feeding milk at night can cause decay.
Human Breast Milk: Contains 7% lactose and is lower in calcium and phosphate. It generally does not initiate decay except in cases of high frequency nighttime feeding and prolonged on demand feeding.
Plant Foods: Are fibrous and protect teeth by mechanically stimulating saliva. Peanuts, hard cheeses, and gum that contains xylitol can act the same way.
Black & Green Teas: Are particularly rich in polyphenols and flavonoids, which are complex antioxidant compounds found in many plant foods. The fluoride in black tea may also protect against decay.
Chocolate: There is some evidence that cocoa in an unrefined form (without added sugars) may have some anti-decay potential due to polyphenolic compounds present, but processed chocolate is too high in sugar to be good for the teeth.
Looking after your teeth is important if you want them to last a lifetime! Sticking to a nutritionally sound diet that is low in free sugars, high in fiber — lots of fruits and vegetables — and drinking plenty of water (preferably fluoridated) will safeguard your oral and dental health as well as your general health and well-being.
source: deardoctor.com website