Prevention of tooth decay starts from the basics:
1) Diet
Limit how often you consume sweetened (organic sugar is just as bad for your teeth as regular sugar!) food and beverages. Try to have a maximum of 4 sugar exposures a day, including your 3 main meals.
False friends that you should try to avoid:
- Fruit juice (mostly natural fruit sugars that are released during the juicing process) [1]
- Dried fruit (like raisins, which are 70% sugar) [2]
- Yoghurt drinks (tend to be sweetened) [3]
- Kombucha
- Isotonic sports/energy drinks (100 Plus, Pocari Sweat, Gatorade, Calpis) [4]
- Energy/breakfast bars [5]
- Honey
Snacking is definitely a no-no!
Eating plenty of green leafy vegetables will improve the decay fighting ability of your saliva [6]. Unsweetened dairy products (unsweetened yoghurt, cheese) and unsweetened tea can boost the calcium and fluoride content of your saliva which helps to strengthen enamel weakened by decay [7].
2) Food patterning
Consuming sugary food/drink BEFORE fibre-rich foods (vegetables or fruits) helps to limit how long the sugar hangs around in your mouth [8]. Fibre helps to clean the sticky sugar residue from the surfaces of the teeth. Fibrous foods require more chewing which stimulates saliva production to help keep the pH of the mouth neutral.
3) Good oral hygiene
Brushing twice a day with a fluoridated toothpaste and flossing at least once a day to remove food remnants from between your teeth [9].
Your dentist may prescribe you a mouth rinse for specific conditions, but mouth rinse IS NOT a substitute for thorough brushing and flossing [10].
To ensure that you are cleaning your teeth thoroughly, ask your dentist to perform a plaque disclosure (there are also home-use tablets). This dyes the clear/tooth-coloured plaque on your teeth in a contrasting colour so that it is visible. This is the best way to learn about the areas you tend to miss out on when cleaning your teeth.
4) pH modification
When there is active tooth decay, the mouth as a whole is acidic. In order to neutralize the oral environment, you should limit how much sugar you consume. The byproduct of bacteria digesting sugar remnants is acid, so reducing sugar reduces the amount of acid produced. Also, consider using sodium hypochlorite (diluted bleach)-containing mouth rinse (Profresh or Carifree).
5) Antibacterial strategies
Fluoride, xylitol, hydrogen peroxide, and chlorhexidine are useful in slowing down the rate of plaque accumulation. Fluoride also helps to slow down the progression of tooth decay.
When the decay has progressed so that the tooth surface is no longer intact (cavitated), then the defect must be sealed so that the roughness does not accumulate more plaque and progress further. This can be done by careful cleaning, treatment, and sealing of the affected enamel with a sealant or a small filling if it is accessible.
References:
1. Caswell H. The role of fruit juice in the diet: an overview. Nutrition Bulletin. 2009;34(3):273-288. doi:10.1111/j.1467-3010.2009.01760.x
2. Restani P, Frigerio G, Colombo F, et al. Raisins in human health: A review. Aurand J-M, ed. BIO Web of Conferences. 2016;7:04005. doi:10.1051/bioconf/20160704005
3. Skafida V, Chambers S. Positive association between sugar consumption and dental decay prevalence independent of oral hygiene in pre-school children: a longitudinal prospective study. Journal of Public Health. 2017;40(3):e275-e283. doi:10.1093/pubmed/fdx184
4. von Fraunhofer JA, Rogers MM. Effects of sports drinks and other beverages on dental enamel. General dentistry. 2005;53(1):28-31. Accessed December 13, 2019.
5. http://www.nbcnews.com/id/32027560. Gooey nutrition bars fuel energy — and cavities. msnbc.com. Published May 21, 2014. Accessed December 13, 2019.
6. Eat Fruits and Veggies For A Healthy Smile | University of Illinois at Chicago (UIC) College of Dentistry. Uic.edu. Published 2017. Accessed December 13, 2019.
7. Dental health | Nutrition Australia. Nutritionaustralia.org. Published 2009. Accessed December 13, 2019.
8. U.S. Department of Agricuture, U.S. Department of Health and Human Services. Dietary Guidelines for Anericans 2010.; 2011.
9. https://www.facebook.com/NIHAging. Taking Care of Your Teeth and Mouth. National Institute on Aging. Published 2016. Accessed December 13, 2019.
10. Queensland Health. Mouth rinses. Queensland Government. Accessed December 13, 2019.
