How Your Diet Affects Your Oral Health

To prevent cavities and maintain good oral health, your diet -- what you eat and how often you eat -- are important factors. Changes in your mouth start the minute you eat certain foods. Bacteria in the mouth convert sugars from the foods you eat to acids, and it's the acids that begin to attack the enamel on teeth, starting the decay process. The more often you eat and snack, the more frequently you are exposing your teeth to the cycle of decay.

Mouth-Healthy Foods and Drinks

The best food choices for the health of your mouth include cheeses, chicken or other meats, nuts, and milk. These foods are thought to protect tooth enamel by providing the calcium and phosphorus needed to remineralize teeth (a natural process by which minerals are redeposited in tooth enamel after being removed by acids).

Other food choices include firm/crunchy fruits (for example, apples and pears) and vegetables. These foods have a high water content, which dilutes the effects of the sugars they contain, and stimulate the flow of saliva (which helps protect against decay by washing away food particles and buffering acid). Acidic foods, such as citrus fruits, tomatoes, and lemons, should be eaten as part of a larger meal to minimize the acid from them.

Poor food choices include candy -- such as lollipops, hard candies, and mints -- cookies, cakes, pies, breads, muffins, potato chips, pretzels, french fries, bananas, raisins, and other dried fruits. These foods contain large amounts of sugar and/or can stick to teeth, providing a fuel source for bacteria. In addition, cough drops should be used only when necessary as they, like sugary candy, contribute to tooth decay because they continuously coat the teeth with sugar.

The best beverage choices include water (especially fluoridated water), milk, and unsweetened tea. Limit your consumption of sugar-containing drinks, including soft drinks, lemonade, and coffee or tea with added sugar. Also, avoid day-long sipping of sugar-containing drinks -- day-long sipping exposes your teeth to constant sugar and, in turn, constant decay-causing acids.

Sugar Substitutes and Sugar-Free Products

Sugar substitutes are available that look and taste like sugar; however, they are not digested the same way as sugar, so they don't "feed" the bacteria in the mouth and therefore don't produce decay-causing acids. They include: erythritol, isomalt, sorbitol, and mannitol. Other sugar substitutes that are available in the U.S. include saccharin, aspartame (marketed as Equal), acesulfame potassium (marketed as Sunett), and sucralose (marketed as Splenda).

Sugarless or sugar-free food sometimes simply means that no sugar was added to the foods during processing. However, this does not mean that the foods do not contain other natural sweeteners, such as honey, molasses, evaporated cane sugar, fructose, barley malt, or rice syrup. These natural sweeteners contain the same number of calories as sugar and can be just as harmful to teeth.

To determine if the sugarless or sugar-free foods you buy contain natural sweeteners, examine the ingredients label. Words that end in '-ose' (like sucrose and fructose) usually indicate the presence of a natural sweetener. On the label, look under sugars or carbohydrates.

Is Chewing Gum OK for Teeth?

Chewing sugarless gum is actually beneficial to your teeth as chewing helps dislodge food that becomes stuck to your teeth and also increases saliva flow to buffer (neutralize) mouth acids. Gums that contain the sugar substitute xylitol even reduce cavities. Chewing gum can be a problem, however, if you have jaw pain or other issues with your jaw.

Teeth and Gum Care Tips

These are some basic tips for caring for teeth and gums:

• Brush your teeth regularly. Brush at least twice a day and preferably after every meal and snack.
• Use a fluoride-containing toothpaste.
• Floss at least once a day.
• Visit your dentist regularly for check-ups and cleanings -- typically twice a year.
• Eat a variety of foods to maintain overall health. Eat fewer foods containing sugars and starches between meals. If you must snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a firm fruit (such as an apple).

Oral Health and Bone Disease

Oral Health and Bone Disease 

Osteoporosis and tooth loss are health concerns that affect many older men and women. Osteoporosis is a disease in which the bones become less dense and more prone to fracture. This disease can affect any bone in the body, although the bones in the hip, spine, and wrist are most often affected. In the United States today, 10 million individuals already have osteoporosis and 34 million more have low bone mass, placing them at increased risk for this disease.

Research suggests that there is a link between osteoporosis and bone loss in the jaw. The bone in the jaw supports and anchors our teeth. When the jaw bone becomes less dense, tooth loss can occur. Tooth loss affects approximately one-third of adults 65 years and older.

Skeletal Bone Density and Dental Concerns

The portion of the jaw bone that supports our teeth is known as the alveolar process. Several studies have found that the loss of alveolar bone is linked to an increase in loose teeth (tooth mobility) and tooth loss. Women with osteoporosis are three times more likely to experience tooth loss than those who do not have the disease.

Low bone density in the jaw can result in other dental problems as well. For example, older women with osteoporosis may be more likely to have difficulty with loose or ill-fitting dentures and may have less optimal outcomes from oral surgical procedures.

Periodontal Disease and Bone Health

It is estimated that Periodontal disease affects up to 80 percent of men and women in the United States. Periodontitis is a chronic infection that affects the gums and the bones that support the teeth. Bacteria and the body's own immune system break down the bone and connective tissue that hold teeth in place. The teeth may eventually become loose, fall out, or have to be removed.

While tooth loss is a well-documented consequence of periodontitis, the relationship between periodontitis and skeletal bone density is less clear. However, some studies have found a strong and direct relationship between bone loss, periodontitis, and tooth loss. It is possible that the loss of alveolar bone mineral density leaves bone more susceptible to periodontal bacteria, increasing the risk for periodontitis and tooth loss.

The Role of the Dentist and Dental X-rays

Research supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) suggests that dental x-rays may be used as a screening tool for osteoporosis. Researchers found that dental x-rays were highly effective in distinguishing people with osteoporosis from those with normal bone density.

Since many people see their dentist more regularly then their doctor, dentists are in a unique position to help identify people with low bone density and to encourage them to talk to their doctors about their bone health. Dental concerns that may indicate low bone density include loose teeth, gums detaching from the teeth or receding gums, and ill-fitting or loose dentures.

The Effects of Osteoporosis Treatments on Oral Health

It is not known whether osteoporosis treatments have the same beneficial effect on oral health as they do on other bones in the skeleton. While additional research is needed to fully clarify the relationship between osteoporosis and oral bone loss, scientists are hopeful that efforts to optimize skeletal bone density will have a favorable impact on dental health.

Of concern is the fact that bisphosphonates, a group of medications available for the treatment of osteoporosis, have been linked to the development of osteonecrosis of the jaw (ONJ). The risk of ONJ has been greatest in those receiving large doses of intravenous bisphosphonates, a therapy used to treat cancer. The occurrence of ONJ is rare in individuals taking oral forms of the medication for osteoporosis treatment.

Taking Steps for Healthy Bones

There are many important steps you can to take to optimize your bone health:

• Eat a well-balanced diet rich in calcium & vitamin D.
• Live a healthy lifestyle. Don't smoke, and if you choose to drink alcohol, do so in moderation.
• Engage in regular physical activity or exercise. Weight-bearing activities, such as walking,  jogging, dancing, and lifting weights, are the best for strong bones.
• Report any problems with loose teeth, detached or receding gums, and loose or ill-fitting dentures to your dentist and doctor. 760-323-2771