Tooth decay is almost entirely preventable

By the time they are five or six years old, one in three Australian children will have tooth decay. By the age of nine or 10, that number jumps to nearly one in two (46.2 per cent).

The sore part of these sorry statistics is that they are almost entirely preventable.

We can change the health of our teeth by what we eat and drink.Credit:Belinda Pratten

According to a new series on oral health, published in The Lancet last week, oral disease including tooth decay, gum disease and oral cancers, affect almost half of the global population, with untreated dental decay the most common health condition worldwide.

Among the recommendations in the series, including more affordable and accessible treatments, the experts from 10 countries, including Australia, argue that the “treat-over-prevent” dentistry model needs a radical rethink.

This is because diet and simple dental hygiene habits are “really the best way of ensuring good oral health and reducing the cost of dental care”, explains Associate Professor Matthew Hopcraft, chief executive officer of the Australian Dental Association's Victorian branch.

“Tooth decay is primarily driven by sugar consumption,” Hopcraft says. “The World Health Organisation recommends limiting added sugar consumption to six teaspoons a day; teenagers are consuming about 20 teaspoons a day.”

While teenagers are getting a lot of their sugar from soft drinks and sports drinks, younger children are getting their sugar hit elsewhere.

On average, Hopcraft says that by the age of two or three, Australian kids are consuming nine teaspoons of added sugar daily. “It’s frightening,” he says. “We’re feeding kids, from a very young age, packaged and processed foods that are just loaded with sugar and people aren’t aware of how much it is.”

Yoghurt pouches, fruit straps, fruit juices, breads and cereals are common sources of added sugar in products that are often marketed as being healthy to young children, Hopcraft says. “Nutrigrain is 25 per cent sugar, but gets four Health Stars,” he adds.

Sugar is a significant part of the dental health picture, but not the whole part.

“Energy drinks and sports drinks and the rise of kombuchas that we’re seeing at the moment … which is very low sugar … are as acidic as Coke and can be damaging to teeth,” Hopcraft explains.

As we age, smoking and alcohol also contribute to poor oral health, increasing the risk of oral cancers, one of the most common forms of cancer in Australia.

But our oral health is as much about what we ought to eat as what we ought to avoid.

While many resign to losing teeth later in life, the reality is that we really should never have dental diseases of any type.

Fresh fruit instead of fruit juice, cheese, which is “very protective for the teeth”, and fresh vegetables, particularly crunchy ones, like carrot sticks and celery sticks are all good.

“There is a bit about the chewing action [of crunchy vegetables] which helps to promote saliva which helps to protect the teeth and it has a cleaning action on the teeth,” Hopcraft says.

Beyond that, the key to healthy teeth is healthy calcium metabolism, explains dentist Dr Steven Lin, author of The Dental Diet.

“That means optimal vitamin D levels from food and the sun,” says Lin. “Teeth depend on vitamin D to fuel their own immune system. However for our body to properly use vitamin D, we need the full spectrum of fats, so that we can absorb and distribute fat-soluble vitamins … A lesser known nutrient called vitamin K2 helps by activating proteins that carry calcium into bones and teeth. Vitamin D and Vitamin K2 work together.”

Good sources include organ meats, egg yolks, full-fat grass raised dairy and meat products as well as fermented foods including soy, sauerkraut and cheeses.

“Cod-liver oil is also a good example that our grandparents used to make sure we had a good dose of. It's rich in Vitamin A, and D,” Lin says, adding: “While many resign to losing teeth later in life, the reality is that we really should never have dental diseases of any type."

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