3 things you need to know to save your kids’ teeth

In one of our previous blog posts, You might have missed World Oral Health Day, but don’t miss your teeth, we gave you some alarming statistics that the Australian Dental Association (ADA) and Australian Health Policy Collaboration (AHPC) at Victoria University reported in their national oral health report card.

As well as confirming that tooth decay is the most common chronic disease in Australia, they found that:

• 3 out of 4 children and young people are consuming too much sugar;
• one third of Australian 5 and 6-year-olds have had decay in their baby teeth; and
• in 2015-16, there were 67,266 potentially preventable hospitalisations for oral health problems and almost one-third of these were children under the age of nine!

So, how did it come to this and – more importantly – what can we do about it?

 

Three key facts

If knowledge is power, these are the things that you really need to know and (hopefully) be able to explain to your kids. 

1. Both sugar and acidity are damaging to teeth, so foods that combine the two have even greater potential to cause harm to our teeth.

2. Both tooth decay and dental erosion are cause for concern, so we need to be aware of what causes both.

3. It’s the number of times that your teeth are exposed to sweet, sticky, and acidic foods and drinks that is more important than how much of those are consumed.

 

Is there acid in everything we eat and drink?

Many of the things we eat and drink, both natural and manufactured, have a degree of acidity. The most obvious natural one is the citric acid in citrus fruits (oranges, lemons, limes, grapefruit), but even apples are fairly acidic (malic acid is the main organic acid in apples). Blue plums, grapes, blueberries, peaches, and pineapples are other fruits that are high in acid.

There are two relevant measures of the acidity in food. One is the pH level. A pH of 7 is neutral and anything less that 5.5 is considered detrimental to tooth enamel. Different sorts of apples range between 3 and 4, orange juice about the same, with other acidic fruits such as pineapple, plums, and strawberries also in that range.

As a reference point, potatoes and white bread are around 5.5, pasta and noodles are in the low 6 range, and (cow’s) milk is mid-to-high 6. A whole egg is about 6.5, with the yolk around 6 and the white closer to 8.

The other measure is titratable acidity (TA), which is the total amount of acid present. This matters because the higher the TA level, the more difficult it is for your saliva to neutralise the acid (which is a big part of your saliva’s job).

 

How acidity impacts dental health

Acid breaks down, burns, or ‘eats through’ even the strongest materials, including tooth enamel (the strongest material in our bodies).

Teeth are made up of thousands of tiny crystals of calcium phosphate that are in a constant state of flux, as calcium and phosphate ions move back and forth between tooth enamel and saliva.

Under acidic conditions – a pH level less than about 5.5 – there is a net loss of calcium and phosphate ions from the tooth. This is known as demineralisation.

 

Is it tooth decay or dental erosion? 

When plaque forms on the surface of our teeth, the bacteria in the plaque use the sugar we consume as energy and produce acids as a by-product. Those acids can damage the calcium phosphate crystals in our teeth.

The more often you have sugary foods and drinks, the more acid the bacteria can make. If you brush your teeth twice a day, there’s plenty of time in between for the bacteria to produce those acids which cause tooth decay.

So, it’s basically the sugar we ‘feed’ to the bacteria that becomes decay-causing acid.

On the other hand, the acids that come directly from the foods or drinks with lower pH levels (or from our stomach acids if we throw up) can cause the irreversible loss of the outer crystals of our teeth. That’s dental erosion.

Our saliva works to dilute and neutralise acids, however if salivary flow is poor, or the consumption of acidic foods is too regular for the saliva to cope with, permanent damage to our tooth enamel is more likely.

 

What can we do?

1. The first and most important thing to understand is that eating or drinking decay (or erosion) producing foods and drinks more often is worse than eating and drinking more of them in a couple of ‘sittings’.

So, start by reducing the number of times each day that sticky, sweet, and/or acidic things are consumed. 

 

2. The second thing that not enough people realise is that drinking water or milk after eating will reduce the acid on teeth. Alternately, chewing sugar-free gum forces greater saliva production, which is also helpful (as outlined above).

If your children eat fruit between meals, try to get them into the habit of a water or milk ‘chaser’ – or even a piece of cheese, which is also effective in removing some of the potentially-damaging acid.

 

3. The third thing you should do is identify the best and worst snacking foods, because all kids need to snack.

Among the most tooth-friendly snacks are: dry biscuits (crackers), rice cakes, nuts, cheese slices/sticks, sushi, popcorn, sliced ham or turkey, peanut butter or Vegemite, and cut-up vegetables with dips (such as tzatziki or hummus).

Some of the worst are lollies (obviously), sweet biscuits, sweetened cereals, honey, jam, Nutella, dried fruit and fruit bars, cake, soft drinks (including sugar free), sports drinks, flavoured milk, cordial, and juice. 

The very, very worst are sour lollies, which are all three of sweet, sticky, and acidic. In fact, they’re ridiculously, highly, dangerously acidic! 

Some even warn “In case of eye contact, flush with clean water”! But, apparently, suck on them in your mouth for as long as you can stand it! How did this even become a ‘thing’?

 

Treatment options 

Good luck teaching your kids the good habits and how to minimise the bad ones. If you can set a good example as well, it’s more likely that they’ll follow your lead.

Please keep in mind that we’re always here to help.

For example, we can recommend the appropriate oral hygiene products (Pronamel toothpaste, Toothmousse, etc) to protect against acid erosion and decay.

We can also provide fillings that restore the eroded and/or decayed lesions.

Often, though, it starts with the right advice, so don’t be afraid to ask us how to improve your child’s (or your own) eating habits and oral health.