Nutrition & Oral Health
Diet & Tooth Decay
• Dietary imbalance increases the risk of developing chronic diseases such as obesity, heart disease, type 2 diabetes, as well as the risk of developing tooth decay
• Added sugar in the diet is one of the main causes of tooth decay
• Tooth decay refers to the destruction of tooth enamel (the harder outer layer) and dentine (the softer inner layer). It happens when a sticky film of bacteria, called “plaque”, forms on the teeth and gums
• When you consume food and beverages containing sugar, the bacteria in plaque produce acids that attack the tooth surface. The build-up of plaque and acid from bacteria causes enamel or dentine to break down, resulting in the formation of a cavity (hole) in the tooth
Sources of added sugar in diet:
1. Naturally occurring sugar: fruit juices, fruit smoothies, sugar cane drinks
2. Sugar added by consumers: sugar or honey added into beverages or in cooking
3. Sugar added by manufacturers: soft drinks, breakfast cereals, 3-in-1 drinks, ice-cream, cakes, biscuits
Tips to reduce tooth decay:
• Reduce the amount and frequency of consumption of food and drinks containing sugar
• If taken, sugary food and drinks should only be consumed at mealtimes, rather than in between meals. Saliva is produced when we chew and protects the teeth against decay
• Avoid sugar-containing food and drinks near bedtime. There is a drop in salivary flow at night and with reduced swallowing activity, sugar remains in the mouth longer
• Plain milk or plain water between meals are better options than sugary drinks
• It is a good practice to rinse your mouth after eating and drinking
Diet & Dental Erosion
• Dental erosion is a chemical process where acid causes the loss of hard tissues from the tooth surface. Acids can dissolve enamel and dentine resulting in permanent loss of tooth substance (permanent loss of tooth)
• Dental erosion may be caused by intrinsic (e.g. acid reflux and excessive vomiting) and/or extrinsic (e.g. dietary) factors
• Increased consumption of acidic food and drinks, including carbonated beverage, fruit juice, sports drinks and sour candy can increase risk of dental erosion
Dental erosion can be caused by what you eat and drink (especially acidic food and drinks):
• Fruit juices and fruit teas like oranges, lemons, pineapples
• Preserved food like achar and sour plum
• Soft drinks like carbonated drinks and sports drinks
• Sour candy
• Vinegar, sauces and pickles (in large quantity)
• Wine, cider and spirits consumed with mixers
Tips to reduce the erosive effects of acidic food and drinks:
• Acidic food and drinks (e.g. fruit juice) should only be consumed at mealtimes rather than in between meals and should be avoided at bedtime
• Acidic drinks served in a cup should NOT be sipped slowly or swished round the mouth as this increases the likelihood of decay or dental erosion. If a straw is used, it should be placed behind the front teeth and well to the back of the mouth
• Wait at least 30 to 45 minutes before brushing your teeth as it is more vulnerable to abrasion after consuming acidic food or drinks
Reducing sugar intake & avoiding acidic food and drinks must be combined with thorough and regular tooth brushing with fluoride toothpaste.
Dry Mouth
• Autoimmune diseases such as Systematic Lupus Erythematosus (SLE), Sjögren’s syndrome or medical treatments such as cancer radiotherapy can reduce salivary production resulting in dry mouth
• Without the cleansing effects of saliva, the risk of tooth decay and other oral health problems increases
• People suffering from dry mouth may try to increase saliva flow by sucking on sweets or taking sweetened drinks. However, these sugary food or drinks would further increase the risk of tooth decay
• Dry mouth can be relieved by drinking plain water frequently or sucking on sugar-free sweets
Tips to relieve dry mouth:
• Schedule regular water intake
• Sip on cool drinks in between meals to ensure adequate fluid intake
• Sucking on sugar-free mint or candy may help stimulate saliva
• Keeping ice chips, sugar-free candy, popsicles or frozen grapes in the mouth helps keep the mouth moist
• Avoid alcoholic drinks or alcohol-containing mouthwash
• Reduce intake of drinks containing caffeine
• Apply moisturising oral gels to relieve dry mouth or waterbased lip balm for dry and cracked lips
• If you need to restrict fluid intake as advised by your doctor, use a small cup or glass, take small sips of fluid, and rinse your mouth with water (but do not swallow) to relieve dry mouth or quench thirst
If your food intake is affected by dry mouth:
• Eat small and frequent meals to ensure adequate energy and nutrient intake
• Choose foods that are easier to chew and swallow like mashed potato, scrambled egg, pudding or ice cream
Oral Health & Nutrition for People at Risk of Malnutrition or are Malnourished
The risks of undernutrition and dehydration for nutritionally vulnerable people like frail older adults are likely to have a greater impact on their general health than oral health. Therefore, it is important to follow the prescribed nutritional recommendations while maintaining adequate oral care:
• When individuals need additional calories, artificial sweeteners like stevia are inappropriate as they do not contain calories (energy)
• Sugar-sweetened drinks like malted drinks and fruit juices may be required for individuals who need additional calories (energy) or are encouraged to drink for hydration
• Oral nutritional supplement drinks contain added sugar and are usually recommended to enhance the nutritional intake of those who are at risk of malnutrition or are malnourished. In such cases, it is important to clean the mouth after taking sugar-sweetened drinks and/or supplement drinks to reduce the risk of tooth decay
• Enhanced oral hygiene measures such as the use of fluoridated toothpaste can help to reduce the risk of tooth decay
Please contact KTPH Nutrition & Dietetics at 6602 2420 or YCH
Nutrition & Dietetics at 6807 8584 if you have any nutrition-related question.
