Foods that do, and don't, cause cavities

                  

                  

 

Food Choices and Dietary Patterns

Food choices and dietary patterns - along with many other factors - influence dental health. The development of dental caries (tooth decay) involves the interaction of saliva, oral bacteria, fermentable carbohydrates, and the tooth. Each plays an important role in the process.

Saliva usually contains high amounts of calcium and phosphate, the primary minerals found in tooth enamel. These two minerals continuously move into and out of the tooth when the tooth is bathed with saliva. Demineralization occurs if more minerals move out of the tooth than in, and remineralization occurs if more move in than out. Dental caries occurs when there is more demineralization than remineralization over an extended period of time. Acid produced by the oral bacteria decreases the plaque pH and causes demineralization. After a while, the plaque pH increases to a more neutral level and remineralization can occur. Dental erosion occurs when acidic foods and beverages dissolve the enamel of the tooth.

Food Choices

Sugar is not the only fermentable carbohydrate responsible for the negative effects of diet on dental health. Fermentable carbohydrates include simple sugars that can be added to foods, natural sugars like those found in fruit, and cooked starches. All of these can be used by oral bacteria to produce acid but at different rates. Therefore, it is appropriate to consider all fermentable carbohydrates when making food choices to enhance dental health.

Dietary protein is not used by oral bacteria and helps to protect against the development of caries by acting as a buffer and reducing demineralization. A practical application would be to combine dairy foods with sweet or starchy foods, or protein-rich foods with cooked or processed starches. Daily food choices according to the Food Guide Pyramid, especially from the dairy and meat groups, helps to promote anticariogenic activity.

Dietary fat accelerates the clearance of food from the mouth, thereby reducing the exposure time of the oral bacteria to fermentable carbohydrates. The extent of oral clearance depends on the type of fat. However, promoting high-fat diets for caries prevention is contrary to dietary guidelines for overall good health and is not recommended for caries prevention.

Water is an essential nutrient often overlooked in discussions of diet and dental caries, yet it is a significant component of saliva. Also, an adequate intake of water at the time fermentable carbohydrates are consumed can enhance oral clearance.

Many people believe that "sticky" foods are cariogenic. However, foods like caramel and jelly beans may have high initial retention or "stickiness" which is followed by rapid oral clearance if eaten within a short time frame. Conversely, foods like white bread, pretzels, chips, and cereal may not feel "sticky" but exhibit a slow rate of oral clearance when eaten alone.

Fluoride and Oral Hygiene

Fluoride strengthens dental enamel by being incorporated into the enamel during remineralization. The presence of fluoride in water supplies (either naturally or added), toothpastes, mouth rinses, and many foods has contributed greatly to the decline in the caries rates in the u.s. But optimum fluoride exposure will not fully protect the teeth from bad dietary practices.

The best advice for good oral hygiene is to brush teeth regularly, to apply fluoride, floss, and monitor food choices and the frequency of eating. Additional advice is to follow a sugary snack with an anticariogenic one such as sugar-free gum, or a cariostatic food such as milk to raise the plaque pH.

Dietary Patterns

The frequency of meals and snacks and the way foods are combined within meals and snacks greatly influence the risk for developing dental caries. Frequent eating occasions promote caries development, especially if they involve constant nibbling or sipping of foods and beverages that are sources of fermentable carbohydrates. A frequent intake of cariogenic food between meals, as opposed to with meals, also increases the risk for caries. When cariogenic foods are consumed with a meal, the protein and fat in the meal can help prevent caries development.

Here are five dietary messages that promote both good oral health and general health.

• Eat a balanced diet representing moderation and variety as depicted by the Food Guide Pyramid and the U.S. Dietary Guidelines.
• Combine and sequence foods to promote saliva production and oral clearance. For example, combine sweet or starchy foods with protein rich foods.
• Plan eating occasions that allow time for the plaque pH to increase after exposure to fermentable carbohydrate. Chewing sugarless gum after meals and snacks can help.
• Consume sweetened and acidic beverages with meals and snacks that contain other foods that can buffer their cariogenic and acidogenic effects.
• When trying to reduce an excessive dietary intake of fermentable carbohydrates, identify food choices and meal patterns that sustain energy requirements, provide nutrient density, and promote oral and general health.

Terms and Definitions

Anticariogenic

Foods or beverages that can prevent cariogenic activity when eaten before a cariogenic product.

Caries

Scientific name for dental cavities; it is both singular and plural.

Cariogenic

Any food containing fermentable sugar or starch that can be used by bacteria living in the plaque on the tooth to form acid.

Cavity

The hole made in the outer surface of a tooth when oral bacteria produce acid and tooth enamel demineralizes

Demineralization

When more calcium and phosphate move out of the tooth than into the tooth.

Fermentable Carbohydrate

Any sugar or starch used by oral bacteria to produce acid.

pH

A measure of acid strength (bacteria in the mouth produce acid when they ferment sugars and starches; dental plaque and saliva become acidic and the pH drops).

Plaque

An invisible, sticky film that forms on teeth, giving them a "fuzzy" feeling; contains bacteria which can ferment sugars and starches in food to form acid.

Remineralization

When more calcium and phosphate move into the tooth than out of the tooth

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