Diet and tooth decay

We all know that prevention is better than cure. To keep dental problems from arising, however, we first need to know how to care for oral hygiene effectively and comprehensively.

Why should I attend check-up visits if I have no cavities?

Even daily, repeated brushing, flossing and rinsing of the teeth cannot fully protect us from decay or other irregularities, e.g. of an unusually sensitive mucosa. That is why everyone who cares about themselves and their health should have "their own", trusted, attending dentist who – knowing the patient – will be able to make a diagnosis much faster in the case of any newly arising problems.

Diet and dental health

At our NL Clinic dental centre, the dentists try to make patients aware that the prevention of dental and oral diseases cannot be limited to procedures alone. Teeth are a product of our body and, in line with the true principle that we are what we eat, the choice of the food we consume has a decisive influence, firstly, on the condition of the teeth and gums, and secondly, on the potential for cariogenic bacteria to develop.

Contrary to appearances, adjusting the diet so that it is more favourable to dental health is not difficult. Basic knowledge of what does and does not serve the teeth is enough. Detailed help and advice can be obtained during a visit to our dental practice, but it is already worth learning about the basic relationships between nutrition and the condition of our teeth.

You can read in detail about how decay develops in the article "How a tooth gets sick". Let us only briefly recall that for it to develop, three main factors are needed at once:

1. cariogenic bacteria, which must enter the mouth,
2. carbohydrates, on which these bacteria will feed,
3. the time needed for them to produce the organic acids that demineralise the enamel.

Sometimes the susceptibility of the teeth to decay is also listed as an additional factor. Decay begins to wreak havoc in the mouth the moment the pH in it falls to or below 5.5 and all the factors listed above are present. What kind of diet contributes to such a state?

Dangerous deficiencies

Dental ailments such as increased sensitivity to extreme temperatures or tastes can be caused by an insufficient supply of vitamins A, C and D, fluoride, phosphorus and calcium in the diet. The culprit behind gum inflammation, which can be a catalyst for more serious problems, is most often a lack of vitamin C. The condition of the teeth and gums is also not helped by a lack of protein in the daily diet, as it can cause the salivary glands to work incorrectly. Vitamin D, in turn, is responsible for the proper development of the enamel, as it contributes to its correct formation and prevents so-called hypoplasia.

Cariogenic versus cariostatic foods

In principle, both external causes and food products themselves can be divided into two groups depending on whether they promote the development of decay or prevent it. The first group of products and factors is called cariogenic, and the second – cariostatic. The most common cariogenic (decay-promoting) factors are:

1. Excessive and frequent consumption of carbohydrates

Carbohydrates are the basis of the metabolism of cariogenic bacteria and the reason they produce acids that decalcify the enamel. The most dangerous sugar is the commonly encountered sucrose. Thanks to the enzyme amylase contained in human saliva, sucrose is broken down into fructose and glucose. Both of these simple sugars ferment thanks to cariogenic bacteria in the process of glycolysis and increase the bacteria's adhesion to dental plaque, which is a direct path to decay. Sucrose is present especially in sweets, coloured drinks and jams, but unfortunately also in fruit, dairy products and flavour additives such as mayonnaise or ketchup. Glucose-fructose syrup is now slowly ousting sucrose from many food products…

Sweet snacks and nibbling on sweets between meals are particularly dangerous precisely because it takes time for the anti-decay properties of our saliva to neutralise them. For example, the sugars found in fruit, vegetables and drinks begin to be neutralised after about 5 minutes, while those coming from sweets – only after 20. Importantly, complete neutralisation takes as long as an hour, and nibbling reverses this process and gives our saliva no chance to act. In addition, consuming sweetened drinks favours the lowering of pH in the mouth and creates an ideal environment for bacteria to live and develop.

2. Solid products and the sticky consistency of food

Food with a sticky consistency forms a deposit on the teeth that is an ideal environment for bacteria to develop. This form of food gets into the interdental spaces and is difficult to remove from between them without using dental floss.

3. The order in which food is eaten

To minimise the risk of creating a cariogenic environment, it is recommended to finish meals with cariostatic products. Such products include, among others:

• products that have an inhibiting effect on the development of Streptococcus mutans bacteria. These include nuts, legumes, groats, brown rice, vegetables and drinks such as beer, wine, tea and home-made vegetable and fruit juices – but note that after drinking the latter it is also recommended to brush the teeth, because of the acids present in them;
• hard, yellow cheeses, which have a threefold effect: they protect the enamel thanks to their casein content, stimulate the secretion of saliva and raise the amount of calcium in the plaque.

A solution for people who cannot imagine life without a sweet taste is sweeteners, because – apart from being low in calories – they are also not broken down by bacteria into dangerous acids.

Chewing gum – to use or not?

An undeniable advantage of chewing gum in the fight against decay is its general availability and its stimulation of saliva production, which naturally neutralises harmful acids. Increased saliva production also hinders the development of cariogenic bacteria in the plaque, which halts the process of enamel demineralisation. The sweet, alkaline xylitol contained in chewing gum, derived from birch bark, is not only not a catalyst for bacterial development but an inhibitor of it. That is why chewing gum when there is no possibility of brushing the teeth should be an obligatory habit.

What the enamel soaks up in youth…

In an era flooded with widely available sweets, making the youngest aware of the harmfulness of sugar plays a considerable role in dental prevention – something our dentists at NL Clinic always try to draw parents' attention to. Before we begin educating the youngest, however, we ourselves should make sure we do not have dangerous habits, e.g. "dipping" dummies in sugar, allowing sleep without first brushing the teeth or even after consuming sweet drinks. Sweets should never be a reward, and thirst should be quenched with mineral water.

Nutritional education in the context of dental health is therefore of considerable importance and, begun early, can protect further generations from finding themselves in the inglorious top ranks of countries with the highest incidence of decay. The link between diet and decay is enormous and should be as much an object of our interest and memory as regular and frequent brushing and preventive visits to the dentist.

What services does dental prevention at NL Clinic cover?

Early recognition of problems usually allows for more effective, less invasive treatment, which is why we carry out reliable check-ups and offer a range of preventive measures aimed at eliminating potential threats in the bud. Placing yourself in the hands of dentists by vocation, you can be sure that their overriding goal is to spare you pain.

Dental prevention at NL Clinic covers procedures such as sealing (or deep sealing) of the fissures of permanent teeth, varnishing of permanent teeth with the FLUOR PROTECTOR preparation, removal of tartar, professional cleaning of the teeth with sandblasting and tooth RVG.

What do preventive-hygienic dental treatments give, and how do they differ?

• Sealing of the fissures of permanent teeth – a dental procedure involving the sealing of the depressions and fissures on the chewing surface of the tooth. The filling is done using a fissure sealant – a special light-cured substance. Only healthy molars and premolars can be sealed. The procedure strengthens the protection of the enamel against the attack of cariogenic bacteria and acids and is recommended to be carried out as soon as possible after eruption.
• Varnishing of permanent teeth with the FLUOR PROTECTOR preparation – a preventive fluoridation procedure involving rubbing fluoride varnishes into the teeth, which form an effective protective layer for the enamel on the surface of the tooth. The concentration of fluoride in such preparations (from 0.1 to 6%) is much higher than in commonly available toothpastes or liquids. Varnishing with the Fluor Protector preparation just twice a year reduces decay by up to 75%.
• Tooth sandblasting is a procedure aimed at mechanically removing impurities from the surface of the teeth using a so-called sandblaster and specialist chemical agents. It involves removing certain discolourations, deposits and small tartar using a stream of water containing a sandblasting agent. For the patient's comfort, a suction device is used during the procedure that continuously suctions the sand out of the mouth. After the procedure the tooth surface becomes smooth and whiter. In the case of larger tartar deposits, sandblasting often goes hand in hand with scaling.
• Scaling, like sandblasting, is also a method of removing tartar, but recommended in the case of significantly harder and larger deposits of it. It is done using a so-called ultrasonic scaler which, through the very high frequency of ultrasound, causes the tartar to fall off. Thanks to this preventive procedure we prevent such consequences of tartar as the lowering and exposure of the tooth necks, atrophy of the alveolar bone, loosening of the teeth or, finally, periodontosis. After scaling, a varnishing procedure is often carried out to eliminate tooth sensitivity and strengthen the cleaned surfaces.
• Tooth RVG – the most modern and precise method of taking digital images of teeth thanks to radiovisiography. What is more, the radiation used for the images is even 20 times lower than in the case of RTG images. This makes it possible to analyse the condition of the tooth precisely and repeatedly from every angle without exposing the patient's health to unnecessary risk.

Before applying any of the mentioned methods of dental prevention, our doctors conduct a thorough interview to detect any contraindications. Some procedures cannot be recommended due to the condition of the teeth, having a cardiac pacemaker or pregnancy.

Although the importance of dental prevention for health is enormous, it is often undertaken too late or does not turn out to be sufficient to protect against decay or other conditions. In such cases we undertake conservative treatment.

Studies

1. Effect on Caries of Restricting Sugars Intake

   Moynihan P. J., Kelly S. A. M. (2014) · Journal of Dental Research · systematic review

   Lower intake of free sugars was associated with less caries, and restricting it below 10% of energy brought benefit. The data supported additional benefit at even lower intake, particularly across a whole lifetime.

2. Dietary free sugar and dental caries in children: A systematic review on longitudinal studies

   Mahboubi Z., Pakdaman A., Yazdani R., Azadbakht L., Montazeri A. (2021) · Health Promotion Perspectives · systematic review of longitudinal studies

   Frequent sugar consumption in children increased the risk of developing caries over time. Not only the amount matters but also how often exposure happens, especially snacks and drinks between meals.

3. Fluid Intake and the Occurrence of Erosive Tooth Wear in a Group of Healthy and Disabled Children from the Małopolska Region (Poland)

   Piórecka B., Jamka-Kasprzyk M., Niedźwiadek A., Jagielski P., Jurczak A. (2023) · International Journal of Environmental Research and Public Health · cross-sectional study in a Polish population

   Among healthy children and children with disabilities in the Małopolska region, the frequency and type of fluids consumed were associated with erosive tooth wear. Frequently sipping acidic drinks can harm enamel regardless of whether they are seen as healthy.