How does sugar intake influence our dental health?

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Reducing sugar in our everyday diet is still a challenge. We have no medical condition that forces us to do so though. Then how come we made this decision? Let me start by saying that it was a sudden decision and it all started with a book.

Note: when saying “sugar”, I am referring to “table sugar” also known as “sucrose”, extracted from sugarcane or beet sugar

About eight years ago I started reducing the amount of salt in my diet, replacing salt with mixed herbs.

After becoming a mum and reading books about baby weaning, I decided to reduce, as much as possible, the sugar intake my kids would have. I considered it to be “calories without other nutrients”. Therefore, every time I cooked, I avoided sugar and replaced it with banana, dates or xylitol.

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One Sunday we found ourselves in a lovely charity bookshop in Angel/Islington area (north London). On a bookshelf, I noticed a book. The title read “Human Nutrition“. It seemed like a ‘heavy’ book, not just a booklet about eating more nutritious foods.

The book is edited by Catherine A Geissler, “Emerita Professor of Human Nutrition, Nutritional Sciences Division, King’s College London” and “Director, Health Sciences and Practice Subject Centre, Higher Education Academy, London, UK” and Hillary J Powers, “Professor of Nutritional Biochemistry and Head of Human Nutrition Unit, Faculty of Medicine, Dentistry and Health Sciences, University of Sheffield, Sheffield, UK”. And the list of contributors was 3 pages long.

I decided to buy it. As soon as I had arrived home I started randomly reading through it.

On page 499, Chapter 25, I came across “Dental diseases”. And this is how I found out some very interesting facts about sugar intake and dental health. I will summarize them below, but please note that these are just some main ideas that are relevant to my story. The chapter in the book is long and full of useful and documented information.

Lower sugar consumption means lower dental decay

The key point here is that “In developing countries, where sugars intake has increased/is increasing, the prevalence of decay has increased/is increasing”.

There are mentioned several studies that sustain this idea, from which I will mention one, just so we all get the picture.

Routtinen et al (2004) monitored dental caries and diet from birth to age 10 years and found that kids with the highest intake of sucrose (table sugar) had a significantly higher level of dental caries compared with those with the lowest sucrose consumption. Actually, those with the highest intake had twice as much dental caries as those with the lowest intake.

Frequency of sugar intake influences dental caries

Experiments on rats show that there is a strong link between the number of dental caries and the frequency of sugar intake. When the rats were offered sugar 12 times/day, there were 0.7 carious fissures/rat. When other rats were offered sugar 30 times per day, there was 4.7 carious fissures/rat.

Interestingly, the daily amount of sugar intake was the same. Only the frequency was different.

My mind had been at ease until now! I was using sugar just for my coffee, and just one teaspoon of sugar. But wait! I used to drink a cup of coffee throughout the day… Which meant the sugar intake frequency was pretty high! I had not known this could influence my dental health.

Whole fruit does not pose significant risk to dental health

More than that: replacing foods high in free sugars with fresh fruit is likely to reduce dental decay.

Fresh fruits contain sugars that are part of the fruit (intrinsic sugars) and are not thought to be a threat to oral health. And it is probable that there is no relationship between whole fresh fruit and dental decay. By the way, I also learned that:

• there are fruits that contain almost no sucrose even when ripe: grapes, cherries, blueberries, blackberries, figs, pomegranates, tomatoes, avocados, lemons, and limes
• dried fruits can contain high amounts of sucrose if they are infused in sweeteners or if they are candied fruits. Otherwise, the “conventional” dried fruits are just fruits with the water in them evaporated and, for example, raisins contain no sucrose (source)!

As for fruit juice, it contains ‘extrinsic sugars’ and fruit acids and could pose a threat to dental health.

After reading this information, I searched online and understood better the following fact.

Sucrose is the only dietary sugar that can be converted to sticky glucans

These sticky glucans allow the bacteria to adhere to the tooth surface and to build up thick layers of plaque.

This information was life-changing for me. It was at this moment that I realized how sugar can affect oral health and why sugar (“table sugar”) is more harmful to our teeth than any other type of sugar. It is the only one that actually sticks to the teeth and creates a wonderful environment in which harmful bacteria thrive!

This was the moment we decided to:

• reduce our sugar intake for our dental health without demonising it (by drinking black coffee and using xylitol/stevia when cooking/baking)
• eat anything with sugar in one go and brush the teeth immediately after

Consequently, to sum it all up, we decided to reduce our sugar (sucrose) intake because we were concerned with the future of our family’s dental health. This is the only aspect that we took into consideration when making this decision.

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Raluca

Raluca Zagura is a mum of two, based in London, and she is also a Certified Hand in Hand Parenting Instructor.