The Academy of Nutrition and Dietetics recently updated their position on Oral Health and Nutrition which serves as a worthy reminder of the connection between a healthy diet and a happy mouth.
According to the paper, tooth decay is the most prevalent chronic, common and transmissible infectious oral condition (1). Diet and nutrition impact many oral diseases, in particular dental caries. The caries process results when bacteria in the mouth come into contact with fermentable carbohydrates from foods, producing acids to attack tooth enamel and enzymes to attack the protein of the tooth. Untreated, tooth decay can cause pain and infections, leading to a change in dietary intake and patterns and ultimately tooth loss. I might not think about it much, but it turns out I’m doing what I can to prevent dental caries – practicing and encouraging good oral hygiene, using fluoridated toothpaste, drinking fluoridated water, routine preventive dental visits, and eating a healthy diet.
The same dietary recommendations for promoting overall health support dental health as well: a diet high in fresh fruits and vegetables, some whole grains, and quality protein such as eggs and beans. Additionally, mostly unprocessed foods have a protective effect because they require more chewing stimulating more salivary output to get rid of acidity in the mouth.
Attention to the oral health of young children is important as tooth decay remains the most common chronic disease of children and adolescents (2). The prevalence of caries in the primary teeth is over one-third in 3-5 year olds and 54.4% in 6-9 year olds (3). Ask any parent or child what causes cavities and they will likely respond “sugar.” Sugar is the main culprit to tooth decay engrained in our heads at a young age - and for good reason. Foods that contain a lot of sugar fuel bacteria in the mouth. Research shows that not all the blame falls on the sweet treats kids eat. The development of caries in children younger than 5 years is associated with maternal intake of sugar and weight during pregnancy (4).
According to the AND position paper, dietary factors associated with increased risk of dental caries in both children and adults comprise sipping sugar-sweetened drinks for prolonged periods, including regular soda, lemonade and other fruit juices; sucking on candy; frequent intake of added sugars and starchy foods such as cookies, crackers, and muffins; and eating sticky food alone, such as dried fruit and licorice (1). Sounds like I better start pairing dried cranberries, one of my son’s frequently-asked-for snacks, with nuts or cheese.
Frequent eating and snacking, especially on sugary foods and drinks, can be especially problematic because the teeth get constant exposure to acids that cause tooth decay. Instead it’s best to offer young kids snacks consisting of crunchy fruits and vegetables, cheese, and yogurt. Crunchy produce like apples and celery have a high water content which can help protect against decay. Foods such as cheese and yogurt contain calcium and phosphorus, the two main minerals that compose our teeth. As for beverages, we know it’s recommended to limit sugary drinks and mainly offer kids water and milk. But this message is usually tied to calcium and balancing calorie intake, and not so much oral health. Yet it’s well known that drinking tap water is effective in preventing and even reversing tooth decay. As a side note: If your water comes from a public system, you can call your local water utility authority to find out more about fluoride in your water.
It’s important to remember that the sugar substitutes in food and beverages don’t feed the bacteria in the mouth so don’t produce acids that contribute to tooth decay. Beyond managing calories, dental health is another reason to consider foods and beverages made with sugar substitutes.
I recently saw a YouTube video of a dad who teasingly went after his boys’ teeth with a toothbrush attached to a power drill. I could relate; admittedly it’s usually a daily battle getting my son’s teeth brushed and a power drill might make those tough few minutes a bit more playful. Brushing teeth is one important tool of many serious ones in the oral healthcare toolbox. Diet shouldn’t be overlooked. There is a unique interrelationship between diet and oral health. Poor oral health can negatively impact nutritional intake and good nutritional status correlates with good oral health, as well as overall systemic health.
By: Jennie McCary, MS, RD, LD
Jennie McCary MS, RD, LD, is a registered dietician practicing at Presbyterian Healthcare Services in Albuquerque, New Mexico. She also provides expert counsel to the Aspartame Resource Center.
- J Acad Nutr Diet. 2013;113:693-701.
- Centers for Disease Control and Prevention, Children’s Oral Health. Available at: http://www.cdc.gov/oralhealth/topics/child.htm; Accessed June 1, 2013.
- Healthy People 2020. Available at: http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=32; Accessed June 1, 2013.
- Wigen TI, Wang NJ. Maternal health and lifestyle, and caries experience in preschool children. A longitudinal study from pregnancy to age 5 yr. Eur J Oral Sci. Dec 2011;119(6):463-8.