Tag Archives: cavities

What You Eat vs. What Eats Your Teeth

Earlier this month on our office Facebook page, I posted a link to a media release debunking several dental myths. Since then, I’ve seen quite a few articles focusing on just one of them: the belief that more sugar means more cavities.

 

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Why focus on this? Maybe it’s because it can be spun to suggest that it’s okay to eat all the sugar you want so long as you brush and floss afterwards. (Of course, sugar contributes to a host of other health problems, some of which can contribute to other dental and periodontal problems, but they’re not mentioned.)

After all, in and of itself, sugar does not cause cavities. So why do dentists recommend avoiding it? It’s the preferred food of the oral bacteria that live in your mouth. Their acidic waste products are what cause decay, as explained in this humorous video:

 

 

Importantly, the sugars that microbes love aren’t just “obvious” ones like table sugar and high fructose corn syrup. All carbohydrates can be broken down into sugars. What’s more, many carbs – especially processed carbs – tend to stick to the teeth, giving the oral bacteria plenty of opportunity to feed on them – at least until you brush and floss, which both removes food particles and breaks up the microbial colonies that form the biofilm most people call “plaque.”

A recent article in Caries Research highlights the point. Looking for links exist between snacking behaviors and caries (the clinical name for “cavities”), researchers studied the snacking habits and dental health of more than 1200 American preschoolers. Unsurprisingly, those who ate the most sweet snacks, chips and especially chips with a sugared drink had a higher rate of caries than those who consumed less of such things. The team also found that those who ate chips tended to eat more sweet snacks, including candies and ice cream. All of these foods are ones that tend stick to the teeth or, in the case of sweetened drinks, bathe them in sugars – two factors that tend to increase the length of time the teeth are exposed to sugars, and thus the opportunities for microbes to feed and excrete their cavity-causing acids.

Interestingly, this matter of sugar and cavities was not the crux of the Nutrition Today article touted in the “6 Myths” media release, the title of which expresses its broader focus: “It’s More Than Just Candy: Important Relationships Between Nutrition and Oral Health.” Here’s the abstract:

Oral problems can affect and be affected by both diet and systemic nutrition. Dental caries (tooth decay) remains the most prevalent disease of children: 7 times more common than hay fever and five times more common than childhood asthma. The mouth is an early indicator of general health and nutritional status; clinical signs and symptoms of nutritional and other health problems frequently appear first in the oral cavity. Conversely, oral problems can have profound effects on nutritional status. Emerging research is revealing even more important relationships between nutrition and oral health issues and chronic health conditions such as heart disease, diabetes, and immune-compromising conditions. Health care professionals should help their patients by asking patients about oral health concerns and referring patients for dental consults when indicated. Promoting good oral health as well as good nutrition is essential to optimal overall health status.

To which we can only say, yes, exactly.

 

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How Cavities Happen

 

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Does Fluoride Really Prevent Cavities?

Conventional wisdom has it that fluoride prevents caries (cavities), and, as with many things, a lot of people tend to think that more is better. So dentists give fluoride treatments and supplements. Cities fluoridate public water supplies. This is sensible insurance, we’re told; good, preventive medicine.

 

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No doubt the intentions of fluoride proponents are good, but you know what they say about good intentions. And the adage bears even more truth when those good intentions ignore hard facts, starting with the reality that evidence in support of fluoride supplementation is a little sketchy.

In 2008, JADA – the official journal of the fluoride-advocating American Dental Association – published “Fluoride, Supplements, Dental Caries and Fluorosis,” a broad review of the scientific research on whether fluoride supplements actually help prevent cavities. While the authors did find some evidence of their doing so in older children, they concluded that the evidence was “weak and inconsistent” for their preventing caries in children under six years old. They also found that “mild-to-moderate dental fluorosis is a significant side effect.”

Fluorosis is what happens when a person gets too much fluoride. In its mildest form, we see the teeth marked by white streaks or flecks. In more severe forms, we see brown and black staining of the teeth, along with pitting and cracking of the teeth.

Meanwhile, water fluoridation doesn’t appear to prevent caries at all. This is borne out in report after report on outcomes in communities with fluoridated water. A recent one out of New Zealand found that children in non-fluoridated communities actually had 1% fewer cavities than children in communities with fluoridated water. And yet the Ministry of Health continues to recommend fluoridation!

The truth is, fluoride is just not necessary to prevent caries. What does help? Regular flossing and brushing – with any kind of toothpaste or even none at all. Eating a low-sugar, nutritionally-dense diet based on whole foods. Regular dental visits. Habits like these make a much more positive impact.

For the other important thing to remember about fluoride is this: not only is it ineffective and unnecessary; it’s also a poison that can damage many different organs and structures in the human body.

 

 

When you weigh the risk against its negligible benefits, fluoride hardly seems a good solution to the problem of tooth decay.

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Dental Care Great, Dental Health Worse?

An article in the Vancouver Sun this week suggested that Baby Boomers have “unique” dental problems. Although, as a group, Canadian Boomers “are keeping their teeth clean and healthy, they are also experiencing an increase in such problems as exposed gums, dry mouth, acute sensitivity and tooth root cavities.” We see similar trends in the US.

Dr. Steven Weiner, an Ontario dentist featured in the article, generally attributes the phenomenon to better care early in life, more saved teeth and longer lifespans.

“In previous eras, if you had a toothache, you pulled the tooth. Then you had to deal with other issues that involved. People now are retaining their teeth longer – for a lifetime – and that wasn’t the goal back then.

“We see so many perfect teeth now, through orthodontics, great home and dental care, but what we have as a result of the aging population is great teeth and poor gums.”

 

 

How is it that a person can have “great home and dental care” yet have “poor gums” and other dental problems? And is this really unique to Baby Boomers? Or is it more that theirs is just the first generation to have these problems in large numbers?

My hunch is that there’s more truth in the latter.

The article mentions – almost in passing – some trends that I would argue are now having a big impact on people’s dental health. One of them is the increased use of pharmaceutical drugs, many of which cause dry mouth as a so-called “side effect” – drugs as varied as antidepressants, anti-anxiety medications, antihistamines and muscle relaxants. Dry mouth may not sound like anything too serious, but it’s got some significant dental implications, raising the risk of caries (cavities), tooth erosion and periodontal disease. This is because one of the functions of saliva is to wash away the microbes that make up dental biofilm (plaque) and food particles that feed them. Saliva is also a source of the calcium and phosophate particles that help keep tooth enamel strong. The less saliva, the more conditions favor decay and other tooth damage.

There are a number of safe and helpful products available to help increase saliva flow and alleviate dry mouth – products such as GC Dry Mouth Gel and the Dental Herb Company’s Tooth and Gums Tonic. Drinking more water can help, as can eating more foods that require chewing, especially foods like crunchy vegetables.

This brings us to another major trend I see affecting people’s dental health: diet. Since the Boomers came of age, highly processed convenience foods and sugary soft drinks have become much more common – more available and consumed in larger amounts. High fructose corn syrup has become ubiquitous in processed foods, increasing our overall consumption of added sugars. Our intake of refined carbohydrates has skyrocketed, and few of us eat nearly enough whole grains, fresh vegetables and fruit. The result is a diet that is highly acidic, promoting tooth decay and inflammation. (Gum disease, like heart disease, is a chronic, inflammatory condition.) Moreover, the acids and sugars in sodas, energy drinks and similar beverages further contribute to tooth erosion, as a great many studies have shown.

If we, as a society, continue in these directions, we can expect the “unique dental problems” mentioned by Dr. Weiner to be the new norm. But it’s not too late to turn things around. By making positive, healthy life choices, we increase the likelihood of our having both healthy teeth and gums into our senior years.

 

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Secondhand Smoke Hurts Kids’ Teeth & Gums

When we think about the health effects of smoking, the first things that come to mind are usually diseases such as cancer and emphysema. But smoking does a number on a person’s dental health, too – and far beyond simple bad breath and stained teeth. For instance, smokers are four times more likely than non-smokers to develop periodontal disease, even if their home hygiene is exemplary. Gum health deteriorates, often leading to bone and tooth loss. Some periodontists – dentists who specialize in treating the gums – refuse reparative treatments to smokers if they continue to use, such is the ongoing damage.

More than half of all cases of periodontal disease can be attributed to smoking.

 

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If you smoke, you might think, “Fine, but it’s my body. I can do what I want to it,” and that’s certainly your choice – though I would argue it’s far from the best you can make. But you’re not the only one exposed to the toxins in cigarette smoke. Just as secondhand smoke can cause cancer, emphysema and other diseases in non-smokers, so can it cause dental problems for a very vulnerable population: young children.

Two studies published over the past couple years have demonstrated that “passive smoking” (exposure to secondhand smoke) considerably raises young people’s risk of dental problems. The first, published in 2008 in the Archives of Oral Biology showed quite plainly that children exposed to cigarette smoke had more caries (cavities). They also showed higher counts of pathogenic oral bacteria, more acidic saliva and a lower rate of salivary flow – all factors contributing to the formation of caries.

The second study, published earlier this year in the Journal of Clinical Periodontology, found that children exposed to cigarette smoke also show deterioration of their gum tissues. Here, the researchers measured levels of continine – a primary metabolite of nicotine – in the children’s saliva, urine and gingival crevicular fluid (found in the small space between each tooth and the surrounding gum tissue), as well as conducted periodontal exams. Those children with higher continine levels showed lower clinical attachment levels (the attachment of gum tissues to the alveolar bone and tooth structure) – a marker of gum disease. Though it’s not clear why, this effect was more pronounced in children whose fathers smoked compared to those whose mothers smoked.

The moral of the story? If you choose to continue to smoke, avoid doing so around others, especially children. But best of all – for kids’ health as well as your own – is to quit tobacco use altogether. For those of you ready to take that step, here are some resources from the CDC and info on a few natural remedies to help you get started stopping.

 

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