Sugar Consumption and your Teeth

Whilst reading a dental magazines I came across part of the following article.

As Dentists we always worry about sugars causing decay, in this article we can see how Dentists also worry about acid in food and drinks eroding teeth

As an aside I also worry about well meaning overzealous tooth brushing, something I have personally fallen victim to. If your toothbrush is wearing out very quickly and not lasting as long as your partners (as is my case) you are probably using too much pressure. It may not feel as effective as giving them a good scrub but we should brush gently and gentle brushing is enough to keep the teeth clean.

Anyway back to the article – I’ve italicized the conclusions should you wish to skim read

Is fresh fruit good for your teeth?

It is recommended that at least five portions of fruit and vegetables are consumed daily (ie ‘5 A Day’). When consumed as part of a balanced diet, fresh fruit (containing intrinsic sugars) is good for your teeth. While it is recognized that acidic fresh fruits, such as citrus fruit and apples may cause dental erosion if eaten in large quantities, the individual and population health benefits of fruit consumption far outweigh any oral health detriments from these foods.

Is fruit juice good for your teeth?

Fresh unsweetened fruit juice contains free sugars because the juicing process releases the fructose, sucrose and glucose from the whole fruit. The free sugars of unsweetened fruit juice may amount to as much as a standard soft drink, therefore it is potentially cariogenic. Frequent exposure to the sugars and acids present when fruit is juiced can lead to tooth decay and dental erosion. Despite this, fruit and vegetable juice contains beneficial vitamins and minerals and current guidance recommends one glass (150 ml) of unsweetened fruit or vegetable juice per day as part of your ‘5 A Day’. However, juice only ever counts as a maximum of one portion a day, even if you drink more than one glass. This is mainly because it contains less fibre than whole fruits and vegetables. Therefore, it is a good idea to limit the amount of fruit juice you drink and consume at mealtimes only. Pure or 100% fruit juice should not be confused with ‘fruit juice drinks’ which contain very little pure fruit juice, as well as water and added sugar. These are harmful to teeth without the added benefit of vitamins. ‘No added sugar’ fruit juice drinks are also available but these are still acidic and contain free sugars from the small amount of pure fruit juice they contain and could still be harmful if consumed in large quantities.

Are fruit smoothies good for your teeth?

Fruit smoothies contain free sugars as the blending process releases the fructose, sucrose and glucose from the whole fruit. Fruit smoothies are not recommended between meals owing to their free sugars’ content and acidity. A smoothie can count as one of your ‘5 A Day’ due to the vitamins and minerals it provides. A smoothie can provide up to two of your five portions if it contains all of the fruit pulp from the whole fruit as well as juice. Is dried fruit good for your teeth? Dried fruit can be a very convenient, portable snack. However, dried fruit contains free sugars and is not good for your teeth. The sugar in dried fruit is super-concentrated. When fruit is dried, almost all the water is lost, but no sugar is lost. Also, dried fruit is very sticky and can easily get stuck in your teeth, giving it a prolonged oral retention time and compounding its cariogenicity. As consumption of dried fruit is low, there are no epidemiological data linking its consumption to dental caries. Small portions of dried fruit can contribute to the ‘5 A Day’ target; however, it should not be chosen as a between meals snack.

Is milk good for your teeth?

Milk is an important source of calcium and phosphorus, both of which contribute to the maintenance of healthy teeth. The most abundant protein in milk is casein and is protective as it forms a thin film on the enamel surface which prevents loss of calcium and phosphate from the enamel when the teeth are exposed to acids in the mouth. Cow’s milk contains about 4.8 g lactose per 100 g milk. This amount could be sufficient to classify as cariogenic, but there is much evidence that lactose is the least cariogenic of the common dietary sugars. Milk may have a role in the control of dental erosion but evidence is, at present, limited. However, infants should not be put to bed with a feeding bottle as this can lead to early childhood caries. The frequency and duration of sugar from milk in the mouth increases the risk of development of tooth decay.

Is honey good for your teeth?

Honey is a naturally occurring free sugar. There has been much debate in the past about whether or not honey is harmful to the teeth, mostly as part of the debate about raw sugar versus refined sugar. Occasionally this debate has recognized that honey has antibacterial activity, but where the effect of this has been investigated the results have been equivocal. However, what has not been taken into account is that honey varies very markedly in the potency of its antibacterial activity. Recent research with honey selected to have a good level of antibacterial activity has shown that there is potential for protection of dental health if such honey were used in place of refined sugar in the manufacture of candy. It can be concluded that, although honey may be cariogenic because of its high content of fermentable sugars, with selected honeys that have higher levels of antibacterial activity there is the potential for harm to the teeth to be reduced by inhibition of the cariogenic bacteria. However, as with all sugars, honey should be consumed in limited amounts and at mealtimes only. Dummies should not be dipped into honey or sugary drinks. This introduction to sweetness at an early age can encourage a sweet tooth and the development of tooth decay.

Is canned fruit good for your teeth?

Most canned fruit on the market are bathed in sugar-rich syrup which contains free sugars. Due to this added sugar, canned fruit can be harmful to your teeth. However, an alternative would be to choose canned fruits containing natural fruit juice instead, which contain lower amounts of free sugars and are less harmful to teeth.

Brian – 10/2015 (Dental Update)

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E-Cigarettes and Smoking Cessation

Another interesting article

The main advantages of e-cigs are that they are less dangerous than conventional cigarettes (from what is currently known), that they cause less contamination to the environment and that they can help with smoking cessation. Each of these points will be discussed.

In terms of the negative health effects of e-cigs compared to conventional cigarettes, studies demonstrate that e-cigs contain substances (particularly flavourants) that may have cytotoxic effects on the respiratory and cardiovascular systems and may impair immunity. However, due to the lack of longterm follow up, these negative health effects are not proven and it is impossible to say for definite whether e-cigs would cause damage to the health of their users.

Conventional cigarettes, on the other hand, have a proven track record of damaging human health. The smoking of conventional cigarettes causes over 100,000 deaths per year across the UK.81 While it is a valid argument that e-cigs cause less contamination to the environment, they still do cause contamination (which could be avoided if e-cigs were not used) and the widespread dissemination of e-cigs in society is an environmental concern.

Moreover, there is a large evidence base to support that the use of e-cigs has positive effects on smoking cessation as demonstrated earlier in this review. Therefore, the use of e-cigs as a smoking cessation aid may be useful and cost effective in a clinical setting. It is worth trying e-cigs as a smoking cessation aid as it appears to be effective in many users and the health service is suffering due to the burden of smoking. Smoking costs the NHS £2.7 billion each year, with costs to the wider UK economy of around £2.5 billion in sick leave and lost productivity. However, if e-cigs are considered a pathway to quitting, they are by no means a safe alternative based on current knowledge.

No amount of nicotine is known to be safe to take during pregnancy.

Brian 10/2015 (British Dental Journal)