HOW SUGAR AFFECTS YOUR TEETH
Alright, I am not going to beat around the bush – because this is basic, common knowledge that all of us know from childhood – sugar is bad for your teeth. No surprises there. But how does that actually happen? Well for this blog, I would explain how sugar is involved in developing tooth decay and what habits, activities and sources can facilitate or even hasten this process.
Based on the community studies conducted by National Monitoring and Epidemiological Dental Survey (NMEDS) in 1998, 92.4% of Filipinos have tooth decay. Simply put, 9 out of 10 people here in the Philippines have holes on their teeth. In a more recent (2006) data gathered from studying children in the country, a staggering 97.1% of six year old kids already suffer from tooth decay. Children as young as that, having just sprouted new permanent molars in their lower jaws, should not even have this problem! Doesn’t this give you reason to be concerned? Honestly, it gives me chills. Dental decay is definitely a public health concern as its prevalence is even more common than heart disease or diabetes.
The diagram is a simple depiction of how caries or decay is developed in our oral cavity. This picture shows that caries development is a multifactorial process, an event influenced by an interplay of certain elements. There are four requirements for decay to develop: the susceptible tooth, time, fermentable carbohydrates (“sugar”) and dental biofilm. Dental biofilm, or more commonly known as plaque, is basically an aggregate of broken down food, sloughed off cells from the tissues in the mouth and lots of bacteria. Mind you, this insidious substance can develop in as little as 30 minutes after eating and in as little as 4 hours after brushing so we almost always have plaque on the surfaces of our teeth. Now do you see why 9 out of 10 Filipinos suffer from dental caries? It is all too easy to develop decay especially so if good oral hygiene is not a habit or a priority.
As earlier mentioned, all these four elements must be present in an environment for caries to develop. The mouth – a thriving ecosystem that is always wet due to saliva – is the perfect setting for these microorganisms to further proliferate, making caries development an almost inevitable outcome. Whenever we eat anything that contains sugar, the enzymes in the saliva plus the microorganisms inside our mouth break down these food molecules to kick-start the digestion process starting from the oral cavity. Due to the action of the bacteria involved in this cascade of events, acid comes out as the by-product of the process. When the acid is liberated from the breakdown of sugars/food that’s when the series of unfortunate events start. Give it time to linger, or should I say fester, in and around the surfaces of your teeth and the enamel (outermost layer of the tooth) becomes softer. Once your enamel has softened, the next thing you know is that a break in its surface happens and this becomes the start of dental decay or holes in the teeth.
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Now that we have tackled how caries develops, we will go to the activities that contribute to decay development. Being a dentist for a number of years, I have seen caries in children as young as 7 months old (typically called “milk bottle caries”). You might wonder – how come someone as young as that has caries? Surely that baby has not even eaten much sugary stuff! Well, the common culprit for dental decay in young children is usually the milk that they drink and this is particularly a concern for those who take in formula as opposed to natural breast milk.
Why is that? It is because formula normally contains a higher level of sugar as opposed to breast milk, therefore, having more substrates to break down that can cause decay. Having said this, I know the mommies reading this may feel slightly alarmed, thinking: what else to give these babies aside from milk and being able to avoid caries development at the same time? The good thing is, we just need to put into practice some changes in the way we clean our babies’ teeth. The best thing to do after your child has had his/her milk is to make them drink water so as to wash away the sugars from feeding, not allowing them to stay inside the mouth long enough to cause problems. It is also advisable to wipe the surfaces of your babies’ teeth and even their tongue with a wet towel basically for the same purpose.
For bigger children who are eating solid food, the best way to prevent carious lesion formation is to make sure that they do not eat their meals longer than 30 minutes. Why is that? We mentioned earlier that one of the factors in development is time. The longer food stays inside the mouth – and we know many children have this habit of chewing their food and keeping the partly digested food inside their mouth for a while before swallowing – the more time for our teeth to be suffused in an acidic environment, hence facilitating decay development. So the faster your child eats, lesser chance for acid attack to occur. It would also help if we minimize giving our kids sugary treats even those “healthy-yet full-of-sugar” drinks and snacks. And whenever we oblige, please make sure that we ask them to drink water periodically to wash the sugars down.
As for us adults, the best advice I can give you to prevent caries formation is the same one I have prescribed for the slightly older children – minimize your intake of sugary stuff (carbohydrate loaded food included like the seemingly innocent rice or pasta). This also includes minimizing the intake of beverages that may contain “hidden” sugars such as those energy drinks, carbonated drinks or those sports themed drinks that are not only loaded with sugar but highly acidic as well. Disappointing as it may be but alcoholic beverages such as wine also contains sugar and coupled with its inherent acidity, this may very well be something that you may want to stay away from. I know, I know this may be difficult for many of us so if I can just urge you – every time you drink these not-so-friendly-to-the teeth beverages, make it a habit to gargle with water periodically for the same purpose of washing away the sugars and acids that may otherwise accumulate in your pearly whites. This habit would help stave off tooth destruction.
Of course, you already know that having good daily oral hygiene habits helps minimize decay formation and gum disease. Brushing after each meal is ideal and I cannot overemphasize that. Lastly, a regular visit to your dentist for upkeep and spotting early signs of decay is very important. We have mentioned how easy it is to develop decay and having a professional look at you and see signs of early developing decay can save you a lot of trouble.
So as a summary, the combination of elements such as time, tooth, bacteria and dental biofilm/microorganisms being altogether in the same space is needed for decay to develop. The few things we can control in this dilemma is to strengthen the teeth, avoid sugary food and drink intake and practicing good oral hygiene. Caries – no matter how prevalent – is preventable. We just really need to be more conscious of how easily our teeth are susceptible to acid attack and nip in the bud all the factors that contribute to this. Sugar may be sweet, but not necessarily a friend to be associated with.
Source: Epidemiological data gathered from the Philippine Department of Health website
