Dental Decay, acids and how to protect your teeth

Teeth and Gums are central to your health in general, and this is backed by years of science. In 2003, the World Oral Health Report clearly showed that there is a clear relationship between oral health and general health. This is significant as most people pass off dental health and dental disease as being unimportant or low priority. Whilst I understand that unless it hurts or you can see it, our radar can not fire. However I would love to change this mentality, and that is the focus of iDental.

In 2006, a world wide studied showed that those people with poor gum health and periodontal disease, have a statistically significant increase in the level of cardiovascular disease. In other words, poor gum health is closely linked with heart disease. If you lose teeth due to gum disease, that chance that you will have a heart attack is much, much higher. In one study, people who have less than 10 teeth remaining have 7 times the chance of having a heart attack than those people that have 25 teeth or more. The impact of gum disease is huge on your heart health. It is quite common for patients to be referred by their cardiologist to the dentist to clear their health, before dealing with heart surgery to improve their outcomes.

Poor oral health is also linked with diabetes. This is a long established relationship that has been further backed by more recent studies. People with diabetes are more likely to have periodontal disease than people without diabetes, most likely because diabetics are more susceptible to infection anywhere in the body. Some dentists and doctors would consider periodontal disease as a direct complication of diabetes.

Some other linked diseases and concerns include the higher risk of stroke, respiratory diseases, pregnancy complications, stomach ulcers and dementia. Dementia has been shown to be more common in those with few or no teeth, compared to those with all their natural teeth. 

If we break these health links down, gum disease shows up as bleeding gums, which then becomes an easy entrance for pathogens to enter our blood stream. Our immune system is then challenged to fight, and our ability to continue a chronic fight of gum disease lessens over time. Thus our body will succumb to the challenge in some way, that can show up as another problem as disussed above.

Stop the lemon water!

For some time now, it has been a ‘trend’ to have a glass of lemon water in the morning, to change your gut function and detox your body. Some people swear by the benefits. However these claims to improving your body are mostly dubious and not proven. What we do know is that drinking water is great for you. Our body need water to function well, and this shows up as good skin health, good hydration and great mental capacity. Whilst it is true that lemons have more vitamin c than oranges, a daily does of lemon juice can be harmful long term on the health of your teeth. Lemon juice has a pH of around 2, which is marginally higher than battery acid. So everyday the enamel is subject to being dissolved. We would never consider starting the day with a diet coke (ph of 3.2), so why lemon juice is being sipped every morning is astonishing.

What about decay? How does decay start?

The outer part of a tooth is called enamel. It is the hardest part of our entire body, and is designed to take a daily insult from food, and help grind our food up as the first part of digestion. Enamel is a crystal, called Hydroxyapatite (calcium and phosphate minerals). Enamel protects the inner layers of the tooth. The next layer under enamel is called dentine, and is softer and more like bone in structure. Dentine is alive and carries nerve endings. The next layer under that is the dental nerve.

The reason that an understanding of the tooth anatomy is important, as it explains how dental decay happens. Dental decay needs three components:

  • A tooth (a place for decay to occur)
  • Sugar (food for bacteria)
  • Plaque (bacteria)

Plaque sits on the enamel and digests sugar. As a result, acid is formed. Acid on the enamel dissolves a hole into it, by dissolving calcium and phosphate mineral out. The bacteria can now sit safely inside the hole and carry on this process. Now that the decay is inside the tooth, they can have a much greater effect, that progresses much faster in the softer dentine. This will start to cause sensitivity and pain as the decay gets deeper in the tooth. 

So if we look at the decay process, sugar + plaque = acid. But if we cut out the middle men, and just consume acid, we can get acidic wear and holes in our teeth, without the need for major sugar. So basically people with a high acid intake have a higher chance of decay and wear, even with good oral hygiene. Thus cut out the lemon water in the morning. Your teeth will thank you. I should also mention that you should visit your dentist twice a year to keep your teeth and gums under control.

Strawberries and Apples – the effects on teeth

So it follows that lots of foods fall into this acidic category. Strawberries and apples that have naturally occurring sugar (frustose). Strawberries have a pH of around 3.5 and apples have a level of around 3-4. Excessive consumption can put you at higher risk of decay.

I am not saying that we should cut out all fruits, but consumption should be short and sharp. Eat them in one sitting, say straighter after lunch and dinner. Grazing on them all afternoon will keep you saliva acidic and make you more vulnerable. Whereas if you eat the fruit in the space of 30 minutes for example, your saliva can then return to a ph of 7 and stay there.

If you prefer to graze on food, stick with non-acidic and non-sugary items. Alternatives could include avocados, cheese, corn or eggs. These are all around a pH of 7, and do not contain high levels of sugar, so are tooth friendly and great appetite satisfiers.

Calcium plays a role in making the jaw bones healthy and strong to hold the teeth in place. Children’s teeth need adequate calcium and phosphorus to form a hard structure during growth. Once we are past this growing phase, calcium is still important. As mentioned earlier, each time our teeth are subjected to acid, calcium and phosphate are dissolved out of the tooth structure. Our saliva becomes a sea of both minerals along with whatever we are eating. When the pH of our mouth starts to rise back up to 7 (neutral), calcium and phosphate can remineralise or reharden the tooth, provided both minerals are still available. This is kind of like recharging a battery. Milk and cheese are great calcium sources, however there are other sources of calcium too. Other options include sardines, salmon, kale, broccoli, spinach, nuts, sesame seeds, fortified cereals and beans. For patients that are particularly prone to decay, dentists often recommend a product called Tooth Mousse, that was developed at the University of Melbourne. Tooth Mousse contains no lactose, and is a great source of both calcium and phosphate, and can be applied directly to the tooth structure. Lactose intolerant patients can use it safely, but it is not suitable for people with a true milk protein allergy.

Finally fizzy drinks. Let’s talk about that, keeping in mind that to cause damage to a tooth you need sugar or acid, or worse still, both.

Carbonated or fizzy drinks are drinks that have naturally occurring (mineral water) or man-made bubbles in them, that is carbon dioxide gas. The process by which the gas dissolves in the drink is known as carbonation. This process was invented back in the 1700s, where carbon dioxide was forced under pressure into liquid. That fizz sensation we taste and feel is a result of carbonic acid created as part of carbonation. This acid creates a mild tingling sensation on the tongue, but plays havoc with your teeth if consumed too often. So if it fizzes, we know that the pH is low. If it is sweet, this usually means sugar. If the drink does both, limit consumption or your risk of decay will skyrocket.

Thanks for reading!

Written by Giulia D’Anna

BDSc (Melb), MRACDS, Honorary FIADFE (NY), Graduate Diploma Dermal Therapies (AACDS), Cert. Practice Man (UNE), Editor APJ (APAN) + | + 3 Belmore Road, Balwyn North, Victoria, Australia 3104 + | + Founder of iDental and Dermal Distinction

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