Introduction to nutrition and teeth
The main cause of tooth loss is tooth decay (also known as dental caries) and one of the most significant factors in the start of tooth decay is what we eat. The diet we consume can also play a significant role in erosion of teeth as well as the development of defects in the tooth structure (e.g. enamel hyperplasia, fluorosis). Gum disease (also known as periodontitis) is another cause of tooth loss. However, what we eat does not tend to affect gum disease as much as tooth decay.
Diet and tooth decay
There is no doubt that what we eat is linked with tooth decay. The bacteria that sits on our teeth, known as dental plaque, uses sugars in our diet as a source of energy so that more bacteria can form.
The bacteria metabolize sugars, and these results in the formation of acid that starts the process of tooth decay by softening the enamel or dentine.
Three bacteria are primarily involved with tooth decay:
Certain Lactobacillus spp.; and
As acid is introduced into the mouth and eventually onto the teeth (from bacteria that release acids or from acidic food and drink) the mouth encounters a drop in pH (meaning it becomes more acidic). The pH at which damage to teeth occurs is 5.5. The normal pH is around 6.8-7.5. If the pH in the mouth remains above 5.5 for sufficient time then complete repair of enamel may occur following this initial damage. If the pH is too low for too long, then damage to the tooth will be greater than the repair of the tooth and this will result in tooth decay.
The repair process is a result of good saliva. Saliva provides lubrication, washes away sugars, has antibacterial components and has buffering components to fight against acidic attack. Dry mouth is related with higher tooth decay.
Diet and dental erosion
Dental erosion is the progressive loss of enamel and dentine that is chemically lost from the tooth surface in any way apart from acid released by bacteria.
Low salivary flow rate and poor buffering capacity to fight acidic challenges occur in people with dry mouth and so dental erosion can be a significant issue.
Acids can be intrinsic (from inside) or extrinsic (from external sources). Intrinsic acids are from vomiting and regurgitation. The extrinsic acids are from the diet, e.g. citric acid, phosphoric acid, ascorbic acid, malic acid, tartaric acid and carbonic acids found in fruits and fruit juices, soft drinks (both carbonated and still), some herbal teas, dry wines and vinegar-containing foods.
Excess fluoride ingestion during enamel formation can lead to dental fluorosis and this condition is observed particularly in countries that have high levels of fluoride in water supplies. It is also observed in people, who in their childhood years ingested a reasonably high amount of fluoride via fluoride supplements or ingestion of fluoride containing mouthwashes and toothpastes.
Dietary sugars and teeth
Nutrition and healthy teeth Sugar is undoubtedly a large factor in tooth decay.