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Dental Health and Diet


Good nutrition is essential for good physical health. Nutrition also plays a key role in the development and maintenance of a healthy mouth, especially the teeth and gums. The food we eat affects our teeth, and conversely, the health or lack of health of our teeth and gums affects what we can eat. Good dental health begins early in life and must be practiced throughout life.

Tooth Structure and Formation

First, let’s look at the main parts of the tooth: the outer layer (enamel), the cementum, the dentin, and the dental cavity that contains the tooth nerves.

The outer layer of the tooth (above the gum) is a protective layer of enamel. Below the gum, this is a thinner layer of calcified connective tissue called cementum, which covers the bulk of the tooth. Beneath the enamel is the dentin, a bone-like material that forms the bulk of the tooth. This surrounds and protects the dental cavity which is made up of the pulp cavity at the top of the tooth and the narrower root canal lower down. Nerves run through this cavity.

Tooth development begins shortly after conception, usually between the sixth and eighth weeks of gestation, and continues throughout pregnancy. It seems that severe nutritional deficiencies in the mother are required to cause obvious changes in the child’s tooth formation. However, slight deficiencies may cause changes in tooth structure that will increase risk of decay later in life.

A good, balanced diet during pregnancy is important for proper tooth formation in the infant, as nutrient excesses as well as nutrient deficiencies can play a role in congenital anomalies of the mouth. Therefore, it is advisable that pregnant women eat a varied and nutritionally balance diet, and only take supplements on the advice of a doctor or dietician.

Fluoride Intake

The child’s nutrition is equally important during infancy, childhood and adolescence, when the child’s body is growing. Before they emerge, the child’s primary teeth (milk teeth) and later, the permanent teeth become mineralized. Fluoride is incorporated into the tooth structure during tooth development, before the teeth erupt, making the tooth strong and decay resistant.

Fluoride intake from birth has been shown to reduce dental caries (tooth decay) by as much as sixty percent. For this reason, many community water supplies are fluoridated at the rate of one part per million, which has proven safe yet still effective at reducing dental caries. The normal daily intake from fluoridated water is about one milligram per day. When teeth are forming, an intake of more than two parts per million may cause fluorosis, a condition in which tooth enamel becomes toughened, mottled and discoloured. However, teeth remain strong and resistant to decay. If you live in an area where drinking water has little or no fluoride, prescription fluoride drops or tablets may be prescribed by your doctor. An alternative to supplements is the daily use of fluoridated toothpaste and mouthwash. If you don't know the fluoride level of your water, contact your local water department.

Nursing Bottle Syndrome

One preventable dental problem that affects young children is "nursing bottle syndrome", which is characterized by rapid decay of the primary upper teeth and some of the lower back molars in small children. The lower front teeth are seldom affected. This condition develops when a child is given a bottle that contains a carbohydrate liquid or a sweet pacifier at bed or nap time. While the child is awake and sucking, saliva flow helps wash sugars away from teeth. As the child falls asleep, sucking and saliva flow decrease; the sugars in the liquid pool around the teeth and provide an excellent feeding ground for bacteria.

Painful decay results from this practice. If left untreated, infections and abscesses are possible. Premature loss of upper teeth may lead to the child developing poor "tongue-thrust." This could cause poor alignment of permanent teeth and future orthodontic and speech problems. All of these problems can be avoided by never allowing a child to fall asleep with a bottle.

Preventing Decay

The decay process begins when the bacteria that are always present in the mouth break down components of saliva. These components adhere to tooth enamel. This is the start of dental plaque: a clear, gelatinous material that allows bacteria to remain on the teeth. Inside this dental plaque, the bacteria ferment dietary carbohydrates for a food source. This fermentation produces lactic and other acids that demineralize the tooth enamel. As the tooth demineralizes, bacteria move into the tooth, decay begins and a cavity is formed.

Unremoved plaque on the gums can accumulate and calcify to form tartar (also called calculus). This situation can result in the seals between the gums and teeth being broken, making the gums susceptible to infection. In early stages, gums can become sore and even bleed. This condition leads to inflammation called gingivitis. The condition can be reversed if tartar is removed. If neglected, it can develop into more serious tooth decay and result eventually in tooth loss.

Untreated dental caries are painful and can result in tooth loss. Pain or loss of teeth may cause malnutrition. These conditions often prevent a person from chewing and eating adequate amounts, as well as eating some hard, high-fibre foods. This is why frequent visits to a dentist and regular, thorough cleaning by a dental hygienist is very important. Otherwise, brushing after meals and snacks is one of the best ways to remove sugars and food particles from tooth surfaces.

Another way to prevent tooth and gum disease is to reduce the amount of simple carbohydrates in the diet. Bacteria need carbohydrates for food and especially thrive on simple sugars. Because sugars convert to acids faster than other foods, the intake of sugar should be restricted in order to reduce tooth decay. Starches and other carbohydrates will also convert to acids, but more slowly. Acids may also come from other food sources directly. Some cold drinks, sweets and fruits contain acids. NB: Even fruit juices (e.g. lemon juice) contain acid which can cause decay.

By cutting back on simple carbohydrates, especially sugar, fructose, lactose and glucose, which ferment easily and support bacteria growth, you can reduce of rate of dental caries. Simple sugars are found in many foods in different forms: sugar, corn syrup, honey, molasses and dextrose. By reading labels on food products, you can limit foods high in simple sugars and thus reduce the chance of dental caries.

Bacteria also can ferment complex carbohydrates (starches), but the process takes longer. However, many complex carbohydrates are sticky and become lodged between teeth and gums. This allows the bacteria time to ferment the carbohydrate.

Meats and foods such as fresh fruits and vegetables that are high in fibre help clean the teeth of food particles and sugars during the chewing process. These foods promote saliva flow, which helps rinse the teeth of food particles. Saliva also neutralizes the acid.

Although fresh fruits and vegetables do contain carbohydrates that can be fermented by bacteria, the fibre content counteracts the effect and helps clean the teeth, therefore protecting against dental caries.

Snacking between meals presents special dental health problems. Many of us enjoy snacks that are high in simple sugars (for example, dried fruits and raisins, sweet rolls, candy, caramel corn, cookies, and ice-cream). Snacking need not be completely omitted, and in many situations, snacking is important for good physical health. Young and growing children, for instance, need the calories and nutrients from snacks for proper growth. However, we can choose snacks that do not harm teeth. Such snacks also tend to be more nutritious, as well, and they can include cheese, yogurt, meats, plain nuts (not recommended for children younger than school age), peanut butter, fresh fruits and vegetables, unsweetened breads or cereals, and popcorn.

Dental disease is almost entirely preventable, and diet management is a major way of bringing about this prevention. Decay does most damage before the age of 25. Disease of the tissues supporting the teeth (e.g. gums) is the main cause of teeth being lost in middle-aged adults.

Further Information:
The authors of this article are staff orf ACS Distance Education. This school operates from both Australia and the UK, offering over 350 courses (Hobby and Vocational). See www.acs.edu.au, www.acsedu.co.uk
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