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Nutrition & Oral Health

How Nutrition Impacts Oral and General Health

By Dr. Paula Moynihan

(Continued)

Fruit.

Fruits and Decay

There is little evidence that fruit is an important factor in development of decay unless consumed excessively. Dried fruit, on the other hand, may be more cariogenic (decay causing) since the drying process releases free sugars. Fresh fruit appears to have low ability to promote decay and even citrus fruits have not been found to cause tooth decay (but may cause dental erosion, which we will cover in the next section). It's important for us all to know that the more fresh fruit we consume instead of free sugars is likely to have a positive impact in decreasing decay.

Diet and Dental Erosion

Dental erosion is a progressive irreversible loss of tooth structure that is chemically etched (dissolved) away from the tooth surface by acid. This action does not involve bacteria. It is often associated with overzealous oral hygiene and grinding habits. Tooth erosion is caused by the over ingestion of acids (extrinsic acids) such as citric, phosphoric, ascorbic, malic, tartaric, and carbonic acids found in fruit juices, soft drinks (either carbonated or still) and some fruits if consumed frequently. Any acidic drink even if mildly acidic may initiate erosion. Intrinsic acids (those from inside the body), produce erosion following vomiting, regurgitation or reflux and can be extremely damaging to the teeth. A condition now known as GERD (gastro-esophageal reflux disease) is now a recognized cause of tooth erosion from stomach acids. One of the most potent and acidic of acids is hydrochloric acid from the stomach and it is responsible for the extensive erosion of teeth seen in conditions like bulimia and anorexia where reflux is common and constant.

Erosion is an ever-increasing problem in industrialized countries. The observed levels are thought to be largely due to increased drinking of acidic beverages — soft drinks. Brushing the teeth following consumption of an acidic product before the saliva has had a chance to buffer (or counteract) the acid, will enhance the removal of the softened enamel.

Recommendations to promote good oral and general health

  1. Eat a healthy diet and follow the recommendations of the USDA (www.mypryamid.org).
  2. Eat sugars in the form of fresh fruits & vegetables.
  3. Limit free sugar intake to a maximum equivalent of 10 teaspoons per day (a can of soda contains over 6 teaspoons!).
  4. Free sugars should be limited to a maximum of four times a day.
  5. Don't snack on sugars between meals.
  6. Ensure optimal fluoride level in water supplies.
  7. Promote adequate fluoride exposure via toothpaste, tablets or dentist recommended application.
  8. Brush teeth with a fluoride toothpaste at least twice daily especially at night.
  9. Do not eat for at least one hour before bedtime especially foods containing free sugars because low salivary flow rates during sleep reduce the ability to neutralize acid.
  10. To minimize erosion limit the amount and frequency of soft drinks and juices.

Here are other factors that protect against decay:

Cheese: consuming cheese following a sugary snack virtually abolishes the increase in acidity. Cheese stimulates saliva and is rich in calcium influencing the balance of re-calcifying teeth and protecting against loss of calcium from teeth.

Cow's Milk: contains lactose which is less acid producing than other sugars and therefore does not promote decay as readily. In addition, cow's milk also contains calcium, phosphorus and casein all of which help stop decay. However the practice of bottle feeding milk at night may promote decay.

Human Breast Milk: contains 7% lactose and is lower in calcium and phosphate. It generally does not initiate much decay except in cases of very 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 contain sorbitol and 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-caries potential but processed chocolate is too high in sugars to be good for the teeth so there is little hope for chocolate lovers.

Looking after your teeth is important if you want them to last a lifetime! Sticking to a diet that is high in fruits and vegetables and starchy staple foods, drinking lots of water (preferably fluoridated) and limiting the intake of sugary foods and soft drinks will safeguard your dental as well as your general well being.



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