Big Red Tooth – Dr Candice Schwartz

Where teeth and health meet

Diet and teeth.

How does diet affect your children’s teeth?

 

Diet is the key to a healthy, cavity free mouth. Many parents believe that choosing the best toothpaste will protect their young one’s mouths from holes and problems. This is unfortunately not the case. In order to fully understand the concept of diet affecting our teeth, you will need a short biology lesson.

 

Streptococci Mutans and Lactobacilli are the most common bacteria in the mouth responsible for tooth decay. When sugar is present in the mouth, these bacteria thrive off it, but unfortunately for us, through their own digestive process of these sugars, the waste products produced are acid. Specifically known as lactic acid, these by products leach out the calcium present in the teeth, thereby slowly weakening it. Over time, this demineralization (leaching out of calcium) of the tooth surface produces a hole. When sugars are present in high amounts, plaque forms. Plaque is the white/yellowish fur that we brush off our teeth every day. If plaque is left to ferment on the tooth surface, a cavity will result.

 

The goal in controlling plaque formation and cavities is to ultimately reduce the total intake of dietary sugar. It must be stressed however, sucrose (found in all sweets) is not the only sugar which damages teeth. Glucose (found in breads and rice), fructose (found in fruit), maltose (found in cereals and pastas) and lactose (found in milk) are all easily digested by mouth bacteria to form acid and destroy teeth. Dietary changes to alter the acidity of the mouth will directly reduce amount of plaque build up on the teeth, thereby reducing the chance of dental decay.

Our bodies do have a natural defense against acidity and this is saliva. Saliva acts as a natural cavity fighter. One of the key strategies in cavity reduction/elimination is to keep your mouth at a more alkaline pH (reduce bacterial acidity) throughout the day for longer periods. You do this by increasing saliva production and encouraging saliva production between meals.

This is how it works: When we eat a meal the pH of our mouths change in accordance to the type of food we have just eaten. Food containing higher amounts of carbohydrates and sugars will leave the mouth with an acidic pH, ranging from 1- 5. Increased saliva production will kick in and our saliva will buffer this acidity, slowly raising it back to the resting pH of approximately 7.5. If immediately after eating your main meal you have a sweet treat (piece of chocolate or a dessert), the acidity of your mouth does not change by much. Saliva is still produced and your mouth will quickly recover back to an alkaline pH, which does not allow sufficient time for bacterial colonization and acid production. The problem encountered, particularly with children, is sugary snacks given in between meals. Sugary snacks given an hour after a main meal will bring the pH of the mouth back down to an acidic level and bacteria will begin to thrive and produce more acid. It does not give the mouth time to recover from the acid overload and the mouth remains acidic for most of the day. This gives bacteria plenty of time to produce acidic waste and demineralize the teeth.

Give your children sugar free snacks between meals. Example: whole fruits and vegetables, nuts, sugar free (xylotol containing) chewing gum, cheese. Beware of dried fruit; this is very acidic and very high in sugar and not a good choice for in between meal snack.

Quick easy steps to making your child’s diet a tooth friendly diet

 

–     Allow sugar intake (sweets and treats) directly after main meals only. When sugar is given between meals as a snack, this leads to a high incidence of decay. The frequency of sugar intake has more impact than the amount of sugar intake. Between meal snacks should contain no sugar.

 

–      The best type of sweet for a child is chocolate. Sticky sweets like toffees/fizzers/jelly sweets/suckers stick in between and around the teeth and result in destruction of the teeth for a much longer duration as the sugar lies in and around each tooth. It is difficult to clean this sugar off the teeth and they are extremely acid producing.

–      Beware of dried fruit; this is not a good snack. It has a very high sugar content and high acidity. It not only causes dental decay but acid erosion of the teeth.

–      End each meal with a small piece of cheese/some milk/xylotol chewing gum. This neutralizes the mouth and stimulates saliva production.

–      Limit fruit juice intake to ½ a cup per day (if needed). I always advise parents to try to eliminate all juice and sodas from the diet. They do not give hydration. Children should only drink water. If your child does drink a soda/fruit juice, ensure they drink it through a straw, so it bypasses the mouth and the teeth and is swallowed immediately.

–      All babies must be weaned off their nighttime milk bottle/breast feed by the age of 1. At 1 year old they no longer require the nutrition of the milk during the night, as their diet is predominantly solid food. If your child still enjoys the bottle as a pacifier at night, put only water in this bottle. Rampant dental decay results if children are kept on a bottle/breast past one year of age.

–      Never add sugar/honey to rooibos tea. This sugar will rapidly decay teeth, especially if given through a bottle/sippy cup.

Dental decay is a preventable disease. Diet is at the centre of this preventative concept. Without a lower sugar intake, you cannot expect a cavity free mouth. The acidity produced by sugar does not only affect the mouth. This type of acidic environment in the body allows viruses/bacteria/infections to thrive and leaves the body more susceptible to disease. Reducing/eliminating sugar from your child’s diet will have positive effects in all the bodily systems. Change their eating habits today.

 

 

 

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Tooth decay and your diet

This post looks at how to reduce tooth decay through your diet.Teeth are constantly changing. The tooth consists of different layers. The innermost core of the tooth (called the dental pulp) contains a mass of nerves and cells. These cells have a regenerative function. So teeth are able to heal themselves. This is why some cultures like the African Wakamba tribe can file their front teeth into sharp points without causing damage. The process of regeneration is slow (like the process of tooth decay). Fortunately, a decaying or broken tooth has the ability to heal itself. Pulp contains cells called odontoblasts, which form new dentin if the diet is good. Below is a copy of what Dr. Edward Mellanby commented about his wife’s research on the subject. This is taken from Nutrition and Disease:

Since the days of John Hunter it has been known that when the enamel and dentine are injured by attrition or caries, teeth do not remain passive but respond to the injury by producing a reaction of the odontoblasts in the dental pulp in an area generally corresponding to the damaged tissue and resulting in a laying down of what is known as secondary dentine. In 1922 M. Mellanby proceeded to investigate this phenomenon under varying nutritional conditions and found that she could control the secondary dentine laid down in the teeth of animals as a reaction to attrition both in quality and quantity, independently of the original structure of the tooth. Thus, when a diet of high calci­fying qualities, ie., one rich in vitamin D, calcium and phosphorus was given to the dogs during the period of attrition, the new secondary dentine laid down was abundant and well formed whether the original structure of the teeth was good or bad. On the other hand, a diet rich in cereals and poor in vitamin D resulted in the production of secondary dentine either small in amount or poorly calcified, and this happened even if the primary dentine was well formed.

Drs. Mellanby set out to see if they could use their dietary principles to cure tooth decay that was already established in humans. They divided 62 children with cavities into three different diet groups for 6 months. Group 1 ate their normal diet plus oatmeal (rich in phytic acid). Group 2 ate their normal diet plus vitamin D. Group 3 ate a grain-free diet and took vitamin D.

In group 1, oatmeal prevented healing and encouraged new cavities, presumably due to its ability to prevent mineral absorption. In group 2, simply adding vitamin D to the diet caused most cavities to heal and fewer to form. The most striking effect was in group 3, the group eating a grain-free diet plus vitamin D, in which nearly all cavities healed and very few new cavities developed. Grains are the main source of phytic acid in the modern diet, although we can’t rule out the possibility that grains were promoting tooth decay through another mechanism as well.

Dr. Mellanby was quick to point out that diet 3 contained some carbohydrate (~45% reduction) and was not low in sugar: “Although [diet 3] contained no bread, porridge or other cereals, it included a moderate amount of carbohydrates, for plenty of milk, jam, sugar, potatoes and vegetables were eaten by this group of children.” This study was published in the British Medical Journal (1) and the British Dental journal. Here’s Dr. Edward Mellanby again:

The hardening of carious areas that takes place in the teeth of children fed on diets of high calcifying value indicates the arrest of the active process and may result in “healing” of the infected area. As might be surmised, this phenomenon is accompanied by a laying down of a thick barrier of well-formed secondary denture… Summing up these results it will be clear that the clinical deductions made on the basis of the animal experiments have been justified, and that it is now known how to diminish the spread of caries and even to stop the active carious process in many affected teeth.

Dr. Weston Price also had success curing tooth decay using a similar diet. He fed underprivileged children one very nutritious meal a day and monitored their dental health. From Nutrition and Physical Degeneration (p. 290):

About four ounces of tomato juice or orange juice and a teaspoonful of a mixture of equal parts of a very high vitamin natural cod liver oil and an especially high vitamin butter was given at the beginning of the meal. They then received a bowl containing approximately a pint of a very rich vegetable and meat stew, made largely from bone marrow and fine cuts of tender meat: the meat was usually broiled separately to retain its juice and then chopped very fine and added to the bone marrow meat soup which always contained finely chopped vegetables and plenty of very yellow carrots; for the next course they had cooked fruit, with very little sweetening, and rolls made from freshly ground whole wheat, which were spread with the high-vitamin butter. The wheat for the rolls was ground fresh every day in a motor driven coffee mill. Each child was also given two glasses of fresh whole milk. The menu was varied from day to day by substituting for the meat stew, fish chowder or organs of animals.

Dr. Price provides before and after X-rays showing re-calcification of cavity-ridden teeth on this program. His intervention was not exactly the same as Drs. Mellanby, but it was similar in many ways. Both diets were high in minerals, rich in fat-soluble vitamins (including D), and low in phytic acid.

Price’s diet was not grain-free, but used rolls made from freshly ground whole wheat. Freshly ground whole wheat has a high phytase (the enzyme that degrades phytic acid) activity, thus in conjunction with the long yeast rises common in Price’s time, it would have broken down nearly all of its own phytic acid. This would have made it a source of minerals rather than a sink for them. He also used high-vitamin pastured butter in conjunction with cod liver oil. We now know that the vitamin K2 in pastured butter is important for bone and tooth development and maintenance. This was something that Dr. Mellanby did not understand at the time, but modern science has corroborated Price’s finding that K2 is synergistic with vitamin D in promoting skeletal and dental health.

In these early studies, it is clearly evident that diet is a huge contributing factor to tooth decay. This fact seems to have fallen to the back of most dentists’ minds and their patients. It is important to remember that tooth decay needs a substrate of carbohydrate to occur. Without this, the decay process cannot take place. It is almost impossible to eliminate this carbohydrate substrate from our diet entirely and from our mouths, however when it is reduced, the impact is exponential and the decay process is halted in its tracks.

More emphasis needs to be placed on diet. A combination of a caries-preventing diet and good oral hygiene practices will inevitably result in a reduction and elimination of decay.

Some elements to bring into your new and improved “decay reducing” diet I have recommended below:

  • Bread and refined grain products (like cereals) should be limited/avoided.
  • Limited nuts; beans in moderation, only if they’re soaked overnight or longer in warm water (due to the phytic acid).
  • Increase your intakes of GREEN, leafy vegetables
  • A limited quantity of fruit and especially fruit juice
  • At least two portions of cooked/raw vegetables daily
  • Vitamin D3 supplements (this also boosts the immune function)
  • Eliminate all processed and “fast” foods from the diet.
  • Constant sipping of water throughout the day.
  • Eliminate all fizzy cool drinks and “sticky sweets” (like toffees and fizzers)
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