What you eat affects your teeth

It is in the mouth that the process of digesting food actually begins. The teeth, gums and tongue are the first place where nutrients entering our body come into contact. If your nutrition is deficient, the first signs will often manifest themselves in your mouth.

Furthermore, dietary advice for the prevention of oral diseases should be part of routine patient education practices. There is no consensus among nutritionists and dentists to provide nutritional guidelines to prevent dental decay.

Today we will learn about the oral-systemic connection, the foods that undermine your dental health, the foods that benefit it, what sugar has to do with all of this, and what you can do to reduce your risk of cavities.

It has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. ( 1 )

It is becoming increasingly clear that the oral cavity may act as a site of origin for the dissemination of pathogenic organisms to distant body sites, especially in immunocompromised hosts such as patients suffering from malignant tumors, diabetes or rheumatoid arthritis, or receiving treatment with corticosteroids or other immunosuppressants. Several epidemiological studies have suggested that oral infection, especially certain types of periodontitis, may be a risk factor for systemic disease.

For example, a stroke or cerebral hemorrhage is a cerebrovascular disease affecting the blood vessels that supply blood to the brain.

Inflamed periodontium (the gingiva or gingival mucosa which is the part of the oral mucosa surrounding the neck of the teeth) releases inflammatory cytokines, LPS (endotoxins) and bacteria into the systemic circulation, and can promote atherosclerosis and affect blood coagulation, platelet function and PG (Prostaglandins or fatty acid derived products) synthesis, thus contributing to the appearance of effusion. In a case-control study, the dental status of 40 patients under 50 years of age with cerebral infarction was compared with 40 community controls randomly selected and matched by sex and age. Poor oral health, assessed by total dental index and orthopantomography (radiography of the dental arch), was more frequent in patients with cerebral infarction than in individuals in the control group.

Bacterial pneumonia results from aspiration of oropharyngeal flora (bacteria that reside in the mouth and throat) into the lower respiratory tract, failure of the host defense mechanisms to eliminate them, multiplication of the microorganisms, and subsequent tissue destruction. Most pathogens appear to first colonize surfaces of the oral cavity or pharyngeal mucosa prior to aspiration. These pathogens may colonize from an exogenous source following overproduction of normal oral flora after antibiotic treatment.

It makes sense then that a healthier diet not only improves overall health, but dental health, concluding that a poor diet can lead to cavities and gum disease, but it can also lead to serious health problems.

 

Nutrition directly connected to oral health

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There is a two-way relationship between oral health and dietary nutrition. Diet and nutrition affect the health of oral tissues; and oral health affects the nutrients consumed.

The relationship between caries and carbohydrates is well understood; hard dental tissues are demineralized by acidic byproducts produced by biofilm bacteria (dental plaque) through the fermentation of dietary carbohydrates.  More specifically, a rapid drop in pH (to 5.5 or less) occurs in dental biofilm following carbohydrate ingestion. This drop in pH may also affect the balance of microbes in the biofilm, resulting in a higher proportion of acidic biofilm species, which exacerbates tooth demineralization. Carbohydrate consumption is therefore an important nutritional factor in the development of caries.

The foods and drinks you consume can have a direct influence on the incidence and progression of tooth decay. ( 2 ) It depends on:

• The shape of the food: it makes a difference whether it is liquid, solid, sticky or slow to dissolve.
• How often you consume sugary foods or drinks, as well as acidic foods or drinks.
• The nutritional composition of your meals.
• The combination of foods and the order in which you consume them.
• Medical conditions such as gastrointestinal reflux, eating disorders, which can increase the risk of cavities and weaken teeth.

Please note especially that:

Sugar consumption has been associated with an increased risk of developing tooth decay.

Frequent consumption of acidic foods and drinks is associated with an increased risk of erosive tooth wear. These would be the main causes of dental deterioration.

Foods that damage your dental health

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Foods full of empty calories (no nutrients) such as candy, sweets, mints, gum and sticky sweets, as well as cookies, cakes, muffins and packaged snacks are a cause of dental concern not only because they do not provide any nutritional value, but also because of the amount and type of sugar they contain that can stick to the teeth.  The bacteria in the mouth feed on these sugars, releasing acids that lead to tooth decay.

Sugar-based drinks such as soda, juice, lemonade, and sugar-sweetened coffee or tea are particularly damaging as continued sipping causes a constant bath of sugar on the teeth which also promotes tooth decay. 

Some nutritious but acidic foods such as tomatoes and citrus fruits can have an acidic effect on tooth enamel, so they should be eaten as part of a meal and not alone.  Dried fruits like raisins provide nutrients, but because of their sticky consistency, they stick to teeth and the plaque acids they produce continue to damage teeth long after they have been consumed.

Foods that benefit your dental health

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Cheese, milk (if you do not have intolerance problems), yogurt, tofu, green leafy vegetables and almonds are foods that should benefit your dental health thanks to their high content of calcium and other nutrients.

Other protein-rich foods such as eggs and milk are the best sources of phosphorus. Both calcium and phosphorus play a very important role in oral health as they protect and rebuild tooth enamel.

Vegetables (spinach, kale, broccoli, celery, carrots, bell peppers, cucumbers, garlic and onions, shiitake mushrooms) and some fruits (crunchy ones like apples and pears; kiwi, strawberries and pineapple) can be good choices for good oral health since they have a high fiber and water content that helps balance the sugars they contain and helps clean teeth.  These foods help stimulate the production of saliva that rinses harmful acids and food residue from the teeth, as well as neutralizing acid protecting teeth from decay.  Additionally, many contain vitamin C (important for healthy gums and rapid wound healing) and vitamin A (another key nutrient for tooth enamel formation).

According to the British Dental Journal ( 3 ), Diet can be a good ally in preventing tooth decay.

1. Increased fiber consumption: decreased absorption of sugars contained in other foods.
2. Diets characterized by a high amide /low sugar ratio have very low levels of caries.  
3. Cheese has cariostatic properties (agents that inhibit the progression of dental caries).
4. The calcium, phosphorus and casein contained in cow's milk inhibit caries.
5.  Whole grain foods have protective properties: they require more chewing, thus stimulating salivary secretion.
6. Peanuts, hard cheeses and, in some cases, chewing gum are good gustatory/mechanical stimulants of salivary secretion.
7. Black tea extract increases fluoride concentration in plaque and reduces the cariogenicity of a high-sugar diet.
8. Fluoride.

Fluoride remains a key element in the prevention and control of dental caries. It has a pre-eruptive mechanism of action (incorporation into the enamel during amelogenesis) and a post-eruptive mechanism of action (topical action). Fluoride reduces caries by 20-40% in children, but does not eliminate them completely: even when fluoride is used, the association between sugar intake and caries is still present ( 4 ).

The sugar and tooth decay connection

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The bacteria in your mouth use carbohydrates as food. By reducing your consumption of sugar and other sources of simple sugars that are easily fermented, you can reduce your risk of tooth decay.

Limit added sugars in your diet by reading food labels to determine how much added sugar is in what you are eating.  Because foods are listed on the label in descending order of weight, if one of the following ingredients is in the first three, the food is likely high in sugar.

Different names for added sugar:

• Sugar
• Brown sugar
• Glucose
• Dextrose
• Sugarcane
• Icing sugar
• Turbinada sugar
• Unrefined sugar
• Corn sweeteners
• Corn syrup
• Crystallized cane sugar
• Maltose
• Fructose
• Saccharose
• Evaporated sugarcane juice
• Fruit juice
• Honey
• High fructose corn syrup
• Inverted sugar
• Syrup
• malt syrup
• Maple syrup
• molasses 

Healthy habits to prevent cavities

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• Brush your teeth twice a day for two minutes to remove sugars and food residue from your teeth. Floss between each tooth to make sure there is no residue left behind.
• Avoid eating between meals as much as possible.
• Reduce added sugars to a minimum in your diet and prefer healthy foods and drinks.
• Include proteins such as aged cheeses and eggs or kefir and yogurt (if you are not dairy intolerant) with all their fat, green leafy vegetables, fruits such as blueberries, strawberries, raspberries, guava. Likewise water , as they all play an important role in your dental health.
• It is also a good idea to rinse your mouth after drinking sugary drinks or drinks that can stain your teeth, such as coffee or wine.

Furthermore, the types of sugar ingested through the diet also influence the appearance of diseases. In fact, studies on the pH of dental plaque have shown that lactose produces less acidity compared to other sugars.

A 1970 Finnish study of supervised dietary change revealed that, in an adult population, almost total replacement of dietary sucrose with xylitol resulted in an 85% reduction in caries over a 2-year period; its mechanism of action lies in the inhibition of the growth of Streptococcus mutans, the most important microorganism responsible for caries formation. ( 5 )

Feeding times to keep in mind

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A diet that promotes good oral health is not just about what foods you eat or avoid, but also about when and how you eat them. One way to protect your teeth is to eat raw foods at the end of meals. These foods help clean your teeth and massage your gums, as well as generating more saliva to wash away food particles left behind after eating.

According to an article from the University of Illinois, USA, "Food sequence, or the order in which foods and drinks are consumed, is important and can help prevent cavities. Trying to consume acid-neutralizing foods after a sweet meal or dessert will prevent prolonged acid attacks on the teeth and therefore help prevent cavities. The best examples are milk, unsweetened tea or coffee, or cheese." (6 )

Finally, be sure to drink plenty of water between meals to help flush out the sugars and acids left over from snacks and meals. Here is the water system I recommend after extensive research:

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